Transformation of Non-Small Cell Lung Cancer to Combined Squamous Cell and Small Cell Carcinoma after Chemotherapy: Case Report

非小細胞肺癌經化學治療後轉變為聯合型鱗狀上皮細胞與小細胞癌：病例報告

羅永鴻(Yung-Hung Luo) ； 陳育民(Yuh-Min Chen)

《胸腔醫學》 27卷5期 (2012/10) Pp. 305-310

https://doi.org/10.29806/TM.201210.0008

摘要

大約百分之五的小細胞肺癌會同時具有非小細胞癌的成分。據估計聯合型小細胞肺癌與鱗狀上皮細胞癌或腺癌的發生率約占所有小細胞肺癌的百分之一至二以下。我們報告一例非小細胞肺癌經化學治療後轉變為聯合型鱗狀上皮細胞與小細胞癌。小細胞肺癌幾乎只發生在吸菸的人身上。據我們所知，這是第二個被報導的發生在不抽菸患者身上的聯合型鱗狀上皮細胞與小細胞癌。肺癌經治療後發生組織學形態上的變化被認為是不常見的狀況。腫瘤的異質性可能在最初的診斷時就發現，也可能隨著時間的推移而自然發生，或者是被化學治療或放射線治療而誘發。這種現象更加強調了在組織學、及分子檢驗方面，例如上皮生長因子受體基因突變狀態方面作確定診斷的重要性，如此才能對肺癌的治療作出完善之計畫。

關鍵字

聯合型鱗狀上皮細胞與小細胞癌 ； 非小細胞肺癌 ； 轉變

並列摘要

About 5% of small-cell lung cancer (SCLC) may be combined with non-small cell components. The estimated incidence of SCLC combined with squamous cell and/or adenocarcinoma was probably less than 1% to 2% of all SCLC cases. We presented a case with transformation of non-small cell lung cancer to combined squamous cell and small cell carcinoma after chemotherapy. SCLC occurs almost exclusively in smokers. To our knowledge, this is the 2nd reported case of combined small and squamous cell carcinoma occurring in a patient without a smoking history. A histological change in lung cancer after treatment is considered unusual. Tumor heterogeneity may be found at initial diagnosis, may occur spontaneously over time or may be elicited by chemotherapy and/or radiotherapy. This emphasizes the importance of histological confirmation, even at molecular levels, such as epidermal growth factor receptor (EGFR) mutation status, in order to make appropriate plans for lung cancer therapy.

並列關鍵字

combined squamous cell and small cell carcinoma ； non-small cell lung cancer ； transformation