Germline Predisposition and Copy Number Alteration in Pre-stage Lung Adenocarcinomas Presenting as Ground-Glass Nodules

Conclusion: Our data suggests that the precancerous unstable CNVs with potentially predisposing genetic backgrounds may foster the onset of driver mutations and the development of independent SM-GGNs during the local stimulation of mutagens. Introduction The widespread use of advanced chest computed tomography (CT) for lung cancer screening has facilitated the detection of ground-glass nodules (GGNs) (1–3). Recent data indicates that up to 20% of GGN patients (3% of the screening population) are diagnosed with synchronous multiple ground-glass nodules (SM-GGNs) (4). GGNs are like atypical adenomatous hyperplasia (AAH), adenocarcinoma in situ (AIS), minimally invasive adenocarcinoma (MIA), or invasive adenocarcinoma (AD) (5). To date, neither auxiliary tests that can assist in the differential diagnosis (6) nor recommended strategies for the identification and treatment of GGNs exist in clinical practice guidelines for lung cancer. In fact, a major clinical challenge is to distinguish between independent synchronous multiple primary lung cancer (SMPLC) and intrapulmonary metastasis, which makes a treatment decision difficult. Thus, molecular characterization of GGNs may provide insight into the genetic drivers of synchronous multiple tumors and identify inter-tumor heterogeneity (7–9). Although SM-GGNs appear within the same environmental and genetic background as GGNs, SM-GGNs may comprise of a complex combination of different gene alterations and disti...
Source: Frontiers in Oncology - Category: Cancer & Oncology Source Type: research