肿瘤预防与治疗2025，Vol.38Issue(9)：804-809,6.DOI:10.3969/j.issn.1674-0904.2025.09.007
ALK阳性肺腺癌向小细胞肺癌转化:3例病例报告暨文献复习
Transformation of ALK-Positive Lung Adenocarcinoma into Small Cell Lung Cancer:Three Case Reports and Literature Review
摘要
Abstract
Anaplastic lymphoma kinase(ALK)gene rearrangements are present in about 4％～6％of non-small-cell canc-ers(NSCLC).These rearrangements are caused by a chromosomal inversion within the short arm of chromosome 2,resulting in the formation of echinoderm microtubule-associated protein-like 4(EML4)-ALK fusion oncogenes in echinoderm cells.ALK tyrosine kinase inhibitors(ALK-TKIs)are the therapeutic options against ALK rearrangement of NSCLC,and the trans-formation to small-cell lung cancer(SCLC)is one of the mechanisms of drug resistance to ALK-TKIs.However,the proba-bility of this transformation is low.We report three patients with ALK gene rearranging NSCLC.Abnormal elevation of the tumor markers,i.e.gastrin-releasing peptide precursor and neuron-specific enolase,was observed after second-generation ALK-TKIs treatment,and histological analysis of related biopsies suggested transformation from NSCLC to SCLC.In this study,we reviewed the literature on the mechanisms underlying SCLC transformation,predictive factors and treatment meth-ods after transformation,and emphasized the importance of monitoring tumor markers,repeated biopsy and genetic detection in the process of disease development,so as to timely detect changes in pathological types and change treatment plans,ho-ping to improve the quality of life of patients.关键词
非小细胞肺癌/间变性淋巴瘤激酶/ALK酪氨酸激酶抑制剂/基因突变/小细胞肺癌/转化Key words
Non-small cell lung cancer/Anaplastic lymphoma kinase/ALK-TKIs/Gene Mutation/Small cell lung canc-er/Transformation分类
医药卫生引用本文复制引用
杨匹容,刘宇凤,冯其蔚,李娟..ALK阳性肺腺癌向小细胞肺癌转化:3例病例报告暨文献复习[J].肿瘤预防与治疗,2025,38(9):804-809,6.基金项目
四川省科技厅课题(编号:2024YFHZ0143) This study was supported by grants from Science and Technology Department of Sichuan Province(No.2024YFHZ0143). （编号:2024YFHZ0143）
