Clinical And Genomic Features Of Early-stage Synchronous Multiple Primary Lung Cancer

【Introduction】 To explore the pathogenesis and help better diagnose and treat patients with synchronous multiple primary lung cancers(sMPLC),we systematically described the clinicopathological features of early-stage sMPLC,and compared the differences in gene mutation between early-stage single primary lung cancer(SPLC)and sMPLC.【Methods】This study retrospectively observed 465 patients with early sMPLC who received surgical treatment in the Department of Thoracic Surgery of The Second Xiangya Hospital of Central South University,and described and summarized their clinicopathological features,surgical treatment,and prognosis.191 patients with 191 lung nodules in SPLC group and 132 patients with 295 lung nodules in sMPLC group were resected and enrolled in this study.All the tumor tissue samples were subjected to panel-genomic sequencing(1021-gene).We analyzed the differences in gene mutations between SPLC and sMPLC groups at different levels,thus,the genetic characteristics of sMPLC were further obtained.【Results】In recent years,the incidence of sMPLC has increased significantly,and its clinical and pathological features are unique.Comprehensive evaluation and treatment of sMPLC need to be performed under the guidance of a multidisciplinary team.According to TNM staging,sMPLC patients with a T2 stage tumor had a higher risk to develop a new lung lesion after surgery.Genomically,TMB levels in sMPLC lesions were significantly lower than in SPLC.Although we found some genetic differences in subgroup analysis,sMPLC and SPLC showed similar genetic mutation trends.【Conclusion】 Based on the unique clinicopathological characteristics of sMPLC,the comprehensive treatment mode of "surgical resection +X" can be adopted for multiple lung lesions of early-stage sMPLC.The gene mutation profiles of SPLC and sMPLC were similar,which were consistent with their clinical features.This study provides new ideas and clues for understanding the molecular mechanism of sMPLC pathogenesis.and clues for understanding the molecular mechanism of sMPLC pathogenesis.