Molecular Alterations in Lung Adenocarcinoma With Ground-Glass Nodules: A Systematic Review and Meta-Analysis

Wei, Zihan; Wang, Ziyang; Nie, Yuntao; Zhang, Kai; Shen, Haifeng; Wang, Xin; Wu, Muhong; Yang, Fan

doi:10.3389/fonc.2021.724692

Cited by 3 publications

(4 citation statements)

References 65 publications

(54 reference statements)

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“…observed that PD-L1 expression levels were similar in GGO-LUAD, SN-LUAD, different pathological subtypes, and multiple primary lung ADC ( 16 ). However, a meta-analysis revealed that PD-L1 expression in GGO was significantly lower than in SN ( 34 ). Furthermore, PD-L1 expression is higher in SN nodules than in PNS nodules, suggesting that immune checkpoint adjustment occurs in aggressive nodules ( 17 ).…”

Section: Other Molecular Features Of Ggnsmentioning

confidence: 99%

Multidimensional biological characteristics of ground glass nodules

Chen,

Li,

et al. 2024

Front. Oncol.

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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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Section: Other Molecular Features Of Ggnsmentioning

confidence: 99%

Multidimensional biological characteristics of ground glass nodules

Chen,

Li,

et al. 2024

Front. Oncol.

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“…The differences in EGFR mutation frequency among these studies may be partly explained by differences in study populations (Asian vs. Caucasian), detection methods (polymerase chain reaction vs. next generation sequencing), and nodule subtypes (pure GGNs vs. PSNs). Other genetic alterations identified in lung adenocarcinoma manifesting as SSNs included KRAS mutations, HER2 mutations, BRAF mutations, ALK rearrangement, and ROS1 rearrangement ( 11 , 53 - 58 ).…”

Section: Genetic Alterations In Lung Adenocarcinoma Manifesting As Ssnsmentioning

confidence: 99%

“…Other genetic alterations identified in lung adenocarcinoma manifesting as SSNs included KRAS mutations, HER2 mutations, BRAF mutations, ALK rearrangement, and ROS1 rearrangement (11,(53)(54)(55)(56)(57)(58).…”

Section: Genetic Alterations In Lung Adenocarcinoma Manifesting As Ssnsmentioning

confidence: 99%

A narrative review of the clinical approach to subsolid pulmonary nodules

Kim¹,

Um²

2023

Ann Transl Med

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Background and Objective The widespread use of chest computed tomography (CT) for lung cancer screening has led to increased detection of subsolid pulmonary nodules. The management of subsolid nodules (SSNs) is challenging since they are likely to grow slowly and a long-term follow-up is needed. In this review, we discuss the characteristics, natural history, genetic features, surveillance, and management of SSNs. Methods PubMed and Google Scholar were searched to identify relevant articles published in English between January 1998 and December 2022 using the following keywords: “subsolid nodule”, “ground-glass nodule (GGN)”, and “part-solid nodule (PSN)”. Key Content and Findings The differential diagnosis of SSNs includes transient inflammatory lesions, focal fibrosis, and premalignant or malignant lesions. Long-term CT surveillance follow-up is needed to manage SSNs that persist for >3 months. Although most SSNs have an indolent clinical course, PSNs may have a more aggressive clinical course than pure GGNs. The proportion of growth and the time to grow is higher and shorter in PSN than pure GGN. In lung adenocarcinoma manifesting as SSNs, EGFR mutations were the major driver mutations. Guidelines are available for the management of incidentally detected and screening-detected SSNs. The size, solidity, location, and number of SSNs are important factors in determining the need for surveillance and surgical resection, as well as the interval of follow-up. Positron emission tomography/CT and brain magnetic resonance imaging (MRI) are not recommended for the diagnosis of SSNs, especially for pure GGNs. Periodic CT surveillance and lung-sparing surgery are the main strategies for the management of persistent SSNs. Nonsurgical treatment options for persistent SSNs include stereotactic body radiotherapy (SBRT) and radiofrequency ablation (RFA). For multifocal SSNs, the timing of repeated CT scans and the need for surgical treatment are decided based on the most dominant SSN(s). Conclusions The SSN is a heterogeneous disease and a personalized medicine approach is required in the future. Future studies of SSNs should focus on their natural history, optimal follow-up duration, genetic features, and surgical and nonsurgical treatments to improve the corresponding clinical management. All these efforts will lead to the personalized medicine approach for the SSNs.

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“…Also of great interest is whether or not there is a correlation between the imaging characteristics of LUAD and the frequency with which it undergoes EGFR mutations. Wei et al found no link between EGFR and ground glass opacity (GGO) development, but Ortiz et al found an increased probability of EGFR mutations when GGO was present in pulmonary nodules ( 11 , 12 ). As a result, we aimed to perform a systematic review and meta-analysis of the literature to learn more about the correlation between EGFR mutations and the percentage of ground glass opacity and final histological classification in people with NSCLC.…”

Section: Introductionmentioning

confidence: 99%

Distinguishing EGFR mutant subtypes in stage IA non-small cell lung cancer using the presence status of ground glass opacity and final histologic classification: a systematic review and meta-analysis

Qiu,

Ma,

et al. 2023

Front. Med.

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BackgroundThe progression of early stage non-small cell lung cancer (NSCLC) is closely related to epidermal growth factor receptor (EGFR) mutation status. The purpose of this study was to systematically investigate the relationship between EGFR mutation status and demographic, imaging, and ultimately pathologic features in patients with NSCLC.MethodsA complete literature search was conducted using the PubMed, Web of Science, EMBASE, and Cochrane Library databases to discover articles published by May 15, 2023 that were eligible. The relationship between EGFR mutation status and specific demographic, imaging, and ultimately pathologic features in patients with NSCLC was evaluated using pooled odds ratios (ORs) and their 95% confidence intervals (CIs). The standardized mean difference (SMD) with 95% CIs was the appropriate statistic to summarize standard deviations (SDs) means for continuous variables.ResultsA total of 9 studies with 1789 patients were included in this analysis. The final findings suggested that patients with a greater age, female gender, and non-smoking status would have a relatively higher incidence of EGFR mutations. Additionally, the risk of EGFR mutations increased with larger tumor diameter, tumor imaging presentation of mixed ground glass opacity (mGGO), and tumor pathological findings of minimally invasive adenocarcinoma (MIA) or invasive adenocarcinoma (IAC). Significantly, malignancies presenting as MIA are more likely to contain L858R point mutations (OR = 1.80; 95% CI: 1.04–3.13; p = 0.04) rather than exon 19 deletions (OR = 1.81; 95% CI: 0.95–3.44; p = 0.07).ConclusionThis meta-analysis showed that imaging parameters and histological classifications of pulmonary nodules may be able to predict stage IA NSCLC genetic changes.

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Molecular Alterations in Lung Adenocarcinoma With Ground-Glass Nodules: A Systematic Review and Meta-Analysis

Cited by 3 publications

References 65 publications

Multidimensional biological characteristics of ground glass nodules

Multidimensional biological characteristics of ground glass nodules

A narrative review of the clinical approach to subsolid pulmonary nodules

Distinguishing EGFR mutant subtypes in stage IA non-small cell lung cancer using the presence status of ground glass opacity and final histologic classification: a systematic review and meta-analysis

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