With the rapid development of immunotherapy, the efficacy and feasibility of neoadjuvant immunotherapy for early resectable non-small-cell lung cancer (NSCLC) has been demonstrated. However, there are still difficulties and controversies in evaluating the efficacy of neoadjuvant immunotherapy. In our report, we described a 43-year-old female patient who was diagnosed with stage IIIA (cT1N2M0) pulmonary adenocarcinoma. After two cycles of neoadjuvant immunotherapy (sintilimab) combined with chemotherapy, according to imaging evaluation, the efficacy of the primary lesion was evaluated as stable disease and the mediastinal lymph nodes were evaluated as partial response. However, the postoperative pathological evaluation showed the primary lesion was pathological complete response and the mediastinal lymph nodes were major pathological response. This indicated that neoadjuvant chemo-immunotherapy was effective for both primary and mediastinal lymph nodes, but regression of the lesions was not synchronous. This study provided a complete process of neoadjuvant treatment, illustrating the effectiveness and safety of neoadjuvant chemo-immunotherapy to a certain extent. It is also suggested that the evaluation of neoadjuvant immunotherapy should be combined with imaging and pathology, and the primary tumor and lymph nodes should be evaluated, respectively.

中文翻译：

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IIIA 期非小细胞肺癌患者新辅助免疫治疗加化疗后原发肿瘤和纵隔淋巴结反应的异步性：病例报告。

随着免疫治疗的快速发展，新辅助免疫治疗治疗早期可切除非小细胞肺癌（NSCLC）的有效性和可行性已得到证实。然而，评估新辅助免疫治疗的疗效仍存在困难和争议。在我们的报告中，我们描述了一名 43 岁女性患者，她被诊断患有 IIIA 期 (cT1N2M0) 肺腺癌。新辅助免疫治疗（信迪利单抗）联合化疗两个周期后，根据影像学评价，原发病灶疗效评价为疾病稳定，纵隔淋巴结评价为部分缓解。但术后病理评估显示原发灶为病理完全缓解，纵隔淋巴结为主要病理缓解。这表明新辅助化疗免疫治疗对原发淋巴结和纵隔淋巴结均有效，但病灶消退并不同步。本研究提供了新辅助治疗的完整流程，在一定程度上说明了新辅助化疗免疫治疗的有效性和安全性。也建议新辅助免疫治疗的评估应结合影像学和病理学，分别评估原发肿瘤和淋巴结。