With the broad application of high-resolution computed tomography (CT) and high rates of early lung cancer screening, the number of patients diagnosed with synchronous multiple primary lung cancer (sMPLC) has been increasing. It becomes of great prominence to distinct sMPLC from intrapulmonary metastases in clinical practice. An increasing number of studies have developed high-throughput sequencing based genetic approaches to specify the molecular characteristics of sMPLC, which contributes to a better understanding of its tumorigenesis. The genetic profile of sMPLC also benefits its diagnosis, which mainly relies on its clinicopathological criteria. Here, we summarize the progresses on the diagnostic criteria for sMPLC, and also molecular features of sMPLC from the perspective of clonality analysis.
ObjectiveTo explore the value of artificial intelligence (AI) diagnostic imaging system and three dimensional computed tomographic bronchoangiography (3D-CTBA) surgical planning system in the management of multiple primary lung cancer (MPLC).MethodsThe clinical data of 53 patients with MPLC treated surgically in our hospital from January 2018 to August 2020 were retrospectively analyzed, including 16 males and 37 females, with a median age of 60 (39-75) years. The patients' preoperative CT was analyzed by AI and manually, and the data of patients who underwent 3D-CTBA were compiled to evaluate the value of AI and 3D-CTBA in the diagnosis and treatment of MPLC, respectively.Results The sensitivity of AI screening for MPLC was 84.91%. The sensitivity (91.90% vs. 83.78%) and accuracy (85.60% vs. 84.00%) of AI diagnosis of high-risk MPLC infiltrative lesions were better than those of manual diagnosis. 3D-CTBA was used for planning the surgery in 12 patients, and the intraoperative situation was generally consistent with the reconstructed results.ConclusionAI is of high value in identifying infiltrative lesions of MPLC. 3D-CTBA reconstruction of anatomical structures is accurate and can guide preoperative planning.
In recent years, the detection rate of multiple primary lung cancers has been increasing year by year. However, there existed discrepance in cognition and treatment modalities for multiple primary early lung cancers among different physicians, which affects the standardized treatment for early-stage multiple primary lung cancers. Therefore, based on a thorough review of domestic and foreign literature, our team proposes this expert consensus focusing on the treatment of early-stage multiple primary lung cancers in China, aiming at providing reference for physicians in early-stage multiple primary lung cancers' treatment and further improving the level of standardized diagnosis and therapy of lung cancer in China.