Multidimensional biological characteristics of ground glass nodules

Furong Chen, Jiangtao Li, Lei Li, Lunbing Tong, Gang Wang, Xuelin Zou
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Abstract

The detection rate of ground glass nodules (GGNs) has increased in recent years because of their malignant potential but relatively indolent biological behavior; thus, correct GGN recognition and management has become a research focus. Many scholars have explored the underlying mechanism of the indolent progression of GGNs from several perspectives, such as pathological type, genomic mutational characteristics, and immune microenvironment. GGNs have different major mutated genes at different stages of development; EGFR mutation is the most common mutation in GGNs, and p53 mutation is the most abundant mutation in the invasive stage of GGNs. Pure GGNs have fewer genomic alterations and a simpler genomic profile and exhibit a gradually evolving genomic mutation profile as the pathology progresses. Compared to advanced lung adenocarcinoma, GGN lung adenocarcinoma has a higher immune cell percentage, is under immune surveillance, and has less immune escape. However, as the pathological progression and solid component increase, negative immune regulation and immune escape increase gradually, and a suppressive immune environment is established gradually. Currently, regular computer tomography monitoring and surgery are the main treatment strategies for persistent GGNs. Stereotactic body radiotherapy and radiofrequency ablation are two local therapeutic alternatives, and systemic therapy has been progressively studied for lung cancer with GGNs. In the present review, we discuss the characterization of the multidimensional molecular evolution of GGNs that could facilitate more precise differentiation of such highly heterogeneous lesions, laying a foundation for the development of more effective individualized treatment plans.
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磨玻璃结核的多维生物特性
近年来,磨玻璃结节(GGNs)的检出率不断上升,因为它们具有恶性潜能,但生物学行为却相对懒散;因此,正确识别和管理 GGNs 已成为研究重点。许多学者从病理类型、基因组突变特征和免疫微环境等多个角度探讨了 GGNs 进展缓慢的内在机制。GGNs在不同的发展阶段有不同的主要突变基因,表皮生长因子受体(EGFR)突变是GGNs最常见的突变,p53突变是GGNs浸润期最多的突变。纯GGNs的基因组改变较少,基因组谱较简单,随着病理进展,基因组突变谱逐渐演变。与晚期肺腺癌相比,GGN 肺腺癌的免疫细胞比例较高,处于免疫监视状态,免疫逃逸较少。但随着病理进展和实体成分的增加,免疫负调控和免疫逃逸逐渐增加,抑制性免疫环境逐渐形成。目前,定期计算机断层扫描监测和手术是顽固性 GGN 的主要治疗策略。立体定向体外放射治疗和射频消融是两种局部治疗的替代方法,而全身治疗对于伴有 GGNs 的肺癌的研究也在不断深入。在本综述中,我们讨论了 GGNs 多维分子演变的特征,这有助于更精确地区分这种高度异质性病变,为制定更有效的个体化治疗方案奠定基础。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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