Molecular Approaches Transform Discrimination of Multiple Primary vs Metastatic Lung Cancers
This review evaluates how molecular technologies are resolving the longstanding clinical dilemma of distinguishing multiple primary lung cancers from intrapulmonary metastases. Methods based on somatic mutations, chromosomal alterations, microRNAs, and tumor microenvironment markers are compared, with particular emphasis on NGS-based clonal relatedness assessment. The authors highlight intratumoral heterogeneity as a key challenge and position genomics-based discrimination as the emerging diagnostic standard for treatment-critical surgical decisions.
The original study
Towards the molecular era of discriminating multiple lung cancers.
- Authors
- Wang Z, Yuan X, Jiang G, Li Y, Yang F, Wang J, et al.
- Journal
- EBioMedicine
- Type
- Journal Article, Review
- PMID
- 36958271
Original abstract
In the era of histopathology-based diagnosis, the discrimination between multiple lung cancers (MLCs) poses significant uncertainties and has thus become a clinical dilemma. However, recent significant advances and increased application of molecular technologies in clonal relatedness assessment have led to more precision in distinguishing between multiple primary lung cancers (MPLCs) and intrapulmonary metastasis (IPMs). This review summarizes recent advances in the molecular identification of MLCs and compares various methods based on somatic mutations, chromosome alterations, microRNAs, and tumor microenvironment markers. The paper also discusses current challenges at the forefront of genomics-based discrimination, including the selection of detection technology, application of next-generation sequencing, and intratumoral heterogeneity (ITH). In summary, this paper highlights an entrance into the primary stage of molecule-based diagnostics.