Using molecular characteristics to distinguish multiple primary lung cancers and intrapulmonary metastases

• Published in: PeerJ (San Francisco, CA) CA), 2024-01, Vol.12, p.e16808-e16808, Article e16808
• Main Authors: Li, Zhenhua, Lv, Huilai, Zhang, Fan, Zhu, Ziming, Guo, Qiang, Wang, Mingbo, Huang, Chao, Guo, Lijie, Meng, Fanfei, Tian, Ziqiang
• Format: Article
• Language: English
• Subjects: Algorithms; Genes; Genetic testing; Genomics; High-Throughput Nucleotide Sequencing - methods; Histology; Hospitals; Humans; Intrapulmonary metastasis; Lung - pathology; Lung cancer; Lung Neoplasms - diagnosis; Metastases; Metastasis; Molecular classification; Multiple lung cancer; Multiple primary lung cancer; Mutation; Neoplasms, Multiple Primary - genetics; Next-generation sequencing; Oncology; Patients; Prognosis; Thoracic surgery; Tumors
• ISSN: 2167-8359; 2167-8359
• DOI: 10.7717/peerj.16808

Multiple lung cancers may present as multiple primary lung cancers (MPLC) or intrapulmonary metastasis (IPM) with variations in clinical stage, treatment, and prognosis. However, the existing differentiation criteria based on histology do not fully meet the clinical needs. Next-generation sequencing (NGS) may play an important role in assisting the identification of different pathologies. Here, we extended the relevant data by combining histology and NGS to develop detailed identification criteria for MPLC and IPM. Patients with lung cancer (each patient had ≥2 tumors) were enrolled in the training (  = 22) and validation (  = 13) cohorts. Genomic profiles obtained from 450-gene-targeted NGS were analyzed, and the new criteria were developed based on our findings and pre-existing Martini & Melamed criteria and molecular benchmarks. The analysis of the training cohort indicated that patients identified with MPLC had no (or