Metachronous pulmonary and pancreatic metastases arising from sigmoid colon cancer: A case report.
Metachronous pulmonary and pancreatic metastases arising from sigmoid colon cancer: A case report.
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乙状结肠癌引起的异时性肺和胰腺转移：一例报告
DOI：
10.12998/wjcc.v9.i15.3668
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发表时间：
2021-05-26
影响因子：
1.1
通讯作者：
Zhou J
中科院分区：
文献类型：
--
作者：
Yang J;Tang YC;Yin N;Liu W;Cao ZF;Li X;Zou X;Zhang ZX;Zhou J
背景结直肠癌的肺和胰腺同步转移是罕见的。胰腺转移的诊断是困难的，主要依赖于计算机断层扫描，病理和免疫组织化学。在这里，我们描述了使用下一代测序（NGS）来确定转移的起源和结直肠癌的预后预测。病例总结：一名59岁的男性被诊断为乙状结肠腺癌IIA期（T3N0M0），于2014年4月接受手术，随后接受XELOX辅助化疗。患者右上肺发生肺转移，于2016年5月行手术，未进一步辅助化疗。2018年5月发现胰腺转移，行胰十二指肠切除术。术后，于2018年6月至2019年3月接受S-1辅助化疗。三个病变标本的组织病理学检查显示了结肠癌的一致特征。在三种病变中观察到一致的基因突变谱，包括结肠癌中最常见的致癌驱动突变（如APC、TP53、KRAS和FBXW7）。辅助化疗前血液循环肿瘤（ct）DNA用NGS检测不到，提示化疗反应良好。最后一次随访时患者生存良好，无病生存期为17个月。结论原发肿瘤、转移灶及ctDNA基因谱在辅助诊断、预后及治疗决策方面具有临床价值。
BACKGROUND Metachronous pulmonary and pancreatic metastases from colorectal cancer are rare. The diagnosis of pancreatic metastases is difficult and predominantly relies on computed tomography, pathology and immunohistochemistry. Here, we describe the use of next-generation sequencing (NGS) for determination of the origin of metastasis and prognostic prediction of colorectal cancer. CASE SUMMARY A 59-year-old man was diagnosed with sigmoid adenocarcinoma stage IIA (T3N0M0) and underwent surgery in April 2014, followed by XELOX adjuvant chemotherapy. The patient developed pulmonary metastasis in the right upper lung and underwent surgery in May 2016 without further adjuvant chemotherapy. In May 2018, pancreatic metastasis was found and he underwent pancreaticoduodenectomy. After surgery, he was treated with adjuvant S-1 chemotherapy from June 2018 to March 2019. Histopathological review of the specimens from all three lesions indicated consistent patterns characteristic of colon cancer. Concordant gene mutation profiles were observed across the three lesions that included oncogenic driver mutations most frequently seen in colon cancer (e.g., APC, TP53, KRAS and FBXW7). Blood circulating tumor (ct)DNA before adjuvant chemotherapy was undetectable with NGS, suggesting a favorable response to chemotherapy. The patient was alive and well at the latest follow-up visit, achieving a disease-free survival of 17 mo. CONCLUSION The genetic profiles of primary tumor, metastases and ctDNA may have clinical value in auxiliary diagnosis, prognosis and therapeutic decision-making.
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影响因子：
4
作者：
Song, Yong;Hu, Chengping;Lu, Shun
通讯作者：
Lu, Shun
影响因子：
1.9
作者：
Wiltberger G;Bucher JN;Krenzien F;Benzing C;Atanasov G;Schmelzle M;Hau HM;Bartels M
通讯作者：
Bartels M
影响因子：
4
作者：
Chikhladze, Sophia;Lederer, Ann-Kathrin;Wittel, Uwe A.
通讯作者：
Wittel, Uwe A.
影响因子：
4.3
作者：
Akgul, Ozgur;Cetinkaya, Erdinc;Tez, Mesut
通讯作者：
Tez, Mesut
影响因子：
4.6
作者：
Riihimäki M;Hemminki A;Sundquist J;Hemminki K
通讯作者：
Hemminki K