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One hundred twenty-eight stage I samples from 64 MSLC patients were sequenced on Illumina X10 and analyzed for mutation spectra and phylogenetic/clonality inference. Distinct lesion profiles predominated, while clonally related mutations indicated intrapulmonary spread in a subset.",{"@graph":69,"@context":122},[70,84,105],{"@type":71,"itemListElement":72},"BreadcrumbList",[73,77,79,82],{"item":74,"name":75,"@type":76,"position":8},"https://docshare.wps.com","Home","ListItem",{"item":78,"name":9,"@type":76,"position":14},"https://docshare.wps.com/document/",{"item":80,"name":40,"@type":76,"position":81},"https://docshare.wps.com/document/research-report/",3,{"item":83,"name":65,"@type":76,"position":19},"https://docshare.wps.com/document/genomic-heterogeneity-of-multiple-synchronous-lung-cancers-in-chinese-population-research-article/326851/",{"url":83,"name":65,"@type":85,"image":86,"author":91,"headline":65,"publisher":94,"fileFormat":97,"inLanguage":63,"description":67,"dateModified":98,"datePublished":99,"encodingFormat":97,"isAccessibleForFree":100,"interactionStatistic":101},"DigitalDocument",{"url":87,"@type":88,"width":89,"height":90},"https://docshare.wps.com/thumbnails/genomic-heterogeneity-of-multiple-synchronous-lung-cancers-in-chinese-population-research-article/326851.png","ImageObject",300,407,{"name":92,"@type":93},"Himbo","Person",{"url":74,"name":95,"@type":96},"DocShare","Organization","application/pdf","2026-10-23","2026-09-21",true,{"@type":102,"interactionType":103,"userInteractionCount":52},"InteractionCounter",{"@type":104},"ViewAction",{"@type":106,"mainEntity":107},"FAQPage",[108,114,118],{"name":109,"@type":110,"acceptedAnswer":111},"What clinical challenge does the study address for MSLC patients?","Question",{"text":112,"@type":113},"Inferring the phylogenetic relationship between different tumor lesions, distinguishing independently evolved tumors from intrapulmonary metastases.","Answer",{"name":115,"@type":110,"acceptedAnswer":116},"How was the genomic data generated in this study?",{"text":117,"@type":113},"Illumina X10 sequencing was performed on 128 stage I lung cancer samples from 64 MSLC patients, followed by mutation spectrum analysis and phylogenetic inference.",{"name":119,"@type":110,"acceptedAnswer":120},"What did the genetic evolution and clonality analysis suggest?",{"text":121,"@type":113},"Most of the 64 cases showed distinct mutational profiles across lesions, consistent with independently evolved tumors, while a smaller set showed clonally related mutations indicating intrapulmonary metastasis.","https://schema.org",{"og:url":83,"og:type":124,"og:title":65,"og:site_name":95,"og:description":67},"article",{"robots":126,"canonical":83},"index,follow",{"doc_id":128,"site_id":62},326851,1790411234,{"code":4,"msg":5,"data":131},{"doc_id":128,"user_id":132,"nickname":92,"user_avatar":133,"doc_module":4,"category_id":39,"category_name":40,"doc_title":65,"doc_description":67,"doc_content":134,"file_id":135,"file_url":136,"file_type":137,"file_size":138,"view_count":52,"is_deleted":4,"is_public":8,"is_downloadable":8,"audit_status":8,"page_count":44,"language":139,"language_code":63,"site_id":62,"html_lang":63,"table_of_contents":140,"faqs":141,"seo_title":142,"seo_description":67,"update_tm":143,"read_time":144,"preview_page_count":4},687197100911,"https://ap-avatar.wpscdn.com/avatar/a000239b6f1da00475?x-image-process=image/resize,m_fixed,w_180,h_180&k=1785132997149421697","DOI: 10. 1002/cam4 .6928  \nRESEAR CH ARTICLE  \nGenomic heterogeneity of multiple synchronous lung cancers in Chinese population  \nLei Zhao | Jin Wang | Yixiang Zhang  | Peng Wang | Changsheng Lv | Shilei Zhao | Tao Guo | Fengzhou Li | Chundong Gu | Yuntao Zhu   \nDepartment of Thoracic Surgery, the First Affiliated Hospital of Dalian Medical University, Dalian, China  \nCorrespondence  \nYuntao Zhu and Chundong Gu, Department of Thoracic Surgery, the First Affiliated Hospital of Dalian Medical University, Zhongshan road 222\\#, Dalian 116011, China.  \nEmail: [dyzhuyuntao@163.com](dyzhuyuntao@163.com) and [guchundong@dmu.edu.cn](guchundong@dmu.edu.cn)  \nFunding information  \nNational Natural Science Foundation of China, Grant/Award Number: 81774078  \nAbstract  \nIntroduction: It is clinically challenging to infer the phylogenetic relationship between different tumor lesions of patients with multiple synchronous lung cancers (MSLC), whether these lesions are the result of independently evolved tumor or intrapulmonary metastases.  \nMethods: We used the Illumina X10 platform to sequence 128 stage I lung cancer samples collected from 64 patients with MSLC. All samples were analyzed for mutation spectra and phylogenetic inference.  \nResults: We detected genetic aberrations within genes previously reported tobe recurrently altered in lung adenocarcinoma including, EGFR, ERBB2, TP53, BRAF, and KRAS. Other putative driver mutations identified were enriched in RTK-RAS signaling, TP53 signaling, and cell cycle. Also, we found some interesting cases, two cases that carried EGFR L858R and T790M co-mutation in one tumor and another tumor with only EGFR 19del, and 1 case with two KRAS hotspots in the same tumor. Due to the short follow-up time and early stage, further investigation is needed to determine whether this unique mutation profile will affect their progression-free survival (PFS) and overall survival (OS) . Regarding genetic evolution analysis among 64 tumor samples, 50 of them display distinct mutational profiles, suggesting these are independently evolved tumors, which is consistent with histopathological assessment. On the other hand, six patients were identified to be intrapulmonary metastasis as the mutations harbored in different lesions are clonally related.  \nConclusion: In summary, unlike intrapulmonary metastases, patients with MSLC harbor distinct genomic profiles in different tumor lesions, and we could distinguish MSLC from intrapulmonary metastases via clonality estimation.  \nKEYWORDS  \nclonality index, genomic features, intrapulmonary metastasis, multiple synchronous lung cancers  \n\n| Lei Zhao and Jin Wang made equal contributions in this study. |\n| --- |\n| This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.\u003Cbr>© 2024 The Authors. Cancer Medicine published by John Wiley & Sons Ltd. |\n\nCancer Medicine. 2024;13:e6928 .  \n[https://doi.org/10.1002/cam4.6928](https://doi.org/10.1002/cam4.6928)  \n[wileyonlinelibrary.com/journal/cam](wileyonlinelibrary.com/journal/cam|4 1 of 9)[|](wileyonlinelibrary.com/journal/cam|4 1 of 9)[4](wileyonlinelibrary.com/journal/cam|4 1 of 9)[ 1 of 9](wileyonlinelibrary.com/journal/cam|4 1 of 9)  \n1 | INTRODUCTION  \nLung cancer is the leading cause of global cancer mortality. In recent years, advancements in early detection and diagnostic techniques have led to an increased identification of nodules. Multiple primary lung cancers (MPLCs) refer to the occurrence of multiple primary tumors in different areas of the lungs within a single patient, which can be synchronous or metachronous.1 The prevalence of multiple synchronous lung cancers (MSLC) has been reported to range from 0 .2% to 8% among lung cancer cases,2–5 distinguishing them from pulmonary metastases. Treatment plans for MPLCs depend on whether they are MSLCs or metastatic lung cancers and the","cbCaijtOknuO7vYs","https://ap.wps.com/l/cbCaijtOknuO7vYs","pdf",1408541,"English","# Introduction\n## Rationale and clinical challenge\n## Prior criteria and molecular marker evolution\n## Controversies in CT-based histologic prediction\n# Methods\n## Cohort and sample collection\n## Sequencing and analytical strategy\n# Results\n## Detected recurrently altered genes\n## Driver pathways and notable co-mutation cases\n## Clonality and evolutionary interpretation\n# Conclusion","[{\"question\":\"What clinical challenge does the study address for MSLC patients?\",\"answer\":\"Inferring the phylogenetic relationship between different tumor lesions, distinguishing independently evolved tumors from intrapulmonary metastases.\"},{\"question\":\"How was the genomic data generated in this study?\",\"answer\":\"Illumina X10 sequencing was performed on 128 stage I lung cancer samples from 64 MSLC patients, followed by mutation spectrum analysis and phylogenetic inference.\"},{\"question\":\"What did the genetic evolution and clonality analysis suggest?\",\"answer\":\"Most of the 64 cases showed distinct mutational profiles across lesions, consistent with independently evolved tumors, while a smaller set showed clonally related mutations indicating intrapulmonary metastasis.\"}]","Genomic heterogeneity of multiple synchronous lung cancers in Chinese population - Research article | PDF",1789975556,23]