-
Case Report
-
Korean J Med. 2015;89(1):107-112. Published online July 1, 2015.
DOI: https://doi.org/10.3904/kjm.2015.89.1.107
- Gefitinib에 내성을 보인 폐선암에서 발견된 Epidermal Growth Factor Receptor 돌연변이 양성인 소세포폐암
-
윤진탁1, 박석영1, 양영준1, 박지찬1, 정준원1, 김종옥2, 이정의2
-
1가톨릭대학교 의과대학 대전성모병원 내과
2가톨릭대학교 의과대학 대전성모병원 병리과
- Small Cell Lung Cancer with Mutation of Epidermal Growth Factor Receptor in Patients with Lung Adenocarcinoma Resistant to Gefitinib
-
Jin Tak Yun1, Suk Young Park1, Young Jun Yang1, Ji Chan Park1, Jun Won Jung1, Jong Ok Kim2, Jung Uee Lee2
-
1Departments of Internal Medicine, Daejeon St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Daejeon, Korea
2Departments of Pathology, Daejeon St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Daejeon, Korea
- Corresponding author: Suk Young Park ,Tel: +82-42-220-9821, Fax: +82-42-255-8663, Email: sypark1011@hotmail.com
- Received: February 10, 2014; Revised: April 7, 2014 Accepted: August 21, 2014.
- 저자들은 처음 EGFR 변이 양성인 선암으로 진단되어 EGFR TKI사용 후 저항성을 보였으며 진행된 병변에서 재조직검사를 시행하여 같은 EGFR변이 양성 소세포암으로 판명된 발병기전이 서로 다를 것으로 생각되는(transformed and combined) 증례 2예를 경험하였기에 문헌고찰과 함께 보고하는 바이다.
߽ɾ :소세포폐암; 표피성장인자수용체; 돌연변이; 약물내성
- Abstract
- Most epidermal growth factor receptor (EGFR) gene mutations are detected in lung adenocarcinomas. In contrast, these mutations have rarely been reported in small cell lung cancer (SCLC). We herein report two cases of EGFR-mutant SCLC transformed from and combined with lung adenocarcinoma. In one case, SCLC appeared to be transformed from EGFR mutant 19-del adenocarcinoma when the patient became resistant to gefitinib. The other patient had combined EGFR-mutant 19-del SCLC and adenocarcinoma at the initial diagnosis, which was resistant to gefitinib at multiple sites. Further comparative molecular analyses of these histologically distinct tumors would provide useful information regarding the role of EGFR mutation in the pathogenesis of SCLC. In conclusion, despite the presence of the same EGFR mutation, gefitinib was not effective in treatment of SCLC. Therefore, confirmation of SCLC cell morphology may become an important means of predicting resistance to EGFR tyrosine kinase inhibitors in addition to common secondary genetic alterations.
Keywords :Small cell lung carcinoma, Receptor, Epidermal growth factor, Mutation, Drug resistance
