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Deng H, Wang L, Li Z, Zhan T, Huang L. Optimal treatment strategies for hepatoid adenocarcinoma of the lung: insights from a comprehensive analysis. BMC Cancer 2024; 24:948. [PMID: 39095810 PMCID: PMC11297620 DOI: 10.1186/s12885-024-12682-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2024] [Accepted: 07/24/2024] [Indexed: 08/04/2024] Open
Abstract
BACKGROUND Hepatoid adenocarcinoma of the lung (HAL) is a distinctly uncommon subtype of lung adenocarcinoma (LAC), characterized by hepatoid features and an alarmingly low 5-year survival rate of approximately 8%. The scarcity of information on this condition has contributed to the absence of standardized treatment protocols, and the molecular underpinnings of its pathogenesis remain largely unexplored. To bridge these gaps, this study compiled data from 191 primary HAL patients to delineate treatment patterns, prognostic factors, and potential pathogenic mechanisms. METHODS This study was divided into two cohorts: cohort 1, comprising 110 patients extracted from the Surveillance, Epidemiology, and End Results (SEER) database, and cohort 2, consisting of 70 patients identified through a comprehensive literature review via the PubMed, Web of Science, and Scopus databases, in addition to 11 patients from Tongji Hospital. The Cox proportional hazards regression model was employed to identify independent prognostic factors. Kaplan-Meier survival curves were generated to assess the impact of treatment modalities centered around surgery and chemotherapy. Moreover, this study evaluated the efficacy of first-line treatment regimens and conducted Gene Ontology function and Kyoto Encyclopedia of Genes and Genomes pathway enrichment analyses on identified mutated genes. RESULTS The demographic and clinical profile of HAL patients typically comprises older individuals who are smokers, with a predisposition for diagnosis at advanced disease stages, culminating in a high mortality rate. Key prognostic indicators identified included disease stage, chemotherapy and surgical interventions. The study suggests a treatment strategy that advocates chemotherapy for patients with stage IV HAL and surgery for those with non-stage IV disease. The combination of paclitaxel and platinum-based chemotherapy emerged as an efficacious first-line treatment, with the integration of immunotherapy and targeted therapies showing potential benefits. Genetic analysis underscored similarities between HAL and LAC, particularly highlighting aberrant kinase activity (serine, threonine, and tyrosine) and the activation of PI3K-Akt and MAPK signaling pathways as contributing factors to HAL pathogenesis. CONCLUSION Despite its relatively rare occurrence, this study underscores the significance of treatment strategies and concludes probable prognostic factors. Due to limited reports, a deeper understanding of the molecular mechanisms driving tumorigenesis and progression in HAL is needed.
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Affiliation(s)
- Huijing Deng
- Department of Oncology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, No. 13, Aviation Road, Wuhan, Hubei Province, 430030, China
- The Second Clinical Medical College, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei Province, 430000, China
| | - Luyao Wang
- Department of Oncology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, No. 13, Aviation Road, Wuhan, Hubei Province, 430030, China
| | - Zewei Li
- Department of Oncology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, No. 13, Aviation Road, Wuhan, Hubei Province, 430030, China
- The Second Clinical Medical College, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei Province, 430000, China
| | - Tao Zhan
- Department of Oncology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, No. 13, Aviation Road, Wuhan, Hubei Province, 430030, China
- The Second Clinical Medical College, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei Province, 430000, China
| | - Liu Huang
- Department of Oncology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, No. 13, Aviation Road, Wuhan, Hubei Province, 430030, China.
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Huang X, Tan H, Zhou J, Wang Z. Hepatoid Adenocarcinoma of the Esophagus with Thyroid Metastasis: A Case Report. Laryngoscope 2024; 134:3673-3676. [PMID: 38591893 DOI: 10.1002/lary.31384] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2023] [Accepted: 02/12/2024] [Indexed: 04/10/2024]
Abstract
Rare hepatoid adenocarcinomas are highly heterogeneous. In this case, hepatoid adenocarcinoma occurred in both the esophagus and thyroid, and the combination of chemotherapy and immunotherapy may be a promising therapeutic tool for rare tumors. Laryngoscope, 134:3673-3676, 2024.
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Affiliation(s)
- Xin Huang
- Department of Otorhinolaryngology Head and Neck Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Haoyue Tan
- Department of Otorhinolaryngology Head and Neck Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Jieyu Zhou
- Department of Otorhinolaryngology Head and Neck Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Zhentao Wang
- Department of Otorhinolaryngology Head and Neck Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
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Sun X, Liu J, Hu T, Wu Y, Zhang H. A rare case of hepatoid adenocarcinoma of the lung. THE CLINICAL RESPIRATORY JOURNAL 2023; 17:1368-1371. [PMID: 38071759 PMCID: PMC10730454 DOI: 10.1111/crj.13724] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/27/2023] [Revised: 11/12/2023] [Accepted: 11/19/2023] [Indexed: 12/21/2023]
Abstract
Hepatoid adenocarcinoma of the lung is a special type of primary origin in the lung with obvious pathological features and short survival time. However, standard treatment guidelines have not yet been established. Herein, we report a case of hepatoid adenocarcinoma with the primary lesion located in the left upper lung. The tumour size was reduced after four cycles of combined therapy. Subsequent postoperative pathology confirmed complete remission.
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Affiliation(s)
- Xuejian Sun
- The First Clinical Medical College of Lanzhou UniversityLanzhouChina
- Department of Radiologythe First Hospital of Lanzhou UniversityLanzhouChina
| | - Jialin Liu
- The First Clinical Medical College of Lanzhou UniversityLanzhouChina
- Department of Radiologythe First Hospital of Lanzhou UniversityLanzhouChina
| | - Ting Hu
- The First Clinical Medical College of Lanzhou UniversityLanzhouChina
- Department of Radiologythe First Hospital of Lanzhou UniversityLanzhouChina
| | - Yefan Wu
- The First Clinical Medical College of Lanzhou UniversityLanzhouChina
- Department of Radiologythe First Hospital of Lanzhou UniversityLanzhouChina
| | - Hao Zhang
- The First Clinical Medical College of Lanzhou UniversityLanzhouChina
- Department of Radiologythe First Hospital of Lanzhou UniversityLanzhouChina
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