Chromosomal numerical abnormalities in early stage lung adenocarcinoma

Chromosomal numerical abnormalities (CNA) are ubiquitous in human cancers. However, the question of when a CNA occurs in the course of tumor generation and progression, is controversial. Recent radiological scrutiny has enabled the identification of small peripheral lesions in the lung. A chromosome-wide investigation encompassing almost all the chromosomal centromeres was performed using modified fluorescence in situ hybridization on the archived pathological samples of 16 atypical adenomatous hyperplasia (AAH) and 30 lung adenocarcioma (AdCa) specimens including those smaller than 1 cm in size. The prevalence of the gain was more extensive in male than in female patients, and in non-smokers than in smokers. It tended to be greater in poorly differentiated AdCa, in moderately differentiated AdCa, and in well-differentiated AdCa cases, in that order. Most AAH had non-specific gains affecting all the examined chromosomes. The prevalence of the gain differed significantly between AAH and bronchioloalveolar carcinoma (BAC) 1 cm. It is proposed that the CNA is a distinct phenomenon occurring in the early or premalignant stage of lung AdCa, and that the CNA itself may not be a sequel in the carcinogenetic process, but a driving factor in carcinogenesis.

染色体数目异常（CNA）在人类癌症中普遍存在。然而，CNA在肿瘤发生和进展过程中何时出现这一问题存在争议。近期的影像学检查已能够识别肺部的微小外周病变。利用改良的荧光原位杂交技术，对16例非典型腺瘤样增生（AAH）和30例肺腺癌（AdCa）标本（包括尺寸小于1厘米的标本）的存档病理样本进行了几乎涵盖所有染色体着丝粒的全染色体研究。男性患者的染色体数目增加的患病率比女性患者更广泛，非吸烟者比吸烟者更广泛。在低分化腺癌、中分化腺癌和高分化腺癌病例中，其患病率依次升高。大多数AAH具有影响所有检测染色体的非特异性增加。AAH与直径≤1厘米的细支气管肺泡癌（BAC）之间染色体数目增加的患病率存在显著差异。有人提出，CNA是发生在肺腺癌早期或癌前阶段的一种独特现象，并且CNA本身可能不是致癌过程中的一个后续结果，而是致癌作用的一个驱动因素。