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小细胞肺癌转化是非小细胞肺癌(non-small cell lung cancer,NSCLC)对表皮生长因子受体(epidermal growth factor receptor,EGFR)酪氨酸激酶抑制剂(tyrosine kinase inhibitors,TKIs)产生获得性耐药的机制之一。据报道,小细胞肺癌转化的发生率为2%~14%。目前,小细胞肺癌转化的发生机制尚不十分明确。有些NSCLC可直接转化成小细胞癌,还是初诊时即为复合性小细胞癌,尚存在争议。报道显示,NSCLC仅有部分病灶发生小细胞癌转化,转化的小细胞癌与原发性小细胞肺癌在细胞形态及蛋白表达上尚未见明显差异,但多有与初始NSCLC相同的EGFR基因突变型;而且,经典的抗原发性小细胞肺癌的放化疗方案对转化的小细胞肺癌一般也有较好的疗效。本文对近年来有关小细胞肺癌转化的发生机制、临床特点及处理策略进行综述。
Small cell lung cancer is a non-small cell lung cancer (NSCLC) with acquired resistance to epidermal growth factor receptor (EGFR) tyrosine kinase inhibitors (TKIs) One of the mechanisms. It is reported that the incidence of small cell lung cancer conversion rate of 2% to 14%. At present, the mechanism of SCLC transformation is not yet clear. Some NSCLC can be directly transformed into small cell carcinoma, or newly diagnosed complex small cell carcinoma, is still controversial. The report shows that only a small part of NSCLC lesions occur small cell carcinoma transformation, small cell lung cancer and primary small cell lung cancer cell morphology and protein expression in the no significant difference, but more with the same initial NSCLC EGFR gene mutation ; And classic anti-small cell lung cancer chemoradiation regimen on the transformation of small cell lung cancer generally have a good effect. This article reviews recent years, the mechanism of small cell lung cancer transformation, clinical features and treatment strategies are reviewed.