SMARCA4缺失型非小细胞肺癌CT影像、病理及临床特征分析

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中文摘要：目的探讨SMARCA4/BRG1 缺失型非小细胞肺癌(SMARCA4-dNSCLC)影像、病理及临床特征。方法回顾性分析 2020 年 9 月至 2023 年 9 月福建医科大学附属泉州市第一医院 43 例SMARCA4-dNSCLC患者的临床、病理及影像学资料，包括CT表现、组织学特征及免疫组化表现、治疗策略及随访资料。结果 43 例患者中T1期5例、T2期12例、T3期11例、T4期15例，22例有远处转移;男41例，女2例;中位年龄61岁;有吸烟史 32 例。肿瘤最大径中位数为 52 mm。存在毛刺征 28 例，分叶征 41 例，空泡或空洞 9 例，坏死 35 例，血管集束征 34 例，胸膜凹陷征 34 例，胸腔积液 8 例，胸内淋巴结肿大 30 例，肺内转移灶≥10 个 6 例，合并肺气肿、肺大泡 35 例。病理组织学表现为 43 例肿瘤组织排列均成实性片状、岛状或结节状，其中 32 例伴有大片坏死，多数为异形上皮样细胞形态，细胞黏附性差，核大深染。TTF-1 阳性 11 例，CK7 阳性 30 例，HepPar-1阳性 28 例。PD-L1≥1%有 19 例，10 例患者出现TP53 突变。患者中行手术治疗 14 例，化疗联合免疫治疗15 例，化疗 7 例，放疗 2 例。有随访资料 35 例，5 例死于肿瘤引起的并发症，其余 30 例目前带病存活。结论 SMARCA4-dNSCLC的临床、病理及CT表现均存在一定特征，有助于患者的个体化诊断及治疗。

外文标题：Analysis of CT imaging,pathology and clinical features of SMARCA4-deficient non-small cell lung cancer

外文摘要：Objective To investigate the imaging,pathological and clinical features of SMARCA4/BRG1-deficient non-small cell lung cancer(SMARCA4-dNSCLC).Methods Retrospective analysis of clinical,pathological,and imaging data of 43 SMARCA4-dNSCLC patients at Quanzhou First Hospital Affiliated to Fujian Medical University from September 2020 to September 2023,including CT findings,histological features and immunohistochemical findings,treatment strategies and follow-up data.Results Among 43 patients,there were 5 patients in T1 phase,12 patients in T2 phase,11 patients in T3 phase,15 patients in T4 phase,and 22 patients had distant metastasis,and there were 41 males and 2 females.The median age was 61 years old.There were 32 patients with smoking history.The median maximum diameter of tumor was 52 mm.There were 28 patients with burr sign,41 patients with lobulation sign,9 patients with vacuole or cavity,35 patients with necrosis,34 patients with vascular convergence sign,34 patients with pleural indentation sign,8 patients with pleural effusion,30 patients with intrathoracic lymphadenopathy,6 patients with pulmonary metastases≥10,and 35 patients with complications of emphysema and bullae.Histopathological findings showed that tumor tissues of 43 patients were all arranged in solid sheets,islands or nodules,of which 32 patients were accompanied by large necrosis,most of which were atypical epithelioid cells with poor cell adhesion and large and dark nuclei.TTF-1 was positive in 11 patients,CK7 in 30 patients and HepPar-1 in 28 patients.There were 19 patients with PD-L1≥1%,and 10 patients had TP53 mutation.Fourteen patients underwent surgery,15 patients underwent chemotherapy combined with immunotherapy,7 patients underwent chemotherapy and 2 patients underwent radiotherapy.There were 35 patients with follow-up data,5 patients died of complications caused by tumors,and the remaining 30 patients were currently alive with diseases.Conclusion The clinical,pathological and CT features of SMARCA4-dNSCLC have certain characteristics,which are helpful for individualized diagnosis and treatment of patients.

外文关键词：

SMARCA4BRG1Non-small cell lung cancerTomography,X-ray computer

作者：

张家敏、蔡雅丽、林钱森、陈杰云

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作者单位：

福建医科大学附属泉州市第一医院影像科,福建泉州 362000

关键词：

SMARCA4 BRG1 非小细胞肺癌体层摄影术,X线计算机

出版年：

2024

DOI：