Tu LF, Sheng LY, Zhou JY, Wang XF, Wang YH, Shen Q, Shen YH. Diagnosis and treatment of primary pulmonary enteric adenocarcinoma: Report of Six cases. World J Clin Cases 2021; 9(30): 9236-9243 [PMID: 34786410 DOI: 10.12998/wjcc.v9.i30.9236]
Corresponding Author of This Article
Yi-Hong Shen, MD, Chief Doctor, Department of Respiratory Medicine, The First Affiliated Hospital, Zhejiang University School of Medicine, No. 79 Qingchun Road, Hangzhou 310003, Zhejiang Province, China. drsyh@zju.edu.cn
Research Domain of This Article
Oncology
Article-Type of This Article
Case Report
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Ling-Fang Tu, Ling-Yan Sheng, Jian-Ying Zhou, Xue-Fen Wang, Yue-Hong Wang, Qian Shen, Yi-Hong Shen, Department of Respiratory Medicine, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310003, Zhejiang Province, China
Author contributions: Tu LF and Shen YH helped get all the data of the cases from hospital; Sheng LY, Tu LF, Zhou JY, Wang XF, Wang YH, and Shen Q drafted the manuscript; Shen YH is the supervisor; all authors read and approved the final manuscript.
Supported byMedicine and Health Project of Zhejiang Province, China, No. 2018KY049.
Informed consent statement: Informed consent was obtained from the patients for publication of this report and accompanying images.
Conflict-of-interest statement: The authors declare that they have no conflict of interest for this manuscript.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Yi-Hong Shen, MD, Chief Doctor, Department of Respiratory Medicine, The First Affiliated Hospital, Zhejiang University School of Medicine, No. 79 Qingchun Road, Hangzhou 310003, Zhejiang Province, China. drsyh@zju.edu.cn
Received: May 21, 2021 Peer-review started: May 21, 2021 First decision: June 15, 2021 Revised: June 28, 2021 Accepted: August 20, 2021 Article in press: August 20, 2021 Published online: October 26, 2021 Processing time: 152 Days and 17.2 Hours
Abstract
BACKGROUND
Primary pulmonary enteric adenocarcinoma (PEAC) is a very rare subtype of invasive adenocarcinoma, and there have been no large studies on PEAC to date. Therefore, it is necessary to obtain much more information about the clinical and pathological features, diagnosis, differential diagnosis, and treatment of PEAC.
CASE SUMMARY
All clinical data of six patients with confirmed PEAC from 2013 to 2018 were collected, and data on diagnosis, differential diagnosis, and treatment of PEAC are discussed combined with all the associated literature. The mean age of six patients was 64.0 ± 5.6 (59-73) years old. Their clinical manifestations were heterogeneous, and during their disease course, there were no gastrointestinal symptoms. There was no evidence from colonoscopy or imaging studies to suggest digestive tract tumors or new metastases. The most commonly mutated gene was KRAS (50.0%), and the pathological features of the six cases were similar to those of colorectal cancer. CDX2 (83.3%) and CK7 (66.7%) had the highest positive rates upon immunohistochemical examination. In the associated literature, 252 cases were identified, and the most commonly mutated gene was KRAS (42.9%). Additionally, CDX2 (68.3%) and CK7 (85.8%) had the highest positive rates. Patients mainly received surgery, chemotherapy, and radiotherapy, immunotherapy was not included.
CONCLUSION
Positive results for CDX2 and CK7 play an important role in the diagnosis and differential diagnosis of PEAC, and immunotherapy or targeted therapy focused on KRAS needs to be further studied for the treatment of PEAC.
Core Tip: Primary pulmonary enteric adenocarcinoma (PEAC) is a very rare subtype of invasive adenocarcinoma, and there have been no large studies on PEAC to date. All clinical data of six patients with confirmed PEAC from 2013 to 2018 were collected in this study, and data on the diagnosis, differential diagnosis, and treatment of PEAC are discussed combined with all the associated literature. Our findings highlight that positive results for CDX2 and CK7 play an important role in the diagnosis and differential diagnosis of PEAC, and immunotherapy or targeted therapy focused on KRAS needs to be further studied for the treatment of PEAC.
