肺肠型腺癌研究进展

Research progress of Pulmonary enteric adenocarcinoma

肺肠型腺癌是与结直肠腺癌有相似组织形态的原发性肺腺癌,发病机制尚未明确,可能与癌细胞的肠型分化有关。肺肠型腺癌主要临床症状与普通型肺腺癌类似,包括咳嗽、咳血丝痰等,影像学表现亦相似,漏诊及误诊率高。其血清癌胚抗原和CA199水平显著高于普通型肺腺癌,但与肺转移性结直肠癌比较差异无统计学意义。肺肠型腺癌肠型分化成分>50%,部分表达肠型分化标记,需重点与肺转移性结直肠癌鉴别。病理检查是其确诊的重要手段,二代测序有助于诊断。肺肠型腺癌治疗原则同普通型肺腺癌,治疗普通型肺腺癌的化疗方案对肺肠型腺癌有效。KRAS突变是肺肠型腺癌最常见的基因突变,这种突变特征对肺肠型腺癌的靶向治疗有一定提示。

Pulmonary enteric adenocarcinoma is a primary pulmonary adenocarcinoma with similar histology to colorectal adenocarcinoma.Its pathogenesis is not clear and may be related to the intestinal type differentiation of cancer cells.The main clinical symptoms of pulmonary enteric adenocarcinoma are similar to those of ordinary pulmonary adenocarcinoma,including cough,expectoration,sputum mixed with blood and so on.The imaging findings are also similar.The missed diagnosis and misdiagnosis rate of pulmonary enteric adenocarcinoma is high.The serum levels of CEA and CA199 in Pulmonary enteric adenocarcinoma were significantly higher than those in ordinary pulmonary adenocarcinoma,but there is no statistical difference compared with lung metastatic colorectal cancer.The intestinal type differentiation component of pulmonary enteric adenocarcinoma is more than 50%,and some of them express intestinal type differentiation markers.Pathological examination is an important means for the diagnosis of pulmonary enteric adenocarcinoma.Next-generation sequencing is helpful for diagnosis.The treatment principle of pulmonary enteric adenocarcinoma is the same as that of ordinary pulmonary adenocarcinoma.The chemotherapy regimen for ordinary pulmonary adenocarcinoma is effective for pulmonary enteric adenocarcinoma.The most common genetic mutation in pulmonary enteric adenocarcinoma is the KRAS mutation,which has certain hints for its targeted therapy.