[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"detail-sidebar-cat-0-en-105":3,"doc-seo-330128-105":59,"doc-detail-330128-en":131},{"code":4,"msg":5,"data":6},0,"success",[7,13,18,23,28,33,38,43,48,51,55],{"id":8,"doc_module":4,"doc_module_name":9,"category_name":10,"show_sort_weight":11,"slug":12},1,"Document","Story & Novel",90,"story-novel",{"id":14,"doc_module":4,"doc_module_name":9,"category_name":15,"show_sort_weight":16,"slug":17},2,"Literature",80,"literature",{"id":19,"doc_module":4,"doc_module_name":9,"category_name":20,"show_sort_weight":21,"slug":22},4,"Exam",70,"exam",{"id":24,"doc_module":4,"doc_module_name":9,"category_name":25,"show_sort_weight":26,"slug":27},5,"Comic",60,"comic",{"id":29,"doc_module":4,"doc_module_name":9,"category_name":30,"show_sort_weight":31,"slug":32},6,"Technology",50,"technology",{"id":34,"doc_module":4,"doc_module_name":9,"category_name":35,"show_sort_weight":36,"slug":37},7,"Healthcare",40,"healthcare",{"id":39,"doc_module":4,"doc_module_name":9,"category_name":40,"show_sort_weight":41,"slug":42},8,"Research & Report",30,"research-report",{"id":44,"doc_module":4,"doc_module_name":9,"category_name":45,"show_sort_weight":46,"slug":47},9,"Religion & Spirituality",20,"religion-spirituality",{"id":46,"doc_module":4,"doc_module_name":9,"category_name":49,"show_sort_weight":46,"slug":50},"World Cup","world-cup",{"id":52,"doc_module":4,"doc_module_name":9,"category_name":53,"show_sort_weight":52,"slug":54},10,"Lifestyle","lifestyle",{"id":56,"doc_module":4,"doc_module_name":9,"category_name":57,"show_sort_weight":24,"slug":58},19,"General","general",{"code":4,"msg":60,"data":61},"ok",{"site_id":62,"language":63,"slug":64,"title":65,"keywords":66,"description":67,"schema_data":68,"social_meta":124,"head_meta":126,"extra_data":128,"updated_unix":130},105,"en","using-molecular-characteristics-to-distinguish-multiple-primary-lung-cancers-and-intrapulmonary-metastases","Using molecular characteristics to distinguish multiple primary lung cancers and intrapulmonary metastases","","Multiple lung cancers can be classified as multiple primary lung cancers (MPLC) or intrapulmonary metastasis (IPM), yet histology-based differentiation often fails to meet real clinical needs. This study combines histologic assessment with next-generation sequencing (NGS) using 450-gene-targeted profiles to build detailed criteria for MPLC and IPM. Training and validation cohorts evaluate shared and trunk mutation patterns to support independent imaging and pathologic distinction.",{"@graph":69,"@context":123},[70,84,106],{"@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":35,"@type":76,"position":81},"https://docshare.wps.com/document/healthcare/",3,{"item":83,"name":65,"@type":76,"position":19},"https://docshare.wps.com/document/using-molecular-characteristics-to-distinguish-multiple-primary-lung-cancers-and-intrapulmonary-metastases/330128/",{"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/using-molecular-characteristics-to-distinguish-multiple-primary-lung-cancers-and-intrapulmonary-metastases/330128.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":105},"InteractionCounter",{"@type":104},"ViewAction",12,{"@type":107,"mainEntity":108},"FAQPage",[109,115,119],{"name":110,"@type":111,"acceptedAnswer":112},"What problem does the study address in distinguishing MPLC and IPM?","Question",{"text":113,"@type":114},"Histology-based criteria for differentiating MPLC and intrapulmonary metastasis are often difficult to implement and may not match clinical needs when tumors look similar.","Answer",{"name":116,"@type":111,"acceptedAnswer":117},"What sequencing approach is used to support the new differentiation criteria?",{"text":118,"@type":114},"Genomic profiles are generated using a 450-gene targeted next-generation sequencing panel and then combined with histologic information.",{"name":120,"@type":111,"acceptedAnswer":121},"What mutation patterns help distinguish MPLC from IPM in the results?",{"text":122,"@type":114},"In the training cohort, MPLC cases show no (or fewer than 2) trunk or shared mutations, while IPM shows higher proportions of trunk and shared mutations.","https://schema.org",{"og:url":83,"og:type":125,"og:title":65,"og:site_name":95,"og:description":67},"article",{"robots":127,"canonical":83},"index,follow",{"doc_id":129,"site_id":62},330128,1790071498,{"code":4,"msg":5,"data":132},{"doc_id":129,"user_id":133,"nickname":92,"user_avatar":134,"doc_module":4,"category_id":34,"category_name":35,"doc_title":65,"doc_description":67,"doc_content":135,"file_id":136,"file_url":137,"file_type":138,"file_size":139,"view_count":105,"is_deleted":4,"is_public":8,"is_downloadable":8,"audit_status":8,"page_count":140,"language":141,"language_code":63,"site_id":62,"html_lang":63,"table_of_contents":142,"faqs":143,"seo_title":144,"seo_description":67,"update_tm":145,"read_time":26},687197100911,"https://ap-avatar.wpscdn.com/avatar/a000239b6f1da00475?x-image-process=image/resize,m_fixed,w_180,h_180&k=1785132997149421697","1  \n2 3  \n4  \nSubmitted 3 October 2023  \nAccepted 29 December 2023  \nPublished 31 January 2024  \nCorresponding author  \nZiqiang Tian, [tianzq1026@163.com](tianzq1026@163.com)[ ](tianzq1026@163.com)Academic editor  \nFanglin Guan  \nAdditional Information and Declarations can be found on page 19  \nDOI 10.7717/peerj.16808  \nCopyright 2024 Li et al.  \nDistributed under  \nCreative Commons CC-BY 4.0  \nUsing molecular characteristics to distinguish multiple primary lung cancersand intrapulmonary metastases  \nZhenhua Li 1, Huilai Lv1, Fan Zhang1, Ziming Zhu2, Qiang Guo3, Mingbo Wang 1, Chao Huang 1, Lijie Guo4, Fanfei Meng4 and Ziqiang Tian 1  \nDepartment of Thoracic Surgery, Fourth Hospital of Hebei Medical University, Shijiazhuang, China  \nDepartment of Thoracic Surgery, The First Hospital of Xingtai, Xingtai, China Department of Thoracic Surgery, Affiliated Hospital of Hebei University, Baoding, China OrigiMed, Shanghai, China  \nABSTRACT  \nObjectives: Multiple lung cancers may present as multiple primary lung cancers (MPLC) or intrapulmonary metastasis (IPM) with variations in clinical stage, treatment, and prognosis. However, the existing differentiation criteria based on histology do not fully meet the clinical needs. Next-generation sequencing (NGS) may play an important role in assisting the identification of different pathologies. Here, we extended the relevant data by combining histology and NGS to develop detailed identification criteria for MPLC and IPM.  \nMaterials and Methods: Patients with lung cancer (each patient had ≥2 tumors) were enrolled in the training (n = 22) and validation (n = 13) cohorts. Genomic profiles obtained from 450-gene-targeted NGS were analyzed, and the new criteria were developed based on our findings and pre-existing Martini & Melamed criteria and molecular benchmarks.  \nResults: The analysis of the training cohort indicated that patients identified with MPLC had no (or \u003C2) trunk or shared mutations. However, 98 .02% of mutations were branch mutations, and 69 .23% of MPLC had no common mutations. In contrast, a higher percentage of trunk (33.08%) or shared (9.02%) mutations were identified in IPM, suggesting significant differences among mutated components. Subsequently, eight MPLC and five IPM cases were identified in the validation cohort, aligning with the independent imaging and pathologic distinction. Overall, the percentage of trunk and shared mutations was higher in patients with IPM than in patients with MPLC. Based on these results and the establishment of new determination criteria for MPLC and IPM, we emphasize that the type and number of shared variants based on histologic consistency assist in identification. Conclusion: Determining genetic alterations may be an effective method for differentiating MPLC and IPM, and NGS can be used as a valuable assisting tool.  \nSubjects Bioinformatics, Computational Biology, Genomics, Oncology  \nKeywords Multiple lung cancer, Multiple primary lung cancer, Intrapulmonary metastasis, Nextgeneration sequencing, Molecular classification  \nHow to cite this article Li Z, Lv H, Zhang F, Zhu Z, Guo Q, Wang M, Huang C, Guo L, Meng F, Tian Z. 2024. Using molecular characteristics to distinguish multiple primary lung cancers and intrapulmonary metastases. PeerJ 12:e16808 DOI 10.7717/peerj.16808  \nINTRODUCTION  \nLung cancer has the highest mortality rate of all malignancies worldwide (Martini & Melamed, 1975; Siegel, Miller & Jemal, 2020) . Patients with a history of lung cancer or those with biopsy-proven synchronous lesions are suspected of having multiple lung cancers. Even though multiple primary lung cancers are common (8.4–10% of the diagnosed cases), most of the synchronous lesions indicate metastases (Kozower et al., 2013; Mansuet-Lupo et al., 2019; Nakata et al., 2004) . Therefore, it is critical to determine whether the multiple lung cancers are intrapulmonary metastases (IPM) or multiple primary lung cancers (MPLC, synchronous or metachronous occurrences) . They ","cbCaihBsMJE6piSs","https://ap.wps.com/l/cbCaihBsMJE6piSs","pdf",44965784,24,"English","# Abstract\n## Objectives\n## Materials and Methods\n## Results\n## Conclusion\n# Introduction\n## Clinical significance of MPLC vs IPM\n## Limitations of histology-based criteria\n## Role of TNM staging and genetic differences","[{\"question\":\"What problem does the study address in distinguishing MPLC and IPM?\",\"answer\":\"Histology-based criteria for differentiating MPLC and intrapulmonary metastasis are often difficult to implement and may not match clinical needs when tumors look similar.\"},{\"question\":\"What sequencing approach is used to support the new differentiation criteria?\",\"answer\":\"Genomic profiles are generated using a 450-gene targeted next-generation sequencing panel and then combined with histologic information.\"},{\"question\":\"What mutation patterns help distinguish MPLC from IPM in the results?\",\"answer\":\"In the training cohort, MPLC cases show no (or fewer than 2) trunk or shared mutations, while IPM shows higher proportions of trunk and shared mutations.\"}]","Using molecular characteristics to distinguish multiple primary lung cancers and intrapulmonary metastases | PDF",1789987325]