文章摘要

1例晚期肺鳞癌患者EGFR突变病例报道并文献复习

作者: 1周海英, 2韩进伟, 1吕铮, 3,4吴爱萍
1 河北医科大学附属唐山市工人医院胸外科，河北 唐山 063000
2 河北省唐山中心医院胸外科，河北 唐山 063000
3 华北理工大学基础医学院，河北 唐山 063210
4 华北理工大学附属医院病理科，河北 唐山 063210
通讯: 吴爱萍 Email: 15102536820@163.com
DOI: 10.3978/j.issn.2095-6959.2019.11.047

摘要

1例表皮生长因子受体(epidermal growth factor receptor，EGFR)突变阳性的晚期肺鳞癌患者，男，65岁，无明显诱因出现刺激性咳嗽10余天。胸部CT见右下肺实性肿块，隆突下肿大淋巴结。支气管镜取活检病理诊断为中低分化鳞状细胞癌。全身骨显像检查考虑骨转移。EGFR基因检测结果显示EGFR基因第19号外显子缺失。给予患者口服吉非替尼治疗。1周后症状即消失。胸部CT显示肺部肿物及纵隔淋巴结显著缩小。3个月后患者病情出现进展，复查EGFR基因检测显示T790M突变。遂开始口服奥希替尼治疗。胸部CT可见肿块影显著缩小。口服奥希替尼3个月后，肿瘤复发，再次行支气管镜活检，行基因检测可见C797S突变。之后患者未行任何治疗，3个月后因肿瘤进展死亡。
关键词： 肺鳞癌；表皮生长因子受体；靶向治疗

EGFR mutations in patients with advanced lung squamous cell carcinoma: A case report and literature review

Authors: 1ZHOU Haiying, 2HAN Jinwei, 1LÜ Zheng, 3,4WU Aiping
1 Department of Thoracic Surgery, Tangshan Workers’ Hospital, Hebei Medical University, Tangshan Hebei 063000, China
2 Department of Thoracic Surgery, Tangshan Center Hospital, Tangshan Hebei 063000, China
3 School of Basic Medical Science, North China University of Science and Technology, Tangshan Hebei 063210, China
4 Department of Pathology, Affiliated Hospital of North China University of Science and Technology, Tangshan Hebei 063210, China

CorrespondingAuthor: WU Aiping Email: 15102536820@163.com

DOI: 10.3978/j.issn.2095-6959.2019.11.047

Abstract

A 65-year-old man with advanced lung squamous cell carcinoma of epidermal growth factor receptor (EGFR) mutation positive, was admitted to the hospital for no obvious cause of irritating cough for more than 10 days. A solid mass in the lower right lung and enlarged lymph nodes under carina were displayed by CT exam. Bronchoscopy biopsy was performed and the pathologic diagnosis was medium and low differentiated squamous cell carcinoma. Radionuclide bone imaging showed bone metastasis. The results of the gene test showed the deletion of exon 19 of EGFR gene. Patients were given gefitinib orally. The symptoms disappeared after 1 week. Chest CT showed a significant reduction of lung mass and mediastinal lymph nodes. After 3 months, the disease progressed, and a reexamination of EGFR gene showed T790M mutation. So, the patient was treated with orxitinib. CT scan of the chest shows a significantly reduced mass. Three months after oral administration of oxitinib, the tumor recurred and was biopsied again with bronchoscopy. Gene detection revealed C797S mutation. The patient received no treatment and died of tumor progression 3 months later.
Keywords： lung squamous cell carcinoma; epidermal growth factor receptor; targeted therapy

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