非小细胞肺癌小细胞转化的分子特征及治疗进展  

Molecular Characteristics and Treatment Progress of Small Cell Transformation in Non-Small Cell Lung Cancer

作　　者：杨匹容 蒋兰 刘宇凤 冯其蔚 李娟[2] Yang Pirong;Jiang Lan;Liu Yufeng;Feng Qiwei;Li Juan(Sichuan Clinical Research Center for Cancer,Sichuan Cancer Hospital&Institute,Sichuan Cancer Center,School of Medicine,University of Electronic Science and Technology of China,Chengdu 610054,Sichuan,China;Department of Medical Oncology,Sichuan Clinical Research Center for Cancer,Sichuan Cancer Hospital&Institute,Sichuan Cancer Center,University of Electronic Science and Technology of China,Chengdu 610041,Sichuan,China)

机构地区：[1]电子科技大学医学院,四川省肿瘤医院·研究所,成都610054 [2]四川省肿瘤医院·研究所,四川省肿瘤临床医学研究中心,四川省癌症防治中心,电子科技大学附属肿瘤医院肿瘤内科,成都610041

出　　处：《肿瘤预防与治疗》2025年第1期75-81,共7页Journal of Cancer Control And Treatment

基　　金：四川省科学技术厅课题(编号:2024YFHZ0143);supported by grants from Wu Jieping Medical Foundation (No. 320. 6750. 19094-57)。

摘　　要：小细胞肺癌(small cell lung cancer, SCLC)是一种恶性程度高、预后差的神经内分泌肿瘤。除了传统的SCLC,还存在转化性SCLC,二者有着不同的临床特点、发病机制、分子特征,甚至对于药物的敏感性也不尽相同。SCLC的转化是非小细胞肺癌患者化疗、靶向治疗、甚至是免疫治疗的耐药机制之一。视网膜母细胞瘤蛋白1和肿瘤蛋白p53突变被认为与SCLC的转化有关,但确切的转化机制仍在探索中。除此之外,转化性SCLC的治疗也面临着巨大的挑战。化疗是目前转化性SCLC最常选择的治疗方案,其还可以联合表皮生长因子受体酪氨酸激酶抑制剂、免疫检查点抑制剂或抗血管治疗,但临床效果总体欠佳。本文除了对转化性SCLC的临床特点、机制、分子特征做了总结之外,还着重阐述了免疫治疗、抗血管治疗,甚至是生物制剂等在转化性SCLC中的治疗进展,旨在让大家更好地了解转化性SCLC,也期望为临床应用提供一些支持。Small cell lung cancer(SCLC)is a neuroendocrine tumor with high malignant degree and poor prognosis.In addition to traditional SCLC,there is also transformational SCLC.They have different clinical characteristics,pathogenesis,molecular characteristics,and even different sensitivity to drugs.Transformation of SCLC is one of the resistance mechanisms of chemotherapy,targeted therapy,and even immunotherapy in patients with non-small cell lung cancer(NSCLC).Mutations in retinoblastoma protein 1 and tumor protein p53 are believed to be involved in SCLC transformation,but the exact transformation mechanism is still being explored.In addition,the treatment of transformational SCLC also faces great challenges.Chemotherapy is the most often chosen treatment of transformational SCLC,it can also be combined with epidermal growth factor receptor tyrosine kinase inhibitors,immune checkpoint inhibitors or antiangiogenic therapy,but the overall clinical effect was unfavorable.In addition to summarizing the clinical features,mechanisms and molecular characteristics of transfor mational SCLC,this review also focuses on the progress of immunotherapy,antiangiogenic therapy,and even biological agents in the treatment of transformational SCLC,aiming to give a better understanding of transformed SCLC and provide support for clinical uses.

关 键 词：非小细胞肺癌 小细胞肺癌 转化 治疗 

分 类 号：R734.2[医药卫生—肿瘤]