Lv Xiaodi, Mao Zixian, Sun Xianjun, Liu Baojun
Department of Integrative Medicine, Huashan Hospital, Fudan University, Shanghai 200437, China.
Pujiang Community Health Center of Minhang District of Shanghai, Shanghai 201114, China.
Cancers (Basel). 2023 May 11;15(10):2709. doi: 10.3390/cancers15102709.
The diagnosis and treatment of lung cancer (LC) is always a challenge. The difficulty in the decision of therapeutic schedule and diagnosis is directly related to intratumoral heterogeneity (ITH) in the progression of LC. It has been proven that most tumors emerge and evolve under the pressure of their living microenvironment, which involves genetic, immunological, metabolic, and therapeutic components. While most research on ITH revealed multiple mechanisms and characteristic, a systemic exposition of ITH in LC is still hard to find. In this review, we describe how ITH in LC develops from the perspective of space and time. We discuss elaborate details and affection of every aspect of ITH in LC and the relationship between them. Based on ITH in LC, we describe a more accurate multidisciplinary therapeutic strategy on LC and provide the newest opinion on the potential approach of LC therapy.
肺癌(LC)的诊断和治疗一直是一项挑战。治疗方案决策和诊断的困难与肺癌进展过程中的肿瘤内异质性(ITH)直接相关。事实证明,大多数肿瘤是在其生存微环境的压力下出现和演变的,这种微环境涉及遗传、免疫、代谢和治疗等方面。虽然大多数关于ITH的研究揭示了多种机制和特征,但仍难以找到对肺癌ITH的系统性阐述。在本综述中,我们从空间和时间的角度描述了肺癌ITH是如何发展的。我们详细讨论了肺癌ITH各方面的细节、影响及其相互关系。基于肺癌ITH,我们描述了一种更精确的肺癌多学科治疗策略,并提供了关于肺癌治疗潜在方法的最新观点。