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1、中国科技论文在线http://www.paper.edu.cnSarcomatoidcarcinomatransformation:araremanifestationofEGFRTKIdrugresistanceinapatient#5withlungadenocarcinoma112112XUSong,LIURenwang,LIUXia,SHITao,LIXiongfei,ZHONGDiansheng,211*WANGYan,CHENGang,CHENJun(1.DepartmentofLungCancerSurgery,TianjinMedical
2、UniversityGeneralHospital;2.DepartmentofMedicalOncology,TianjinMedicalUniversityGeneralHospital)10Abstract:Objective:AlmostallEGFR-mutantlungcancersdevelopresistancetoEGFRtyrosinekinaseinhibitors(EGFR-TKIs).Severalmechanismsforthisacquiredresistancehavebeenidentified,includingdev
3、elopmentofanEGFRT790Mmutation,METamplification,hepatocytegrowthfactor(HGF)overexpression,lossofPTENexpression,epithelialtomesenchymaltransitionandtransformationtosmallcelllungcancer.Herein,wepresentedalungcancerpatientwithEGFRexon1519deltionwhowasresistanttoEGFRTKItreatment.Metho
4、d:Tofurtherexploretheunderlyingmechanisms,weperformedagenemutationprofilingbynextgenerationsequencing(NGS).Results:Themechanismofdrugresistanceisveryrare.SomeadenocarcinoamacellsaquiredT790MmutationinEGFRexon20,andotheradenocarcinoamacellstransformedintosarcomatoidcarcinoma.Concl
5、usion:Thiscaseinspiresusagaintheimportanceoftissuere-biopsyoncetheacquiredresistance20occursafterTKIconsistantpressure.SarcomatoidcarcinomatransformationisararemanifestationofEGFRTKIdrugresistanceinapatientwithlungadenocarcinoma.Keywords:drugresistance;adenocarcinoma;sarcomatoidc
6、arcinoma;EGFR-TKI0Introduction25Drugresistanceisthemosttroublesomeproblemforepidermalgrowthfactorreceptortyrosinekinaseinhibitors(EGFR-TKIs)treatmentinnon-smallcelllungcancer(NSCLC)patients.ThemajormechanismswhichcontributetowardsEGFRTKIresistanceinNSCLChavebeendemonstrated,inclu
7、dingsecondarymuationofEGFRT790M,METamplification,epithelialtomesenchymaltransition,activationofalternativeoncogenicpathwaysandtransformationtosmall30celllungcancer(SCLC)[1-5].Herein,wepresentedararecaseoftransformationtosarcomatoidcarcinomaafterEGFR-TKItreatment.1CaseReportAnon-s
8、moker60-year-oldwomanwasdiagnosedwithlef
