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表皮生长因子受体-酪氨酸激酶抑制药(EGFR-TKI)治疗晚期非小细胞肺癌(NSCLC)的耐药机制逐渐明了,其中小细胞肺癌(SCLC)转化引发了学者极大关注。本文详细报道2例女性EGFR基因19外显子缺失突变肺腺癌患者,在EGFRTKI靶向治疗耐药后伴随血清神经元特异性烯醇化酶(NSE)水平的显著升高;同时,二次活检发现小细胞肺癌(SCLC)的转化,予以标准SCLC化疗方案治疗有效。提示医生应考虑NSCLC EGFR-TKI治疗失败后SCLC转化的可能,并重视NSE动态监测及二次活检病理分析的重要性。
The mechanism of drug resistance of epidermal growth factor receptor tyrosine kinase inhibitor (EGFR-TKI) in the treatment of advanced non-small cell lung cancer (NSCLC) is becoming clear. Among them, the transformation of small cell lung cancer (SCLC) has attracted great attention. This article reports in detail two cases of female EGFR gene 19 exon deletion mutation in patients with lung adenocarcinoma, EGFRTKI-targeted therapy with serum neuron-specific enolase (NSE) levels were significantly increased; the same time, the second biopsy Small cell lung cancer (SCLC) was found to be converted to standard SCLC chemotherapy regimens. It is suggested that doctors should consider the possibility of SCLC transformation after failure of EGFR-TKI therapy in NSCLC, and pay attention to the importance of dynamic monitoring of NSE and secondary biopsy pathology.