Institute of Anatomical and Molecular Pathology, Faculty of Medicine, University of Coimbra, Coimbra, Portugal.
CIMAGO - Research Center for Environment, Genetics and Oncobiology, Faculty of Medicine, University of Coimbra, Coimbra, Portugal.
Pathobiology. 2018;85(1-2):96-107. doi: 10.1159/000487440. Epub 2018 Apr 10.
Lung cancer diagnosis is a challenge since it is also one of the most frequently diagnosed cancers. Diagnostic challenges are deeply related to the development of personalized therapy and molecular and precise histological characterizations of lung cancer. When addressing these features, it is very important to acknowledge the issue of tumour heterogeneity, as it imposes several questions. First of all, lung cancer is a very heterogeneous disease, at a cellular and histological level. Cellular and histological heterogeneity are addressed with emphasis on the diagnosis, pre-neoplastic lesions, and cell origin, trying to contribute to a better knowledge of carcinogenesis. Molecular intra-tumour and inter-tumour heterogeneity are also addressed as temporal heterogeneity. Lung cancer heterogeneity has implications in pathogenesis understanding, diagnosis, selection of tissue for molecular diagnosis, as well as therapeutic decision. The understanding of tumour heterogeneity is crucial and we must be aware of the implications and future developments regarding this field.
肺癌的诊断具有挑战性，因为它也是最常见的癌症之一。诊断方面的挑战与个性化治疗的发展以及肺癌的分子和精确组织学特征密切相关。在解决这些特征时，必须承认肿瘤异质性的问题，因为它提出了几个问题。首先，肺癌在细胞和组织学水平上是一种非常异质性的疾病。细胞和组织学的异质性在诊断、癌前病变和细胞起源方面得到了强调，试图为肿瘤发生学提供更好的认识。分子肿瘤内和肿瘤间的异质性也被视为时间异质性。肺癌的异质性对发病机制的理解、诊断、分子诊断组织的选择以及治疗决策都有影响。对肿瘤异质性的理解至关重要，我们必须意识到这一领域的影响和未来的发展。
