靶向治疗致肺原发性腺癌转移至小肠，合并穿孔伴脓肿1例

A Case of Primary Lung Adenocarcinoma Metastasized to the Small Intestine with Perforation and Abscess Formation Following Targeted Therapy

摘要: 肺癌作为全球范围内发病率和死亡率居首的恶性肿瘤，其转移机制及治疗策略仍是临床研究重点。尽管现代诊疗技术的进步显著提升了肺癌患者的生存率，但胃肠道转移因其生物学特性复杂、早期症状隐匿及诊疗难度大，导致多数患者确诊时已进展至晚期，预后不良。广西中医药大学附属国际壮医医院收治的1例肺腺癌小肠转移并发穿孔及脓肿形成的特殊病例，其临床特征显示可能与应用新型抗肿瘤药物注射用SHR-A1921联合阿得贝利单抗的临床试验存在相关性，此类药物相关并发症在国内外文献报道中极为罕见。本研究通过系统回顾相关文献，结合该病例的临床诊疗过程，重点探讨肺腺癌胃肠道转移的病理特征、药物相关并发症的发生机制及多学科诊疗策略，以期为临床实践提供参考依据。

Abstract: Lung cancer remains the most common and deadliest malignancy worldwide, and its mechanisms of metastasis and therapeutic strategies continue to be a focal point of clinical research. Although advances in modern diagnostics and treatment have markedly improved patient survival, gastrointestinal metastasis—owing to its complex biology, subtle early symptoms, and diagnostic challenges—often goes undetected until advanced stages, resulting in poor prognosis. The International Zhuang Medicine Hospital affiliated with Guangxi University of Chinese Medicine diagnosed a case of small intestine metastasis with perforation and abscess formation from lung adenocarcinoma, which may have been caused by complications related to the clinical trial drug SHR-A1921 injection combined with adebrelimab. Reports of drug-related complications of this kind are exceedingly rare in the literature worldwide. By systematically reviewing the pertinent publications and integrating the clinical management of the present case, this study focuses on the pathological features of gastrointestinal metastasis from lung adenocarcinoma, the underlying mechanisms of drug-related complications, and a multidisciplinary treatment strategy, aiming to provide an evidence base for clinical practice.