Molecular analysis of synchronous and metachronous tumors of the lung: impact on management and prognosis.
Molecular analysis of synchronous and metachronous tumors of the lung: impact on management and prognosis.
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DOI：
10.1053/adpa.2001.29338
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发表时间：
2001-12-01
影响因子：
2
通讯作者：
Jagirdar, J
中科院分区：
文献类型：
--
作者：
Huang, J;Behrens, C;Jagirdar, J
肺肿瘤患者在同一时间或不同时间发生第二肺肿瘤的风险增加。确定第二个肿瘤是独立的原发肿瘤（即同步或异时性肿瘤，取决于它是在同一时间出现还是在更晚的时间出现）还是复发/转移是很重要的，因为它将显著改变治疗和预后。由于同一患者的两个肿瘤在形态上往往相似，仅凭组织学检查可能不足以区分这两种可能性。我们试图通过显微解剖恶性细胞和比较配对肿瘤之间多基因和染色体位点杂合性丧失的模式来解决这个问题。我们发现原发性肺肿瘤及其转移瘤具有几乎相同的杂合性丧失模式。相比之下，根据目前的任意标准，大多数同步和异时性肿瘤在基因上似乎是不同的；因此，它们可能代表独立的原发肿瘤。罕见的同步肿瘤具有相似的基因谱，增加了复发/转移的可能性。我们的数据表明，分子分析可以帮助指纹肿瘤，并有可能显著影响患者的管理和预后。
Patients with pulmonary neoplasms have an increased risk for developing a second tumor of the lung, either at the same time or different times. It is important to determine if the second tumor represents an independent primary tumor (ie, a synchronous or a metachronous tumor, depending on whether it is present at the same time or a later time) or recurrence/metastasis, because it will significantly change the management and prognosis. Because the two tumors from the same patient are often morphologically similar, histologic examination alone may not be sufficient to distinguish between the two possibilities. We have attempted to approach this problem by microdissecting malignant cells and comparing patterns of loss of heterozygosity of multiple genes and chromosomal loci between paired tumors. We found that primary tumors of the lung and their metastasis share nearly identical patterns of loss of heterozygosity. In contrast, most synchronous and metachronous tumors as defined by the current arbitrary criteria appeared to be genetically different; therefore, they likely represented independent primary tumors. Rare synchronous tumors had similar genetic profiles, raising the possibility of recurrence/metastasis. Our data suggest that molecular analysis can help fingerprint tumors and has the potential to significantly impact management and prognosis of patients.