A Case Research Of Multiple Squamous-cell Carcinomas Secondary To Hematopoietic Stem-cell Transplantation After Leukemia

We are aware of only a few studies about solid cancers after allogeneic hematopoietic stem-cell transplantation (Allo-HSCT) in which some risks have been shown though with unclearly pathogenesis. In our study of the special case that multiple primary squamous carcinomas after Allo-HSCT, we discuss the characteristics of the patient's history, clinical diagnosis and treatment. At the same time, some relevant experiment detections were performed.Purpose: To found the main causes of the patient's multiple primary squamous carcinomas and offer reference to the diagnosis and treatment of similar cases in future.Content and methods:Detecting gene mutation of free cancer cell on P53, EGFR, KRAS and BRAF in blood with DHPLC technique. Sequencing gene P53, EGFR, KRAS, BRAF and identifying five accepted micro-satellite sites in paraffin-embeded tumor samples. Examining the level of P53 and EGFR protein expression in tumor tissue through immunohistochemistry (IHC) method. Using Flow Cytometer (FCM) to detect T-lymphocyte subsets with patient's peripherial blood.Results:P53 gene mutation was found for the patient, but other significant gene mutation was not found in neither blood nor tumor samples, while IHC for EGFR and P53 protein showed high-level expression in all tumor tissues. Almost all tissues presented lower or higher MSI. And the analysis of T-lymphocyte subsets indicated that the patient's immunologic function was weak.Conclusion:P53 mutation may be the main cause of the tumors, and EGFR protein expressed high-level, which lead to the activation of MAPK pathway rose may play an important part in the tumors, MSI (+) in tissue after Allo-HSCT indicated that the genome of the patient's was instable, which lay the foundation for gene mutation.