周子超^1;2;徐晓玲²;江海涛³;朱慧能⁴;陈奇勋⁵;杜向慧⁶;裘国勤⁶;孙才兴⁷;范云²

• 1:浙江中医药大学第二临床医学院，浙江 杭州 310053中国科学院大学附属肿瘤医院(浙江省肿瘤医院)胸部肿瘤内科，浙江 杭州 310022中国科学院大学附属肿瘤医院(浙江省肿瘤医院)放射科，浙江 杭州 310022中国科学院大学附属肿瘤医院(浙江省肿瘤医院)病理科，浙江 杭州 310022中国科学院大学附属肿瘤医院(浙江省肿瘤医院)胸部肿瘤外科，浙江 杭州 310022中国科学院大学附属肿瘤医院(浙江省肿瘤医院)胸部放疗科，浙江 杭州 310022中国科学院大学附属肿瘤医院(浙江省肿瘤医院)神经外科，浙江 杭州 310022

摘要(Abstract)：

本文介绍1例原发性肺淋巴上皮瘤样癌（lymphoepithelioma-like carcinoma，LELC）的多学科团队（multidisciplinary team，MDT）诊疗过程。该患者经支气管活检病理诊断右肺LELC，结合影像学检查结果合并肝转移可能大，无驱动基因突变。第1次MDT讨论后行一线GP方案（吉西他滨+顺铂）化疗，2个周期后评估示肺内病灶部分缓解，肝内病灶未见缩小。第2次MDT讨论后，行CT引导下经皮穿刺肝内病灶未见肿瘤细胞，暂除外肝转移，肺病灶局限，遂行右肺癌根治术及淋巴结清扫术。术后6个月新发脑转移，第3次MDT讨论后行局部脑转移瘤切除术序贯全脑放疗。疾病稳定14个月后肝脏病灶进展，二线予免疫检查点抑制剂纳武利尤单抗单药免疫治疗，无进展生存期26个月。该晚期原发LELC患者至今总生存期达53个月。本例报道提示，经MDT讨论后行综合治疗，能确保患者获得更合适的治疗，以取得较长的疾病控制时间和长期的生存获益。

关键词(KeyWords)： 肺癌;非小细胞肺癌;肺淋巴上皮瘤样癌;多学科团队;诊断;免疫检查点抑制剂;综合治疗

Abstract:

Keywords:

基金项目(Foundation):

作者(Authors): 周子超^1;2;徐晓玲²;江海涛³;朱慧能⁴;陈奇勋⁵;杜向慧⁶;裘国勤⁶;孙才兴⁷;范云²

DOI: 10.13267/j.cnki.syzlzz.2021.062

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