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Related Experiment Videos

Pulmonary preinvasive neoplasia.

K M Kerr1

  • 1Department of Pathology, Aberdeen Royal Infirmary and Aberdeen University Medical School, Foresterhill, Aberdeen AB25 2ZD, UK. k.kerr@abdn.ac.uk

Journal of Clinical Pathology
|April 18, 2001
PubMed
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Understanding preinvasive lung lesions like squamous dysplasia/carcinoma in situ (SD/CIS) and atypical adenomatous hyperplasia (AAH) is key for lung cancer screening. Molecular changes in these lesions offer potential targets for early detection and treatment.

Area of Science:

  • Pulmonary pathology
  • Molecular oncology
  • Cancer biology

Background:

  • The WHO classification identifies three preinvasive lung lesions: squamous dysplasia/carcinoma in situ (SD/CIS), atypical adenomatous hyperplasia (AAH), and diffuse idiopathic pulmonary neuroendocrine cell hyperplasia (DIP-NECH).
  • SD/CIS grading is complex and its reproducibility is challenging, while AAH is a potential precursor to peripheral adenocarcinoma.
  • DIP-NECH is rare and its biology is largely unknown.

Purpose of the Study:

  • To review current knowledge on the biology of preinvasive lung lesions.
  • To highlight the molecular changes associated with neoplastic progression in these lesions.
  • To emphasize the importance of understanding these lesions for lung cancer screening.

Main Methods:

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  • Review of the literature on lung preinvasive neoplasia.
  • Analysis of morphological and molecular characteristics of SD/CIS, AAH, and DIP-NECH.
  • Discussion of the potential role of these lesions in lung cancer development and screening.

    • Main Results:

    • Molecular alterations are observed in preinvasive lesions, increasing with atypia, and may occur even in morphologically normal epithelium.
    • SD/CIS may progress to invasive bronchial carcinoma over 1-10 years and can be reversible.
    • AAH shows morphological evidence of progression to non-invasive bronchioloalveolar carcinoma and subsequently to invasive adenocarcinoma, though molecular events are poorly understood.

    Conclusions:

    • Understanding the biology and molecular characteristics of preinvasive lung lesions is crucial for developing effective lung cancer screening programs.
    • These lesions may serve as important targets for early detection and potentially therapeutic intervention.
    • Further research is needed to clarify the incidence, progression risk, and molecular mechanisms of these preinvasive lesions.