原发性肺淋巴上皮癌切除术前的新辅助疗法

IF 4.3 3区材料科学 Q1 ENGINEERING, ELECTRICAL & ELECTRONIC ACS Applied Electronic Materials Pub Date : 2024-01-29 DOI:10.1016/j.cllc.2024.01.007

Erik Wu , Joseph Reznicek , Anjana V. Yeldandi , Jyoti D. Patel , David D. Odell

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引用次数: 0

摘要

原发性肺淋巴上皮癌（LEC）是非小细胞肺癌（NSCLC）中极为罕见的一种，自 1987 年发现以来，记录在案的病例不足 500 例。这些病例绝大多数发生在东亚或东南亚，与爱泼斯坦-巴氏病毒（EBV）有关。虽然局部疾病可通过手术切除或切除后辅助化疗来治疗，但目前尚未就明确的治疗策略达成共识。一名 64 岁的患者于 35 年前从越南移民而来，出现间歇性咳嗽，胸部计算机断层扫描发现其左下叶肿块。正电子发射断层扫描显示，该肿块为高代谢性，纵隔和肺周淋巴结可能有活动，提示为 cT4N2M0 或 IIIB 期疾病。在支气管内超声下进行的经支气管针活检的免疫组化结果显示，EBV相关LEC分化较差。此外，还发现90%的肿瘤细胞有程序性死亡配体1（PDL1）阳性表达。患者开始接受顺铂/多西他赛和 nivolumab 的新辅助免疫化疗，并完成了 3 个周期的治疗后进行了复查。经过3个周期的新辅助治疗后，患者的原发性肺LEC肿块缩小了40%。患者接受了左下肺叶切除术，并进行了淋巴结取样。病理结果显示，患者病情明显降低至ypT1N0，术后情况良好。在这里，新辅助化疗加检查点免疫疗法被证明是一种可行的替代疗法，可替代之前尝试的肺癌LEC治疗策略，扩大了有效治疗的选择范围。此外，其他讨论还详细介绍了目前肺癌切除术的研究现状。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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Neoadjuvant Therapy Before Resection of Primary Pulmonary Lymphoepithelial Carcinoma

•
Primary pulmonary lymphoepithelial carcinoma (LEC) is an extremely rare form of lung cancer that is most often associated with Epstein Barr virus and affects a different patient population than other lung cancer subtypes.
•
There is no consensus on treatment strategy for primary pulmonary LEC due to its rarity, and most locally advanced disease is managed with resection followed by adjuvant chemotherapy.
•
This case marks the first documented occurrence of primary pulmonary LEC treated with neoadjuvant chemotherapy and PD1 checkpoint immunotherapy, demonstrating significant radiological response, followed by successful complete resection.

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来源期刊

ACS Applied Electronic Materials Multiple-

CiteScore

7.20

自引率

4.30%

发文量

567