Paper - Review

DOI: 10.1038/s41467-019-10877-8

Abstract

❗: A dramatic increase ← in the detection of lung nodules
→ which are 1⃣ pre-neoplasia atypical adenomatous hyperplasia 2⃣ adenocarcinoma in situ 3⃣ minimally invasive adenocarcinoma 4⃣ invasive adenocarcinoma

❓: 1⃣ the molecular landscape 2⃣ the evolutionary trajectory ← of lung pre-neoplasia
→ have not been well-defined

❗: perform → multi-region exome sequencing of 116 resected lung nodules
← including 1⃣ AAH 2⃣ AIS 3⃣ MIA 4⃣ synchronous

❗: observe → progressive genomic evolution
← at the single nucleotide level
❗: demarcated evolution ← at the chromosomal level
← supporting the early lung carcinogenesis model
→ from AAH to 1⃣ AIS 2⃣ MIA 3⃣ ADC

❗: sub-clonal analysis
→ reveal a higher proportion of clonal mutations
← in 1⃣ AIS 2⃣ MIA 3⃣ ADC > AAH
∴ Neoplastic transformation (← of lung pre-neoplasia) → is predominantly associated
← with a selected sweep of unfit sub-clones

∴ Analysis of multi-forcal pulmonary nodules ← from the same patients
→ reveal evidence of convergent evolution

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