What did she do to overcome abdominal metastasis after lung cancer surgery and achieve stable disease without recurrence?

时间：2026-04-16　人气：

Ms. Wang experienced recurrent coughing and shortness of breath in September 2020. She reported a significant increase in tumor marker CA199 in November 2020. On November 3, 2020, a tracheoscopy was performed to obtain a biopsy, which indicated "left lower lobe basal branch" suspected to be non-small cell carcinoma.

On November 17, 2020, a radical resection of lung cancer, pleural adhesion release, and intercostal nerve block were performed. Postoperative pathology: "left lower lobe and tumor" malignant tumor, suspected to be intestinal adenocarcinoma; intravascular cancer thrombus was observed. Lymph node metastatic adenocarcinoma: "Group 4 lymph nodes" (0/1), "Group 5 lymph nodes" (0/1), "Group 7 lymph nodes" (0/3), "Group 9 lymph nodes" (0/2), "Group 10 lymph nodes" (1/2), "Group 11 lymph nodes" (0/2). Immunohistochemistry: TTF-1 (-), NapsinA (main body -, a small number of cells +), CK5/6 (-), P63 (-), ALK (D5F3) (-), ALK (D5F3) Neg (negative control) (-), TRK (-). From December 2020 to March 2021, four courses of chemotherapy were administered.

On July 1, 2022, a thoracoabdominal CT scan revealed multiple enlarged lymph nodes on the lesser curvature of the stomach and in the retroperitoneum, with the most prominent node located at the lesser curvature of the stomach (approximately 17x12mm in size), showing enlargement compared to previous scans and the presence of necrotic areas, likely due to metastasis.

On July 15, 2022, a laparotomy, right hemicolectomy, para-aortic lymph node dissection, and splenic hilum lymph node dissection were performed. Postoperative pathology: (Group 1, 3, 7 lymph nodes) lymph node metastatic adenocarcinoma (1/5), please refer to clinical history. Immunohistochemical results: cancer cells CK7(+), CK20(focal+), CDX2(partially+), SATB2(-), MUC-2(-), TTF-1(-), NapsinA(-). (Splenic hilum lymph nodes) no cancer found in lymph nodes (0/1). (Paraaortic lymph nodes) metastatic adenocarcinoma in lymph nodes (1/1).

A mass in the ileocecal junction was examined, and a large amount of mucus was found in the intestinal wall tissue. Numerous capillaries were observed within the mucus, and there was a significant infiltration of inflammatory cells accompanied by a granulation tissue response around the mucus. Focal areas were covered by atypical glandular epithelium, consistent with a low-grade appendiceal mucinous tumor, with the lesion located at the opening of the appendix. Immunohistochemical results: tumor cells CerbB2 (approximately 10%, moderately positive), CK7 (focal+), CK20 (+), CDX2 (+), MLH1 (+), PMS2 (+), MSH2 (+), MSH6 (+), SATB2 (+), NapsinA (-), TTF-1 (-), Ki-67 (approximately 30%+).

Early Signs of Lung Cancer
First, persistent cough that does not resolve: If someone experiences a stubborn, irritating, dry cough that does not improve after antibiotic treatment, it should be taken seriously. If the cough is accompanied by wheezing in the throat, shortness of breath, chest tightness, or a large amount of foamy phlegm, it should be highly regarded.
Second, chest pain: Relevant research shows that a high proportion of patients with lung cancer, especially those with peripheral lung cancer, experience chest pain as their initial symptom, which can reach up to 50%.
Third, joint pain: During the proliferation and differentiation process, lung cancer cells can affect the secretion of growth hormones, stimulating bone joints to proliferate, leading to joint pain, swelling, and other symptoms.
Fourth, shoulder and back pain: Peripheral lung cancer often erodes the pleura of patients and affects the chest wall tissue and ribs, causing shoulder and back pain.
Fifth, clubbed fingers: The characteristic of clubbed fingers is that the first phalanx of the fingers and toes is relatively hypertrophic, and the nails are protruding and curved, often accompanied by pain.
Sixth, hoarseness: When lung cancer metastasis compresses the laryngeal nerves, it can lead to paralysis of the vocal cord's single plate muscle, resulting in hoarseness.
Polymyositis is a common manifestation in the early stages of lung cancer: Polymyositis is also one of the common clinical manifestations in the early stages of lung cancer. Before developing typical clinical symptoms, most lung cancer patients only experience symptoms such as appetite loss and progressive generalized muscle weakness.
Source: Wang Dingjun. Persistent Cough Should Be Investigated for Lung Cancer as Early as Possible [J]. Family Life Guide, 2023, 39(09):154-155.

Ms. Wang developed abdominal metastasis one and a half years after surgery. A laparotomy was performed to remove the metastatic tumor, and this major surgery took a heavy toll on Ms. Wang, who is 60 years old. If metastasis were to occur again, she would not be able to withstand the surgical trauma. To prevent tumor recurrence, after extensive research, Ms. Wang's family sought the help of Professor Zhang Minghui's vNKT treatment team at Tsinghua University School of Medicine. After carefully reviewing the case presentations of vNKT cell therapy, they were particularly eager to try it to slow down tumor progression.

After carefully reviewing Ms. Wang's medical records, Professor Zhang Minghui made the following analysis and judgment:

1. Pathological examination after radical resection of lung cancer revealed: The presence of vascular and lymph node metastasis, with cancer cells having entered the bloodstream and lymph nodes.

2. Post-abdominal exploratory laparotomy, pathology indicated lymph node metastasis, increasing the risk of recurrence and metastasis.

3. vNKT therapy utilizes powerful immune cells to eliminate tumor cells that may remain undetected in the body, with essentially no side effects. Combined with vNKT cell therapy after surgical treatment, it can effectively reduce the incidence of tumor recurrence.

CEA: elevated on June 13, 2022, and normal during follow-up from July 4, 2022, to September 14, 2023;

CYFRA 21-1: elevated from June 2022 to December 2022 but showed a decreasing trend;

AFP, CA199, NSE: normal from July 4, 2022, to September 14, 2023;

CA125: normal from June 2022 to July 4, 2022, elevated on July 28, 2022, considered related to surgery, and normal during follow-up from October 12, 2022, to September 14, 2023;

SSC: Normal in June 2022, no follow-up thereafter;

PROGRP: Normal from June 13, 2022, to December 14, 2022;

CA724: Normal on July 14, 2022, but increased during follow-up from July 28, 2022, to October 12, 2022, with a decreasing trend.

In recent years, the incidence rate and mortality of primary lung cancer have been continuously rising. According to data published by the World Health Organization in 2020, there were 2.2 million new cases of lung cancer and 1.8 million deaths, making it the second most common cancer in 2020 and the leading cause of cancer deaths, accounting for approximately one-tenth (11.4%) of diagnosed cancers and one-fifth (18.0%) of deaths. ^[1^]. Lung cancer also poses a serious threat to the health of our nation's citizens, with an estimated number of new cases exceeding 1 million annually in China by 2025.

Lymph node metastasis is the most common mode of metastasis in lung cancer and an important factor affecting patient staging and prognosis ^[2^]. Firstly, the primary tumor continues to expand, generating new lymphatic vessels, and then malignant tumor cells use these lymph nodes to invade local lymph nodes, causing metastasis to other sites.

Ms. Wang's lymph node metastasis and vascular cancer thrombus after her first surgery are risk factors for her second metastasis. vNKT cell therapy is a relatively effective treatment method, which clears residual cancer cells in the body and enhances the patient's immunity, playing an important role in the patient's own disease treatment intervention. Ms. Wang began vNKT cell therapy on October 3, 2022. The first-stage treatment plan: 1 course per month, and she has completed 12 courses (as of September 6, 2023). Through 12 consecutive courses of systematic treatment, her condition is currently stable, with no new space-occupying lesions.

References:

[1] Sung H, Ferlay J, Siegel RL, Laversanne M, Soerjomataram I, Jemal A, Bray F. Global Cancer Statistics 2020: GLOBOCAN Estimates of Incidence and Mortality Worldwide for 36 Cancers in 185 Countries. CACancer J Clin, 2021, 71(3):209-249.

[8] Dezube AR, Jaklitsch MT. Minimizing residual occult nodal metastases in NSCLC: recent advances, current status and controversies. Expert Rev Anticancer Ther, 2020, 20(2):117-130.

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