Mornex J F, Thivolet F, De las Heras M, Leroux C
Université Claude Bernard, UMR 754 UCB-INRA-ENVL, 50 Avenue Tony Garnier, 69366 Lyon, France.
Curr Top Microbiol Immunol. 2003;275:225-48. doi: 10.1007/978-3-642-55638-8_9.
Lung cancer is a leading cause of cancer with a poor prognosis. Bronchioloalveolar carcinoma (BAC) is a rare tumor that has always intrigued physicians. Since the last World Health Organization classification the pathology has been clarified; BAC per se is an adenocarcinoma with a pure bronchioloalveolar growth pattern and appears as an in situ alveolar adenocarcinoma. More usually BAC is a clinically recognizable entity presenting as multi-focal nodules evolving towards pneumonia associated with pulmonary shunting. Pathology is that of a multifocal mixed adenocarcinoma: bronchioloalveolar and papillar. Whatever the stage, survival is better than in other forms of non-small cell lung cancer (NSCLC). The true frequency of BAC is unknown, although it is a rare form of lung cancer; smoking cannot be excluded as a risk factor. It appears that p53 and ras genes are less often mutated than in other lung adenocarcinomas, suggesting that the cellular mechanisms involved are different. Ovine pulmonary adenocarcinoma (OPA) presents with the same symptoms as BAC in humans and is caused by a betaretrovirus Jaagsiekte sheep retrovirus. Very early on, clinical and histological similarities with human BAC were stressed. A recent series of OPA described, according to the third edition of the WHO classification for human lung cancer, mixed adenocarcinoma, BAC and papillary and/or acinar carcinoma. An immunohistochemical study suggested that some human pulmonary tumors (including BAC) may be associated with a Jaagsiekte sheep retrovirus-related retrovirus,but so far no molecular study has confirmed this observation. Thus, OPA is an exquisite model of carcinogenesis for human lung adenocarcinomas.
肺癌是一种预后较差的主要癌症类型。细支气管肺泡癌（BAC）是一种一直吸引着医生的罕见肿瘤。自上一版世界卫生组织分类以来，其病理已得到明确；BAC本身是一种具有纯细支气管肺泡生长模式的腺癌，表现为原位肺泡腺癌。更常见的情况是，BAC是一种临床上可识别的实体，表现为多灶性结节，逐渐发展为与肺分流相关的肺炎。病理表现为多灶性混合腺癌：细支气管肺泡型和乳头型。无论处于何种阶段，其生存率都优于其他形式的非小细胞肺癌（NSCLC）。BAC的真实发病率尚不清楚，尽管它是一种罕见的肺癌形式；不能排除吸烟作为风险因素。似乎p53和ras基因的突变频率低于其他肺腺癌，这表明所涉及的细胞机制不同。绵羊肺腺癌（OPA）在人类中表现出与BAC相同的症状，由β逆转录病毒雅司病绵羊逆转录病毒引起。很早以前，就有人强调其与人类BAC在临床和组织学上的相似性。最近一系列关于OPA的研究，根据世界卫生组织人类肺癌分类第三版，描述了混合腺癌、BAC以及乳头和/或腺泡癌。一项免疫组化研究表明，一些人类肺部肿瘤（包括BAC）可能与一种与雅司病绵羊逆转录病毒相关的逆转录病毒有关，但迄今为止尚无分子研究证实这一观察结果。因此，OPA是人类肺腺癌致癌作用的一个绝佳模型。
