[Progress in pulmonary enteric adenocarcinoma]

Pulmonary enteric adenocarcinoma (PEAC), as a rare histologic subtype of primary lung adenocarcinoma, is defined as an adenocarcinoma in which the enteric component exceeds 50%. It is named after its shared morphological and immunohistochemical features with colorectal cancer. While with such similarity, the differential diagnosis of PEAC and lung metastatic colorectal cancer is a great challenge in the clinic. PEAC may originate from the intestinal metaplasia of respiratory basal cells stimulated by risk factors such as smoking. Current studies have found that肺肠型腺癌是原发性肺腺癌的罕见病理亚型，指肺腺癌中肠型分化成分超过50%者，因其与结直肠腺癌在形态学及免疫组化特征方面有某些共同点而得名，二者间的共同特征也造成肺肠型腺癌与转移性结直肠癌的鉴别诊断具有困难。肺肠型腺癌可能起源于吸烟等危险因素刺激所致的呼吸道基底细胞肠化生，KRAS是其相对高频突变基因，其他驱动基因突变罕见。结合PubMed收录涉及肺肠型腺癌文献分析，肺肠型腺癌CK7阳性率为88.2%(149/169)，CDX2阳性率为78.1%(132/169)，CK20阳性率为48.2%(82/170)，TTF1阳性率为38.8%(66/170)；临床特征方面，肺肠型腺癌平均发病年龄为62岁，男性患者占56.5%(35/62)，吸烟者占78.8%(41/52)，41.4%(24/58)原发病灶位于右肺上叶；治疗方面，现多推荐采用传统非小细胞肺癌治疗方案而非结直肠癌治疗方案对其进行治疗。目前仍亟待更多基础及临床研究，从组学等水平对其分子图谱及发病机制等方面进行深入探索，寻找最优的化疗方案及可能有效的靶向或免疫治疗方案。.