British Columbia Cancer Research Centre, Vancouver, BC, V5Z 1L3, Canada; Department of Integrative Oncology, BC Cancer Research Center, Canada.
Lung Cancer. 2013 Nov;82(2):179-89. doi: 10.1016/j.lungcan.2013.07.025. Epub 2013 Aug 20.
Lung cancer is the leading cause of cancer death worldwide, accounting for more deaths than breast, prostate and colon cancer combined. While treatment decisions are determined primarily by stage, therapeutically non small cell lung cancer (NSCLC) has traditionally been treated as a single disease. However, recent findings have led to the recognition of histology and molecular subtypes as important determinants in treatment selection. Identifying the genetic differences that define these molecular and histological subtypes has the potential to impact treatment and as such is currently the focus of much research. Microarray and genomic sequencing efforts have provided unparalleled insight into the genomes of lung cancer subtypes, specifically adenocarcinoma (AC) and squamous cell carcinoma (SqCC), revealing subtype specific genomic alterations and molecular subtypes as well as differences in cell signaling pathways. In this review, we discuss the recurrent genomic alterations characteristic of AC and SqCC (including molecular subtypes), their therapeutic implications and emerging clinical practices aimed at tailoring treatments based on a tumor's molecular alterations with the hope of improving patient response and survival.
肺癌是全球癌症死亡的主要原因，其死亡率超过了乳腺癌、前列腺癌和结肠癌的总和。虽然治疗决策主要取决于肺癌的分期，但非小细胞肺癌（NSCLC）的治疗传统上被视为一种单一疾病。然而，最近的发现导致人们认识到组织学和分子亚型是治疗选择的重要决定因素。确定定义这些分子和组织学亚型的遗传差异有可能影响治疗，因此目前是许多研究的重点。微阵列和基因组测序工作为肺腺癌（AC）和鳞状细胞癌（SqCC）等肺癌亚型的基因组提供了前所未有的深入了解，揭示了特定于亚型的基因组改变和分子亚型以及细胞信号通路的差异。在这篇综述中，我们讨论了 AC 和 SqCC（包括分子亚型）的特征性复发基因组改变，及其治疗意义和新兴的临床实践，旨在根据肿瘤的分子改变来定制治疗，以期提高患者的反应和生存。
