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从未吸烟者的状细胞癌:对SMARCB1损失的洞察
Akshay J Patel1,2, Hanan Hemead2, Hannah Jesani2
1Institute of Immunology and Immunotherapy, College of Medical and Dental Sciences, University of Birmingham, Vincent Drive, Edgbaston, Birmingham B15 2TT, UK.
International journal of molecular sciences
|August 10, 2024
概括
没有吸烟的人患有状细胞癌 (SqCC) 的肺癌是侵略性的. 从来没有吸烟的人中,SMARCB1缺乏的SqCC呈现出快速进展和低生存率,需要向治疗.
科学领域:
- 在瘤学瘤学.
- 基因组学就是基因组学.
- 胸部外科手术 胸部外科手术
背景情况:
- 肺癌是全球癌症死亡的主要原因之一.
- 非小细胞肺癌 (NSCLC) 占病例的85%,状细胞癌 (SqCC) 与吸烟有关.
- 从未吸烟者的肺癌 (LCINS),特别是LCINS-SqCC,正在增加,并且对基因组驱动因素和结果的理解越来越少.
研究的目的:
- 为了调查肺癌的基因组变化和临床结果,从未吸烟的人与状细胞癌 (LCINS-SqCC).
- 为了确定特定的分子亚型及其预后影响在这个研究不足的人群.
- 为了为LCINS-SqCC提供个性化的治疗策略.
主要方法:
- 追溯分析59名LCINS-SqCC患者在20年 (2003-2023) 期间在两个英国高等医疗中心进行了激进的外科切除.
- 收集人口统计,并发病,遗传病学和生存数据.
- 瘤样本的分子测序以确定基因组异常.
主要成果:
- 患者的中位年龄为71岁,轻微男性占主导地位.
- 39%的患者出现了疾病复发,54%的患者在3年内死亡.
- 在两个年轻的患者中发现了双性SMARCB1损失,与快速进展,PDL1阴性和特定免疫类型 (cytokeratin+,CD56+,p40+) 相关.
结论:
- 在从未吸烟者中,SMARCB1缺乏的SqCC是一种高度侵略性的变异,具有较差的无病存活率.
- 先进的分子诊断对于识别这种攻击性亚型至关重要.
- 对于缺乏SMARCB1的肺癌,需要个性化治疗策略,包括EZH2抑制剂和免疫检查点阻塞.
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