Histopathological and molecular study for synchronous lung adenocarcinoma staging

Donfrancesco, Elsa; Yvorel, Violaine; Casteillo, François; Stachowicz, Marie-Laure; Patoir, Arnaud; Tiffet, Olivier; Péoc’h, Michel; Forest, Fabien

doi:10.1007/s00428-019-02736-0

Cited by 15 publications

(18 citation statements)

References 18 publications

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“…According to the most recent 8th edition American Joint Committee on Cancer staging manual (AJCC staging manual) ( 8 ); i) two or more distinct and histologically different masses were considered MPLC; ii) multiple ground-glass or part-solid nodules, histologically of with lepidic growth pattern were considered MPLC and iii) multiple tumor nodules with the same histological type and/or with same molecular profile were considered IPM ( 6 , 7 ). Genomic alterations were commonly assessed using fluorescence in-situ hybridization and NGS ( 6 , 9 ). These criteria have emphasized the need for a combination of diagnostic approaches, including clinical, histopathological and molecular diagnoses.…”

Section: Introductionmentioning

confidence: 99%

“…Li et al ( 12 ), hypothesized that the mutational status of all multifocal tumors may aid the diagnosis and selection of the most effective treatment strategies. Donfrancesco et al ( 9 ), demonstrated that pathological criteria were less accurate compared with molecular criteria when staging MLC. However, pathological criteria can be used in conjunction with molecular analysis, although this method is not ideal as NGS is not available everywhere ( 9 ).…”

Section: Introductionmentioning

confidence: 99%

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Genetic features and application value of next generation sequencing in the diagnosis of synchronous multifocal lung adenocarcinoma

Chen

et al. 2020

Oncol Lett

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The present study aimed to elucidate the genetic features of multiple lung cancer (MLC) and identify effective molecular markers for diagnosis using next generation sequencing (NGS). The present data may also inform patient treatment and prognosis. A total of 35 lesions were obtained from 17 patients with MLC. Based on lesion histology and NGS, 13 cases of multiple primary lung cancer (MPLC) were identified and 4 cases were classified as intrapulmonary metastasis (IPM). All 4 patients with IPM exhibited an epidermal growth factor receptor (EGFR) mutation and synchronous mutation of at least one tumor suppressor gene. The frequency and percentage of EGFR mutations, accompanied with tumor suppressor genes, were significantly higher in patients with IPM compared with MPLC. Furthermore, a high EGFR-heterogeneity score and male sex were risk factors of IPM occurrence. There were significant differences in mean EGFR mutation abundance alone, mutations of tumor suppressor genes and mutations of EGFR combined with tumor suppressor genes between patients with adenocarcinoma (ADC) and adenocarcinoma in situ (AIS). In conclusion, histological characteristics combined with genetic alterations may be an effective method for the diagnosis of MPLC and IPM, and NGS may serve as a useful diagnostic tool. MLC exhibited unique molecular characteristics, including higher rates of EGFR mutations, EGFR driver mutations accompanied with tumor suppressor gene mutations and the absence of anaplastic lymphoma kinase mutations, which may help distinguish between patients with MPLC or IPM. The present study hypothesized that the mean frequency of EGFR mutations, mutations of tumor suppressor genes and mutations of both EGFR and tumor suppressor genes may serve an important role in the development of AIS to ADC. The results of the present study highlight the potential underlying mechanisms of lung ADC development, which may assist with future elucidation of effective treatments to prevent the progression of lung cancer.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Genetic features and application value of next generation sequencing in the diagnosis of synchronous multifocal lung adenocarcinoma

Chen

et al. 2020

Oncol Lett

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“…Subsequently, NGS screening from 20 to 468 cancer-related genes was applied to identify MPLCs. [52][53][54][55][56][57][58] Seven small studies enrolled a total of 237 patients (range, 11 to 60) and compared the diagnostic efficacy and robustness of the molecular classification with the different histological classifications (Table 2). Overall, NGS provides better discrimination than the clinicopathological classification because it is able to classify more indefinite cases, indicating the importance of NGS.…”

Section: Molecular Characteristicsmentioning

confidence: 99%

“…This study sequencing only 20 genes had no equivocal cases, in part because some indefinite cases sharing only one hotspot driver mutation were classified as IM. 55 In other studies, 53,54,[56][57][58] relationship of 95% of lung adenocarcinomas although the most appropriate detection number of genes remains unknown. Additionally, as shown in Table 2, the molecular classification by NGS conflicts with the histological classification in many cases, and to some extent compensates for the shortcomings of a histological classification.…”

Section: Molecular Characteristicsmentioning

confidence: 99%

“…In terms of the diagnostic approach using NGS, some studies sequencing about 50 genes proposed that multiple tumors were independent if they harbored different driver mutations, and were metastatic if they shared gene mutations for even just one common driver mutation. 52,53,55,57 The former could be interpreted by "trunk and branch" theory. 59,60 Early somatic events triggering oncogenesis are the "trunk" of the tumor, and are present at all tumor sites.…”

Section: Molecular Characteristicsmentioning

confidence: 99%

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<p>Multiple Primary Lung Cancers: A New Challenge in the Era of Precision Medicine</p>

Zhao¹,

Liu²,

Xie³

et al. 2020

CMAR

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With the widespread implementation of lung cancer screening, more and more patients are being diagnosed with multiple primary lung cancers (MPLCs). In the era of precision medicine, many controversies remain in differentiating MPLCs from intrapulmonary metastasis and the optimum treatment choice, especially in patients exhibiting similar histology. In this review, we summarize common diagnostic criteria and novel discrimination methods with a special emphasis on the emerging value of broad panel next-generation sequencing (NGS) for the diagnosis of MPLCs. We then discuss current advances regarding therapeutic approaches for MPLCs. Radical surgery is the main treatment modality, while stereotactic body radiotherapy (SBRT) is safe and feasible for early-stage MPLC patients with inoperable tumors. In addition, immunotherapy and targeted therapy, particularly epidermal growth factor receptor-tyrosine kinase inhibitors, are emerging therapeutic strategies that are still in their infancy. Characteristics of both genomic profiles and tumor microenvironment are currently being evaluated but warrant further exploration to facilitate the application of targeted systematic therapies in MPLC patients.

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Multiple primary lung cancer: Updates and perspectives

Wang,

Zhang,

Wang

et al. 2024

Intl Journal of Cancer

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Management of multiple primary lung cancer (MPLC) remains challenging, partly due to its increasing incidence, especially with the significant rise in cases of multiple lung nodules caused by low‐dose computed tomography screening. Moreover, the indefinite pathogenesis, diagnostic criteria, and treatment selection add to the complexity. In recent years, there have been continuous efforts to dissect the molecular characteristics of MPLC and explore new diagnostic approaches as well as treatment modalities, which will be reviewed here, with a focus on newly emerging evidence and future perspectives, hope to provide new insights into the management of MPLC and serve as inspiration for future research related to MPLC.

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Histopathological and molecular study for synchronous lung adenocarcinoma staging

Cited by 15 publications

References 18 publications

Genetic features and application value of next generation sequencing in the diagnosis of synchronous multifocal lung adenocarcinoma

Genetic features and application value of next generation sequencing in the diagnosis of synchronous multifocal lung adenocarcinoma

<p>Multiple Primary Lung Cancers: A New Challenge in the Era of Precision Medicine</p>

Multiple primary lung cancer: Updates and perspectives

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