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已发表论文
高分化胎儿型肺腺癌中通过基因改变和 PD-L1 表达的演变：一例病例报告及文献综述
Authors Xu Y , Dai K, Chen W, Wu H, Lin P
Received 19 July 2025
Accepted for publication 13 November 2025
Published 3 December 2025 Volume 2025:18 Pages 1519—1526
DOI https://doi.org/10.2147/IMCRJ.S554848
Checked for plagiarism Yes
Review by Single anonymous peer review
Peer reviewer comments 2
Editor who approved publication: Professor Thomas E Hutson
YunQiu Xu, KangJian Dai, Wei Chen, Haifan Wu, Peifeng Lin
Department of Cardiothoracic Surgery, Ruian People’s Hospital, The Third Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, 325000, People’s Republic of China
Correspondence: Peifeng Lin, Email Linpeifeng1981@163.com
Background: Lung cancer, the most common malignancy in humans, can be classified into a wide range of subtypes and molecular variants. Fetal adenocarcinoma of the lung (FLAC) is an infrequent subtype of lung adenocarcinoma with distinct histological characteristics. However, its incidence is extremely low (0.1– 0.5% of primary lung cancers), and its biological features remain poorly understood. In the era of immunotherapy and targeted therapy, characterizing the genetic alterations of FLAC is essential for developing personalized treatment strategies and improving patient outcomes. Here, we report the genetic alterations and PD-L1 expression in a patient with high-grade FLAC (H-FLAC) and review the relevant literature, This is one of the few reported cases describing PD-L1 expression and TP53 mutation status in H-FLAC.
Case Manifestations: A 57-year-old man with a 30-year history of smoking presented to our hospital with persistent cough, sputum, and chest tightness for 30 years, which had worsened for 1 month. Computed tomography (CT) of the chest revealed an irregular nodule in the posterior segment of the upper lobe of the left lung. The patient underwent posterior resection of the left upper lung apex, and postoperative pathology suggested H-FLAC with a tumor stage of pT1N0M0.
Conclusion: This case study provides an opportunity to better understand H-FLAC, whose genetic alterations have not been well characterized, and to identify valuable molecular markers for potential targeted therapies. We conducted gene sequencing and PD-L1 expression testing, which are helpful for H-FLAC research.
Keywords: fetal adenocarcinoma of the lung, programmed death ligand-1, genetic variant, TP53
Department of Cardiothoracic Surgery, Ruian People’s Hospital, The Third Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, 325000, People’s Republic of China
Correspondence: Peifeng Lin, Email Linpeifeng1981@163.com
Background: Lung cancer, the most common malignancy in humans, can be classified into a wide range of subtypes and molecular variants. Fetal adenocarcinoma of the lung (FLAC) is an infrequent subtype of lung adenocarcinoma with distinct histological characteristics. However, its incidence is extremely low (0.1– 0.5% of primary lung cancers), and its biological features remain poorly understood. In the era of immunotherapy and targeted therapy, characterizing the genetic alterations of FLAC is essential for developing personalized treatment strategies and improving patient outcomes. Here, we report the genetic alterations and PD-L1 expression in a patient with high-grade FLAC (H-FLAC) and review the relevant literature, This is one of the few reported cases describing PD-L1 expression and TP53 mutation status in H-FLAC.
Case Manifestations: A 57-year-old man with a 30-year history of smoking presented to our hospital with persistent cough, sputum, and chest tightness for 30 years, which had worsened for 1 month. Computed tomography (CT) of the chest revealed an irregular nodule in the posterior segment of the upper lobe of the left lung. The patient underwent posterior resection of the left upper lung apex, and postoperative pathology suggested H-FLAC with a tumor stage of pT1N0M0.
Conclusion: This case study provides an opportunity to better understand H-FLAC, whose genetic alterations have not been well characterized, and to identify valuable molecular markers for potential targeted therapies. We conducted gene sequencing and PD-L1 expression testing, which are helpful for H-FLAC research.
Keywords: fetal adenocarcinoma of the lung, programmed death ligand-1, genetic variant, TP53