Background: Lung adenocarcinoma with ground-glass opacity (GGO) has been detected increasingly and now accounts for most lung cancer patients. Lung adenocarcinoma with GGO contains a complex ecosystem. The mechanism of lung adenocarcinoma with GGO remains largely elusive. We use mass spectrometry proteomics combined with metabolomics to understand how these characteristics achieve a long-term functional balance and the trend of changes in tumor progression at the cellular functional level. Methods: We initiated a prospective cohort study to characterize lung adenocarcinoma with GGO components or without GGO components. Tumor and para-cancer tissue samples were collected. Multi-omics including transcriptomics proteomics and metabonomics were performed. Results: We found lung adenocarcinoma with GGO had a relatively slow proliferation tumor cells and stronger immune cell infiltration in proteomic and transcriptomic analysis. The immune cell markers expression, including CD47, CD68, CD81, CD86, C1Q, SPP1, CXCL13, ALOX5AP and HPGD was found overexpression in lung adenocarcinoma with GGO, which indicated more immune cell infiltration. In metabolomic analysis, GAPDH, ENO1 and LDHA were highly expressed in pure-solid lung adenocarcinoma, and GPD1 was highly expressed in lung adenocarcinoma with GGO. The combined transcriptome and proteome analysis revealed that proteins with consistent differences mainly included GAPDH, MKI67, AGER, and CRYM. KEGG pathway enrichment analysis showed that several aliphatic acyclic compounds expression were higher in lung adenocarcinoma with GGO. Conclusion: We describe a functional homeostasis in lung adenocarcinoma with GGO, which was constructed by relatively slow proliferation tumor cells and stronger immune cell infiltration. Overexpression of CXCL13 drives the infiltration of immune cells, which means the formation of anti-tumor tertiary lymphatic structures. The dysfunction of macrophage may be an important marker of this progression.

To illustrate the benefits of surgery in conjunction with neoadjuvant chemotherapy in patients with limited-stage small cell lung cancer (LS-SCLC), and to evaluate risk factors affecting patient's survival. Forty-six LS-SCLC patients who received surgery in our center from September 2012 to December 2018 were retrospectively analyzed. Twenty-five patients with LS-SCLC diagnosed after surgery who received postoperative adjuvant chemotherapy were classified into control group, and 21 patients with LS-SCLC who received preoperative neoadjuvant chemotherapy were classified into observation group. The observation group were divided into subgroup 1 (negative lymph nodes) and subgroup 2 (positive lymph nodes). Progression-free survival (PFS) and overall survival (OS) of patients were analyzed. Univariate and multivariate Cox regression were utilized to analyze independent risk factors affecting patient's survival. PFS and OS of patients in the control group and observation group had similar outcomes (<i>P</i> &#62; 0.05). Subgroup 1 and subgroup 2 had similar PFS and OS (<i>P</i> &#62; 0.05). PT2, pN2, BM, and two or more positive lymph nodes were significantly associated with poor PFS and OS (<i>P</i> &#60; 0.05). Furthermore, the pT, number of lymph node positive stations and BM were independent risk factors affecting patient's survival (<i>P</i> &#60; 0.05). Surgery combined with neoadjuvant chemotherapy can achieve long-term survival benefit for some patients with LS-SCLC. It is necessary to find a better plan that enables to select patients suitable for surgery after neoadjuvant chemotherapy.