ABSTRACT:We report the case of an 85-year-old man who was surgically diagnosed with lung adenocarcinoma (pT2aN1M0 stage IIA). He was administered platinum combination chemotherapy as first-line treatment for lung cancer recurrence. The patient’s pleural fluid sample was obtained and analysed using a next-generation sequencer, which demonstrated the presence of mesenchymal-epithelial transition gene (MET) exon 14 skipping mutations. As the patient developed progressive disease after receiving first-line chemotherapy, crizotinib was administered as the second-line treatment. The treatment was effective, and the patient had a stable disease for 7 months. This case suggests that crizotinib is effective against non-small cell lung cancer with MET exon 14 alterations.

目的 探讨细胞信号传导分子SMAD2和血清和糖皮质激素诱导的蛋白激酶3(Serum and glucocorticoid-inducible protein kinase 3,SGK3)在非小细胞肺癌(Non small cell lungcancer,NSCLC)中的表达及临床意义。方法 选取某医院和某肿瘤医院2010年6月至2013年6月收治的98例NSCLC患者作为研究对象,采用系统回顾性分析法分析所有患者的临床资料,根据其资料结果收集98例NSCLC患者其98份癌组织标本(研究组)及98份癌旁组织标本(对照组)作为研究对象,所有组织标本均行SMAD2与SGK3蛋白的检测,并分析二者的表达与NSCLC患者临床病理特征的关系。结果 ①NSCLC组织中SMAD2与SGK3蛋白阳性表达率分别为77.55%和74.49%,明显高于癌旁组织中SMAD2与SGK3蛋白阳性表达(17.35%与15.31%)(P<0.05);②SMAD2蛋白表达与NSCLC患者性别、年龄、病理类型、肿瘤大小均无明显关系(P>0.05);SMAD2蛋白表达与NSCLC患者肿瘤分化程度、淋巴结转移存在显著相关性(P<0.05);③SGK3蛋白表达与NSCLC患者性别、年龄、病理类型、肿瘤大小均无明显关系(P>0.05);SGK3蛋白表达与NSCLC患者肿瘤分化程度、淋巴结转移存在显著相关性(P<0.05);④经单因素分析得出:低分化、淋巴结转移、SMAD2蛋白阳性表达、SGK3蛋白阳性表达患者生存时间均显著缩短(P<0.05);⑤经多因素Cox分析得出:低分化、有淋巴结转移、SMAD2蛋白阳性、SGK3蛋白阳性均为影响NSCLC患者预后的独立危险因素(P<0.05)。结论 SMAD2与SGK3蛋白在NSCLC组织中表达显著高于癌旁组织,其表达水平与NSCLC患者分化程度、淋巴结转移均有显著相关,可能参与了NSCLC的发生、发展。 

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