惰性肺部磨玻璃结节的多维度分子特点

The multi-dimensional molecular characteristics of the indolent pulmonary ground-glass nodules

随着磨玻璃结节(GGN)检出率的升高,对其进行正确认识和处理已成为当前肺癌外科的重点和热点问题。越来越多的学者尝试从分子演化特征和免疫微环境等角度探究GGN惰性进展的潜在机制。GGN不同发展阶段具有不同的主要突变基因,纯GGN的肿瘤突变负荷和基因组不稳定性最低,随病理学进展呈现出逐渐进化的基因组突变特征。GGN型肺癌中免疫细胞浸润程度低,处于免疫监视压力下且免疫逃逸较少,而随着实性成分增加,抑制性免疫环境逐步建立,免疫逃逸逐渐增强。对于GGN多维度分子特点的进一步探索将有助于更加精确地区分这类具有高度异质性的病变,为制定个性化治疗方案奠定基础。

With the dramatically increasing detection rate of ground-glass nodules(GGN),exact understanding and treatment strategy of them has become the hottest issue currently.More and more studies have begun to explore the underlying mechanisms of their indolent characteristics and favorable prognosis from the perspectives of molecular evolution and immune microenvironment.GGN has different dominating gene mutations at different evolutional stages.The pure GGN has a lower tumor mutation burden and genomic instability,while a gradually evolutionary feature of genomic mutation along with the pathological progression can be observed.GGN has less infiltration of immune cells,and they are under the pressure of immune surveillance with weakened immune escape.With the increase of solid components,an inhibitory immune microenvironment is gradually established and immune escape is gradually enhanced,leading to rapid tumor growth.Further exploration of the molecular characteristics of GGN will help to more precisely distinguish these highly heterogeneous lesions,which could be helpful to make personalized treatment plans.