南方医科大学学报

南方医科大学学报 ›› 2023, Vol. 43 ›› Issue (3): 495-498.doi: 10.12122/j.issn.1673-4254.2023.03.22

• • 上一篇    

多原发恶性肿瘤合并SWI/SNF复合体缺陷型胃癌1例报告及文献复习

吕纯鑫，吴秀奇，夏 青   

  1. 上海市浦东新区浦南医院肿瘤科，上海 200120；上海交通大学医学院附属仁济医院肿瘤科，上海 200120
  • 出版日期:2023-03-20 发布日期:2023-03-20

Multiple primary malignancies combined with SWI/SNF complex-deficient gastric cancer: a case report and literature review

LÜ Chunxin, WU Xiuqi, XIA Qing   

  1. Department of Oncology, Punan Hospital of Pudong New District, Shanghai 200120, China; Department of Oncology, Renji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200120, China
  • Online:2023-03-20 Published:2023-03-20

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摘要： 多原发恶性肿瘤合并SWI/SNF复合体缺陷型胃癌的病例报道较少见。本例是由上海交通大学医学院附属仁济医院肿瘤科收治的1例多原发恶性肿瘤合并SWI/SNF复合体缺陷型胃癌的病例，通过分析临床病理特点、诊疗过程等，并结合文献复习，讨论该类肿瘤的发生、病理和免疫组化特征、诊治及预后。该例患者是异时性多原发恶性肿瘤，先确诊早期肺癌，经手术治愈，后确诊为SWI/SNF复合体缺陷型胃癌，合并ARID1A突变及TMB-H，经化疗联合免疫治疗效果不佳，总生存期13月。本报道旨在提高对多原发恶性肿瘤合并SWI/SNF复合体缺陷型胃癌的认知及诊治水平，改善患者的生存预后。

关键词: 多原发恶性肿瘤; SWI/SNF复合体缺陷; 胃癌

Abstract: Multiple primary malignancies combined with SWI/SNF complex-deficient gastric cancer is a rare clinical entity and poorly documented. Herein we report a case of this disease in an 81-year-old male patient treated in our hospital. Before the established diagnosis of metachronous multiple primary malignancies, the patient received left lower lobectomy for a space-occupying mass in the left lung, which was confirmed by postoperative pathology as early stage lung cancer. SWI/SNF complex-deficiency gastric cancer with metastasis was subsequently detected by gastroscopy, and high-throughput sequencing identified ARID1A and TMB-H gene mutations in the tumor tissues. The patient received chemotherapy combined with immunotherapy but failed to respond to the treatment, and died 13 months later. We conducted a literature review and analyzed the occurrence, pathological and immunohistochemical characteristics, diagnosis, treatment and prognosis of this disease.

Key words: multiple primary malignancies; SWI/SNF complex-deficiency; gastric cancer