Abstract

The tumourigenesis of early lung adenocarcinomas, including adenocarcinoma in situ (AIS), minimally invasive adenocarcinoma (MIA), and lepidic predominant invasive adenocarcinoma (LPA), remains unclear. This study aimed to capture disease-related molecular networks characterising each subtype and tumorigenesis by assessing 14 lung adenocarcinomas (AIS, five; MIA, five; LPA, four). Protein–protein interaction networks significant to the three subtypes were elucidated by weighted gene co-expression network analysis and pairwise G-statistics based analysis. Pathway enrichment analysis for AIS involved extracellular matrix proteoglycans and neutrophil degranulation pathway relating to tumour growth and angiogenesis. Whereas no direct networks were found for MIA, proteins significant to MIA were involved in oncogenic transformation, epithelial-mesenchymal transition, and detoxification in the lung. LPA was associated with pathways of HSF1-mediated heat shock response regulation, DNA damage repair, cell cycle regulation, and mitosis. Genomic alteration analysis suggested that LPA had both somatic mutations with loss of function and copy number gains more frequent than MIA. Oncogenic drivers were detected in both MIA and LPA, and also LPA had a higher degree of copy number loss than MIA. Our findings may help identifying potential therapeutic targets and developing therapeutic strategies to improve patient outcomes.

Highlights

  • The tumourigenesis of early lung adenocarcinomas, including adenocarcinoma in situ (AIS), minimally invasive adenocarcinoma (MIA), and lepidic predominant invasive adenocarcinoma (LPA), remains unclear

  • The tumourigenesis of early lung adenocarcinoma is thought to progress in a stepwise manner in the order of AIS, MIA, and LPA; this has not been completely elucidated to date

  • Understanding of diseaserelated molecular mechanisms and profiles in early lung adenocarcinomas would be markedly useful for selecting treatment strategies and could improve the treatment outcomes of individual patients

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Summary

Introduction

The tumourigenesis of early lung adenocarcinomas, including adenocarcinoma in situ (AIS), minimally invasive adenocarcinoma (MIA), and lepidic predominant invasive adenocarcinoma (LPA), remains unclear. About 60% of lung adenocarcinoma subtypes have unique protein markers as oncogenic driver mutations such as EGFR, ALK, ROS1, HER2, KRAS, and BRAF3. These are crucial biomarkers in molecular targeted therapy. In 2011, the International Association for the Study of Lung Cancer, the American Thoracic Society and the European Respiratory Society proposed a new pathological classification of lung adenocarcinoma. This classification introduced the concepts of adenocarcinoma in situ (AIS) and minimally invasive adenocarcinoma (MIA), resulting in the elimination of the term ‘bronchioloalveolar carcinoma’[6].

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