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，但分子图谱和 靶向治疗制度现在被标准化地用于影响可操作突变患者的护理。艾滋病毒-- 感染与患肺癌的风险显著增加有关，但它与肺癌和 它如何影响疾病结果还没有得到很好的研究。正确诊断肺癌的能力 放射影像，组织标本采集，以及随后的组织学确认 非洲肺癌诊断不足和误诊的问题，特别是由于肺癌的流行，而且往往是推定的 结核病感染的临床诊断。因此，在本财团的提案中，我们寻求解决上述问题 1)在乌干达和坦桑尼亚建立全国肺癌诊断转诊网络， 这将改善对肺癌的检测，从而减轻肺癌的负担；2) 调查HIV-1感染对该地区肺癌发病率和预后的影响；3) 确定东非国家肺癌的分子图谱，以促进对规模- 加强靶向治疗(包括基于免疫的治疗)；4)建设肺癌诊断和治疗能力 改善肺癌的影像、病理、放射学和组织获取方面的护理和临床护理 5)创建肺癌研究合作，通过指导初级研究人员来建设能力 未来在这一领域的领导地位。在这个项目的最后，我们设想由非洲主导的肺癌研究 网络、用于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，以及应该支持肺癌研究的大型生物信息库 在未来的许多年里，在该地区。

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.