Song Yang, Liang Naixin, Li Shanqing
Department of Thoracic Surgery, Chinese Academy of Medical Sciences & Peking Union Medical Colledge Hospital, Beijing 100730, China.
School of Medicine, Tsinghua University, Beijing 100084, China.
Zhongguo Fei Ai Za Zhi. 2018 Mar 20;21(3):163-167. doi: 10.3779/j.issn.1009-3419.2018.03.07.
Due to emphasis on early screening for lung cancer, the detection rate of multiple ground glass opacities (GGOs) on computed tomography (CT) image increases in recent years, and research on multifocal adenocarcinomas presented by GGOs has been thriving. It is more common in women and non-smokers and has excellent prognosis both in patients with natural history and after surgery. These clinical features suggest that it is likely to be a distinct disease entity. From the perspective of molecular genetics, lesions in the same individual are likely to have distinct clonal features. Therefore, genetic heterogeneity is the most prominent feature of multifocal pulmonary adenocarcinomas with GGOs. The genetic heterogeneity is expected to assist the diagnosis of multifocal pulmonary adenocarcinoma and intrapulmonary metastasis, and also suggests that genetic testing of the GGO lesions is of great therapeutic significance. Some GGO lesions may harvest the similar clonal feature, which provide new evidence for the theory of spread through air spaces (STAS). .
由于对肺癌早期筛查的重视,近年来计算机断层扫描(CT)图像上多发磨玻璃影(GGO)的检出率有所增加,关于GGO呈现的多灶性腺癌的研究也蓬勃发展。它在女性和非吸烟者中更为常见,在自然病程患者和手术后均具有良好的预后。这些临床特征表明它可能是一种独特的疾病实体。从分子遗传学角度来看,同一个体中的病变可能具有不同的克隆特征。因此,基因异质性是伴有GGO的多灶性肺腺癌最突出的特征。这种基因异质性有望辅助多灶性肺腺癌的诊断及肺内转移的诊断,也表明对GGO病变进行基因检测具有重大的治疗意义。一些GGO病变可能具有相似的克隆特征,这为气腔播散(STAS)理论提供了新证据。