肺癌合并Trousseau综合征患者的治疗及临床特点  

Treatment and Clinical Features in Patients with Lung Cancer Complicated by Trousseau’s Syndrome

作　　者：隋洺骅 姜蕾 孙萍[1] 

机构地区：[1]青岛大学附属烟台毓璜顶医院肿瘤科,山东 烟台 [2]青岛大学附属烟台毓璜顶医院病理科,山东 烟台

出　　处：《临床医学进展》2024年第7期348-355,共8页Advances in Clinical Medicine

摘　　要：目的:探讨特鲁索综合征(Trousseau’s syndrome, TS)的临床表现、治疗及预后。方法与材料:2例渐近性TS发生于1例小细胞肺癌患者和1例表皮生长因子受体(EGFR)突变阳性的非小细胞肺癌(NSCLC)患者。此外,对以往报道的肺癌患者发生TS的典型病例进行分析。结果:我们总结了EGFR突变阳性NSCLC和TS患者的一种可能的治疗选择,酪氨酸激酶抑制剂(TKI)如吉非替尼,然后是奥西替尼,可能有效。对于确诊为小细胞肺癌的患者,还应考虑TS的可能性,必要时应采取抗凝措施。结论:综上所述,这是首个总结肺癌患者TS临床特征的报告,也是首个报道小细胞肺癌合并渐近性TS的病例,以及另一个EGFR突变阳性的NSCLC合并TS的病例。鉴于免疫检查点抑制剂的使用频率越来越高,临床医生应该认识到TS是一种潜在的危及生命的免疫相关不良事件。Aims: The objective of this study is to explore the clinical manifestations, treatment and prognosis of Trousseau’s syndrome (TS). Methods and Material: Two cases of asymptotic TS were developed in a patient with small cell lung cancer and another patient with epidermal growth factor receptor (EGFR) mutation-positive non-small-cell lung cancer (NSCLC). In addition, analysis was performed on the previously reported typical cases of TS that occurred in patients with lung carcinoma. Results: We summarized a possible treatment option for patients with EGFR mutation-positive NSCLC and TS. Tyrosine kinase inhibitor (TKI) such as gefitinib, followed by osimertinib, may be effective. In patients diagnosed with small cell lung cancer, the possibility of TS should also be considered, and anticoagulant measures should be implemented if considered necessary. Conclusions: In conclusion, this is the first report that summarizes the clinical features of cases with TS in Lung cancer patients, as well as reporting the first case of a patient with small cell lung cancer with asymptotic TS, and another with EGFR mutation-positive NSCLC and TS. Clinicians should recognize TS as a potentially life-threatening immune-related adverse event, given the increasing frequency of the use of immune checkpoint inhibitors.

关 键 词：肺癌 TKI TROUSSEAU综合征 脑梗死 癌症治疗 血栓栓塞 

分 类 号：R73[医药卫生—肿瘤]