Phenotype And Genotype Analysis Of 42 Cases Of Synchronous Multiple Primary Lung Cancer

Objective: Thanks to the improvement of people’s health awareness and the wide application of computed tomography,the detection rate of synchronous multiple primary lung cancer(sMPLC)is increasing continuously.However,the pathogenesis,clinical staging and treatment of sMPLC are still controversial.This study aimed to summarize and analyze the clinical data of 42 sMPLC patients.We further discussed the general clinical characteristics and treatment of sMPLC.The clinical characteristics were compared with those of single lung adenocarcinoma.Methods: Thoracoscopic surgery was performed on 42 patients with sMPLC who were admitted to the Department of Thoracic Surgery,Shengjing Hospital of China Medical University from November 2017 to April 2020.Pathological analysis and major lesions’ genetic testing were performed after surgery to analyze genotype and phenotype of patients.Results: sMPLC is more common in patients aged 50 to 70 years.A total of 94 sMPLC lesions were resected.The lesions were mostly located in the upper lobe of the right lung.Of the 42 patients,1 patient(2.4%)presented with adenocarcinoma and squamous cell carcinoma.All lesions in 2 patients(4.8%)were squamous cell carcinoma.All lesions in39 patients(92.8%)were adenocarcinoma.The pathological type is mainly adenocarcinoma,among which mainly acinus.In all patients,genetic mutation was detected in 39,and the three wild-type patients were all male.25 patients(59.5%)were accompanied by EGFR mutations which is more common in women and non-smokers.Among EGFR mutation patients,exon 21 p.L858 R mutation which existed in 13 patients(31.0%)was the most common one.Conclusion: The genotype and phenotype characteristics of patients with sMPLC are similar to those of patients with single lesion.As a result,gene mutation is not the main mechanism of lung cancer occur in plurality.