Lunardi Francesca, Nardo Giorgia, Lazzarini Elisabetta, Tzorakoleftheraki Sofia-Eleni, Comacchio Giovanni Maria, Fonzi Eugenio, Tebaldi Michela, Vedovelli Luca, Pezzuto Federica, Fortarezza Francesco, Schiavon Marco, Rea Federico, Indraccolo Stefano, Calabrese Fiorella
Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padova, 35128 Padova, Italy.
Basic and Translational Oncology Unit, Istituto Oncologico Veneto IOV-IRCCS, 35128 Padova, Italy.
J Pers Med. 2024 Aug 8;14(8):839. doi: 10.3390/jpm14080839.
Chronic Obstructive Pulmonary Disease (COPD) and lung cancer are strictly related. To date, it is unknown if COPD-associated cancers are different from the tumors of non-COPD patients. The main goal of the study was to compare the morphological/molecular profiles of lung adenocarcinoma (LUAD) samples of COPD, non-COPD/smokers and non-COPD/non-smokers, and to investigate if a genetic instability also characterized non-pathological areas. This study included 110 patients undergoing surgery for a LUAD, divided into three groups: COPD/smoker LUAD (38), non-COPD/smoker LUAD (54) and non-COPD/non-smoker LUAD (18). The tissue samples were systemically evaluated by pathologists and analyzed using a 30-gene Next Generation Sequencing (NGS) panel. In a subset of patients, tissues taken far from the neoplasia were also included. The non-COPD/smoker LUAD were characterized by a higher proliferative index ( = 0.001), while the non-COPD/non-smoker LUAD showed higher percentages of lepidic pattern ( = 0.008), lower necrosis, higher fibrosis, and a significantly lower mutation rate in the and genes. Interestingly, the same gene mutations were found in pathological and normal areas exclusively in the COPD/smokers and non-COPD/smokers. COPD/smoker LUAD seem to be similar to non-COPD/smoker LUAD, particularly for the genetic background. A less aggressive cancer phenotype was confirmed in non-COPD/non-smokers. The genetic alterations detected in normal lungs from smokers with and without COPD reinforce the importance of screening to detect early neoplastic lesions.
慢性阻塞性肺疾病（COPD）与肺癌密切相关。迄今为止，尚不清楚COPD相关癌症是否与非COPD患者的肿瘤不同。该研究的主要目的是比较COPD患者、非COPD吸烟者和非COPD非吸烟者的肺腺癌（LUAD）样本的形态学/分子特征，并研究遗传不稳定性是否也表现在非病变区域。本研究纳入了110例行LUAD手术的患者，分为三组：COPD吸烟者LUAD（38例）、非COPD吸烟者LUAD（54例）和非COPD非吸烟者LUAD（18例）。组织样本由病理学家进行系统评估，并使用30基因下一代测序（NGS）面板进行分析。在一部分患者中，还纳入了取自远离肿瘤部位的组织。非COPD吸烟者LUAD的增殖指数较高（ = 0.001），而非COPD非吸烟者LUAD的鳞屑样模式百分比更高（ = 0.008），坏死率更低，纤维化程度更高，并且 和 基因的突变率显著更低。有趣的是，仅在COPD吸烟者和非COPD吸烟者的病理和正常区域发现了相同的基因突变。COPD吸烟者LUAD似乎与非COPD吸烟者LUAD相似，尤其是在遗传背景方面。在非COPD非吸烟者中证实了侵袭性较低的癌症表型。在有和没有COPD的吸烟者的正常肺中检测到的基因改变强化了筛查以检测早期肿瘤病变的重要性。
