Lung cancer in East Africa and the relationship to HIV-1 infection: epidemiology, molecular characterization and imaging

非洲肺癌的分子流行病学几乎完全未知，但分子谱分析和 靶向治疗的制度现在通常用于影响具有可操作突变的患者的护理。艾滋病毒- 感染与肺癌的风险显著增加有关，但其与肺癌的关系， 它如何影响疾病的结果还没有得到很好的研究。正确诊断肺癌的能力 放射学影像、组织标本采集和随后的组织学确认， 非洲肺癌的诊断不足和误诊问题，特别是在患病率和经常推定的情况下， 结核感染的临床诊断。因此，我们在本财团的建议书中， 1）在乌干达和坦桑尼亚建立国家肺癌诊断转诊网络， 这将允许改善肺癌的检测，从而降低肺癌负担; 2） 调查HIV-1感染对该地区肺癌发病率和结局的作用; 3） 确定东非国家肺癌的分子特征，以促进规模化宣传， 靶向治疗（包括免疫治疗）的增加; 4）肺癌诊断能力建设， 在改善肺癌的成像、病理学、放射学和组织采集以及临床护理方面的护理 5)建立肺癌研究合作，通过指导初级研究人员来建立能力 未来在这一领域的领导地位在这个项目的最后，我们设想了一个非洲领导的肺癌研究， 网络，样本采集和护理的临床专业知识，改进的病理学和放射学诊断 服务，肺癌筛查计划和一个大型生物储存库，应该支持肺癌研究 在该地区的未来几年。

The molecular epidemiology of lung cancer in Africa is almost completely unknown, yet molecular profiling and institution of targeted therapy is now standardly used to influence care in patients with actionable mutations. HIV- infection is associated with a markedly increased risk of lung cancer, but its association with lung cancer and how it influences disease outcomes is not well studied. The capacity to correctly diagnose lung cancer on radiological images, tissue specimen acquisition, and subsequent histologic confirmation compounds the problem of under and misdiagnosis of lung cancer in Africa, especially with the prevalence and often presumptive clinical diagnosis of tuberculosis infection. In this consortium proposal, we therefore seek to address the above stated problems by 1) establishing national lung cancer diagnostic referral networks in Uganda and Tanzania, which will allow for improved detection of lung cancer and, hence decrease the lung cancer burden; 2) investigating the role of HIV-1 infection on the incidence and outcomes of lung cancer in the region; 3) determining the molecular profile of lung cancer in East African countries in order to facilitate advocacy for scale- up of targeted therapies (including immune-based therapies); 4) building capacity for lung cancer diagnosis and care in terms of improving imaging, pathology, radiology and tissue acquisition and clinical care of lung cancer 5) creating a lung cancer research collaboration that will build capacity through mentoring of junior researchers for future leadership in the field. At the end of this project, we envision an African-led lung cancer research network, clinical expertise for sample acquisition and care, improved pathology and radiology diagnostics services, a lung cancer screening program, and a large biorepository that should support lung cancer research in the region for many years to come.