肺腺癌间变性淋巴瘤激酶阳性患者临床病理特征及克唑替尼的疗效

Clinicopathological Features of Lung Adenocarcinoma Patients with Positive Degenerative Lymphoma Kinase and Effect of Crizotinib

目的探究肺腺癌间变性淋巴瘤激酶阳性(ALK)患者的临床病理特征及克唑替尼的临床疗效。方法回顾性分析60例ALK患者的病历资料,其中34例克唑替尼一线治疗,26例二线治疗。观察ALK患者临床病理特征及克唑替尼的临床疗效。结果 ALK患者中肺癌TNM分期ⅡA、ⅢA期较多;免疫组织化学染色结果显示所有患者病理标本中肿瘤细胞的细胞质内ALK蛋白强颗粒状着色; HE染色结果显示实体型26例伴黏蛋白分泌为主,20例腺泡样为主;30例患者肿瘤组织伴有黏液分泌,19例伴有筛状结构,11例伴有印戒细胞。克唑替尼一线治疗与二线治疗的总缓解率及无进展生存时间无统计学差异(P> 0. 05);不良反应以Ⅰ、Ⅱ级为主。结论 ALK患者临床病理特征独特,实体型以常见伴黏蛋白分泌、腺泡样为主,组织学形态以筛状结构、印戒细胞为主,经克唑替尼治疗后疗效确切,不良反应较轻。

Objective To explore clinicopathological features of lung adenocarcinoma patients with positive degenerative lymphoma kinase(ALK)and effect of crizotinib.Methods Clinical data of 60 ALK patients were retrospectively analyzed:34 cases of crizotinib first-line treatment,and 26 cases of second-line treatment.The clinicopathological features and the clinical efficacy of crizotinib were observed.Results Among ALK patients,there were a vast majority ofⅡA,ⅢA lung cancer TNM staging;immunohistochemical staining showed that ALK protein granular staining in the cytoplasm of tumor cells among all pathological specimens;HE staining pointed out that the 26 cases of entity type accompanied mainly mucin secretion,20 cases were basically acini;30 cases were tumor tissues and mucous secretion,19 cases were accompanied by cribriform structure,11 cases were complicated with signet ring cell;There was no statistical difference in total remission rate and progression free survival time between first-line treatment and second-line therapy of crizotinib(P>0.05).Adverse reactions were chiefly gradeⅠandⅡ.Conclusion The clinicopathological features of ALK patients is unique,entity type commonly accompanies with mucin secretion and is in acini shape,histological morphology are primarily in sieve structure and signet ring cell,exact curative effect is turned up after crizotinib with mild adverse reactions.