PDF(Pubmed)
Abstract：
Several transcription factors in small cell lung cancer (SCLC), including achaete-scute homolog 1 (ASCL1) and neurogenic differentiation factor 1 (NEUROD1), contribute to rapid tumor growth and early metastatic dissemination. Recent studies suggested that these molecular subtypes represent neuroendocrine differentiation in dynamic SCLC evolution. In the present case, a 62-year-old man was diagnosed with limited disease SCLC originating from the right upper lobe. Biopsy specimens were positive for ASCL1 but negative for NEUROD1. Six months after concurrent chemoradiotherapy and prophylactic cranial irradiation, the primary tumor had regrown and salvage surgery was performed. The pathological diagnosis was recurred SCLC, and postoperative histopathology was positive for both ASCL1 and NEUROD1. The patient was subsequently followed up; however, he had multiple bone metastases 9 months after surgery. It was speculated that the shift to NEUROD1-high expression in tumor cells surviving concurrent chemoradiation therapy may be related to the poor outcome after combined modality treatment.
摘要：
小细胞肺癌（SCLC）中的几种转录因子，包括achaete-scute同源物1（ASCL1）和神经源性分化因子1（NEUROD1），有助于肿瘤的快速生长和早期转移扩散。最近的研究表明，这些分子亚型代表了动态SCLC进化中的神经内分泌分化。在目前的情况下,1名62岁男性患者被诊断患有源自右上叶的局限性疾病SCLC.活检标本ASCL1阳性，而NEUROD1阴性。同步放化疗和预防性颅骨照射后六个月，原发肿瘤已经再生,并进行了挽救性手术.病理诊断为SCLC复发，术后组织病理学检查为ASCL1和NEUROD1阳性。随后对患者进行了随访；然而，术后9个月出现多发骨转移.据推测，同步放化疗存活的肿瘤细胞向NEUROD1高表达的转变可能与联合治疗后的不良预后有关。
