PDF(Pubmed)
Abstract：
A female underwent a right middle lobectomy for a pulmonary adenocarcinoma (AD). She eventually died of a right malignant pleural mesothelioma (MPM; sarcomatoid type) 4 years and 7 months after the removal of the AD even though she did not have any history of asbestos exposure, smoking, or radiation exposure. Her chest CT revealed multiple pulmonary nodules and bilateral pleural effusion with a right pleural tumor directly invading into the abdominal cavity. The genomics of tumor origin and characteristics were examined for the AD and the MPM. As a result, 50 somatic variants were detected in the AD, and 29 somatic variants were detected in the MPM. The variants which were common in both the AD and the MPM were not present, which suggested that the AD and the MPM had occurred independently in different origins. The MPM had two driver oncogenes of TP53 and EP300, but the AD did not. Two driver oncogenes of TP53 and EP300 were hypothesized to make the MPM aggressive. The speed at which the MPM progressed without the patient having a history of asbestos exposure, smoking, or radiation exposure was alarming.
摘要：
一名女性因肺腺癌（AD）接受了右中叶切除术。尽管她没有任何石棉暴露史，但在去除AD后4年零7个月，她最终死于右恶性胸膜间皮瘤（MPM;肉瘤样型）。吸烟,或辐射暴露。她的胸部CT显示肺部多发结节和双侧胸腔积液，右侧胸膜肿瘤直接侵入腹腔。针对AD和MPM检查了肿瘤起源和特征的基因组学。因此,在AD中检测到50个体细胞变异，在MPM中检测到29个体细胞变异。在AD和MPM中都不存在常见的变体，这表明AD和MPM在不同的起源中独立发生。MPM具有TP53和EP300的两个驱动癌基因，但AD没有。假设TP53和EP300的两个驱动癌基因使MPM具有侵袭性。在患者没有石棉暴露史的情况下，MPM进展的速度，吸烟,或者辐射暴露令人震惊。
