Fernandez-Cuesta Lynnette, McKay James D
Group of Genetic Cancer Susceptibility, Section of Genetics, International Agency for Research on Cancer (IARC-WHO), Lyon, France.
Curr Opin Oncol. 2016 Jan;28(1):52-7. doi: 10.1097/CCO.0000000000000251.
Lung cancer remains the most frequent cancer worldwide and the leading cause of cancer death in most countries. The molecular characteristics of lung tumors play an important role in clinical decisions, which ultimately affect patients' survival. This review aims to summarize the most recent genomic discoveries made on lung cancer.
A relatively comprehensive molecular characterization has been achieved for the three major types of lung cancer: adenocarcinoma, squamous-cell carcinoma, and small-cell carcinoma. Little is still known about large-cell neuroendocrine carcinoma and carcinoid tumors. A major finding has been the nonnegligible inter and intratumor heterogeneity of lung cancer and their impact in the clinical management of this disease.
The high load of mutations, the frequent inactivation of major tumor suppressor genes, and the huge heterogeneity of lung cancer tumors may complicate long-lasting therapeutic responses. The development of strategies for the early detection of lung cancer might translate into an increase of the number of surgical resectable tumors, and therefore contribute to improve the survival rate of these patients.
肺癌仍是全球最常见的癌症,也是大多数国家癌症死亡的主要原因。肺肿瘤的分子特征在临床决策中起着重要作用,最终影响患者的生存。本综述旨在总结肺癌方面最新的基因组学发现。
对于肺癌的三种主要类型——腺癌、鳞状细胞癌和小细胞癌,已经实现了相对全面的分子特征描述。对于大细胞神经内分泌癌和类癌,目前了解仍然较少。一个主要发现是肺癌存在不可忽视的肿瘤间和肿瘤内异质性,以及它们对该疾病临床管理的影响。
高突变负荷、主要肿瘤抑制基因的频繁失活以及肺癌肿瘤的巨大异质性可能使持久的治疗反应复杂化。肺癌早期检测策略的发展可能会增加可手术切除肿瘤的数量,从而有助于提高这些患者的生存率。