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자료유형
학술저널
저자정보
우창곡 (충북대학교) 손승명 (충북대학교) 이호창 (충북대학교) 한혜숙 (충북대학교) 이기형 (충북대학교) 김도훈 (충북대학교) 김응국 (충북대학교) 이옥준 (충북대학교)
저널정보
대한암학회 Cancer Research and Treatment Cancer Research and Treatment 제54권 제3호
발행연도
2022.7
수록면
737 - 743 (7page)
DOI
10.4143/crt.2021.773

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PurposeHistologic change is a resistant mechanism in lung cancer. The most common histological change is the switch from adenocarcinoma (AdenoCa) to small cell carcinoma (SCC) against to tyrosine kinase inhibitors (TKI). However, it is not clear whether other treatment modalities are involved in the histologic changes.Materials and MethodsWe investigated histological changes in eight cases, after various treatments, and compared the molecular profiles between primary tumors and changed tumors using exome sequencing where tissue was available.ResultsThree cases of AdenoCa that were changed into SCC retained the initial mutations after TKI and/or surgical treatment. After treatment with TKI and immunotherapy, an <i>EGFR</i> (epidermal growth factor receptor)-mutant AdenoCa changed to squamous cell carcinoma (SqCa). SqCa in a patient treated with surgery was changed into combined AdenoCa and SqCa. These two cases showed the same genetic variations between the two distinct non–small cell carcinomas (NSCC). Three patients experienced two histologic changes, which the changed tumors returned to its original subtype or changed to a combined tumor after treatments. Four cases showed combined histology in the first or second change.ConclusionThe histology of NSCC can be changed to a single pattern or combined subtypes after various treatment modalities, and the phenotypic changes seem not fixed. Therefore, additional morphologic changes may occur regardless of their genetic status and types of treatments. To refine the new treatment strategy, consecutive repeated biopsies in progressive disease or recurrent tumor are necessary.

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