非小细胞肺癌免疫治疗1例  

One Case of Immunotherapy for Non-Small Cell Lung Cancer

作　　者：潘登 张庚艳 陈燕 赵连波[1] 

机构地区：[1]安徽省亳州市蒙城县第一人民医院呼吸与危重症医学科,安徽 亳州

出　　处：《临床医学进展》2024年第8期1304-1310,共7页Advances in Clinical Medicine

摘　　要：肺癌(lung cancer, LC)是一种高发病率和高死亡率的原发性癌症类型。其中分为小细胞肺癌(small cell lung cancer, SCLC)和非小细胞肺癌(non-small cell lung cancer, NSCLC),非小细胞肺癌又分为鳞癌和腺癌。肺癌的危险因素包括吸烟、家族史、辐射暴露和慢性肺病的存在。我们报告了一例非小细胞肺癌患者,其表现为咳嗽咳痰伴胸闷。该患者经胸腔闭式引流后,胸水脱落细胞学检出腺癌细胞,后经全身评估诊断为肺癌(左侧,周围型,腺癌)伴左侧恶性胸腔积液PS评分1分T1bNXM1a IVA期。后家属不同意化疗,胸水基因检测结果示检测出突变位点EGFR 19del。患者遵指南口服奥西替尼,后经复查患者胸部CT好转明显。本病例研究强调了靶向治疗对终末期非小细胞癌治疗的重要性。Lung cancer (LC) is a primary cancer type with high morbidity and mortality. It is divided into small cell lung cancer (SCLC) and non-small cell lung cancer (NSCLC), and NSCLC is further divided into squamous cell carcinoma and adenocarcinoma. Risk factors for lung cancer include smoking, family history, radiation exposure, and the presence of chronic lung disease. We report a patient with non-small cell lung cancer who presented with cough and phlegm with chest tightness. Adenocarcinoma cells were detected by cytology after pleural fluid shedding after closed thoracic drainage. After a comprehensive examination, the patient was diagnosed with lung cancer (left, peripheral type, adenocarcinoma) with a PS score of 1 and left malignant pleural effusion. The TNM staging was T1bNXM1a, stage IVA. After the family refused chemotherapy, the genetic test of pleural effusion showed a mutation site at EGFR 19del. The patient followed the guidelines and took osimertinib orally. After further examination, the patient’s chest CT showed significant improvement. This case study highlights the importance of targeted therapy in the treatment of end-stage non-small cell carcinoma.

关 键 词：非小细胞肺癌 靶向治疗 

分 类 号：R73[医药卫生—肿瘤]