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| 一例伴SMARCA4缺失型肺肝样腺癌患者的综合治疗 |
| A Case of multimodality therapy in a patient with SMARCA4-deficient Hepatoid Adenocarcinoma of the Lung |
| 投稿时间：2024-12-05 修订日期：2025-01-04 |
| DOI： |
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| 中文关键词: 肺肝样腺癌,SMARCA4,手术,综合治疗,转移 |
| 英文关键词:Hepatoid adenocarcinoma of the lung,SMARCA4,surgery,Comprehensive treatment,Metastasis |
| 基金项目:浙江省中医药重大合作项目（GZY-ZJ-KJ-23004） |
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| 中文摘要: |
| 肺肝样腺癌是肺组织产生肝样组织分化后出现的一种原发性恶性肿瘤,通常出现高浓度的甲胎蛋白表达,发生率低,早期即可发生转移,是一种高度恶性的肿瘤。而伴SMARCA4缺失型的非小细胞癌,肺谱系基序的染色质会出现可及性降低,使原发肿瘤去分化,同样容易诱使转移发生。在本文中,我们报道了一例伴SMARCA4缺失型的肝样腺癌患者。患者初诊时为局部晚期,经外院两套方案多轮全身治疗后疾病仍进展；来我院就诊后经MDT讨论,在初诊后11个月接受了根治性手术切除,术后接受辅助治疗；但是患者很快便先后出现肺部及脑部转移灶,多线全身治疗均效果不佳。对于伴SMARCA4缺失型肺肝样腺癌患者,抗肿瘤药物的疗效似乎有限,争取手术机会可能对患者的预后有积极意义。 |
| 英文摘要: |
| Hepatoid adenocarcinoma of the lung is a primary malignant tumor after the lung tissue produces hepatoid tissue differentiation. It usually has a high concentration of alpha-fetoprotein expression, a low incidence, and early metastasis. SMARCA4-deficient NSCLC, the chromatin accessibility of lung lineage motif is reduced, which dedifferentiates the primary tumor and also induces metastasis. In this article, we reported a case of lung hepatoid adenocarcinoma with SMARCA4 deletion. The patient was initially staged as locally advanced, and the disease progressed after multiple rounds of systemic treatment with two sets of regimens in other hospitals. After MDT discussion of our center, the patient underwent radical resection 11 months after the initial diagnosis and received adjuvant therapy after surgery. The patient soon developed lung and brain metastases, and the effect of multi-line systemic treatment was poor. For patients with lung hepatoid adenocarcinoma with SMARCA4 deficiency, the efficacy of antineoplastic drugs seems to be limited, surgical resection may have a positive significance for the prognosis. |
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