Keith R L, Miller Y E, Ghosh M, Franklin Wilbur A, Nakachi I, Merrick D T
Division of Pulmonary Sciences and Critical Care Medicine, Rocky Mountain Regional Veterans Affairs Medical Center, Aurora, CO; Division of Pulmonary Sciences and Critical Care Medicine, University of Colorado, Anschutz Medical Campus, Aurora, CO.
Division of Pulmonary Sciences and Critical Care Medicine, Rocky Mountain Regional Veterans Affairs Medical Center, Aurora, CO; Division of Pulmonary Sciences and Critical Care Medicine, University of Colorado, Anschutz Medical Campus, Aurora, CO.
Semin Oncol. 2022 Jun;49(3-4):254-260. doi: 10.1053/j.seminoncol.2022.02.001. Epub 2022 Feb 27.
Lung cancer (both adenocarcinoma and squamous cell) progress through a series of pre-malignant histologic changes before the development of invasive disease. Each of these carcinogenic cascades is defined by genetic and epigenetic alterations in pulmonary epithelial cells. Additionally, alterations in the immune response, progenitor cell function, mutational burden, and microenvironmental mediated survival of mutated clones contribute to the risk of pre-malignant lesions progressing to cancer. Medical preventions studies have been completed and current and future trials are informed by the improved understanding of pre-malignancy. This will lead to precision chemoprevention trials based on lesional biology and histologic characteristics.
肺癌（腺癌和鳞状细胞癌）在发展为浸润性疾病之前会经历一系列癌前组织学变化。这些致癌级联反应中的每一个都由肺上皮细胞的基因和表观遗传改变所定义。此外，免疫反应、祖细胞功能、突变负担以及微环境介导的突变克隆存活的改变，都增加了癌前病变发展为癌症的风险。医学预防研究已经完成，并且基于对癌前病变的进一步了解，正在开展当前和未来的试验。这将促成基于病变生物学和组织学特征的精准化学预防试验。
