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OBJECTIVE: Distinguishing between multiple primary lung cancers and metastatic tumors is often difficult when the tumor histology is same. Since genomic instability is a common feature of cancer, we hypothesized that independently arising neoplasms in an individual patient would exhibit measurable genomic variation, enabling discrimination of tumor lineage and relatedness. The feasibility of analyzing genomic instability expression profiles to distinguish multiple primary lung cancers from metastatic tumors was evaluated.
METHODS: This study enrolled 5 patients with multiple primary lung cancers demonstrating with the histology and 7 patients who were diagnosed as intrapulmonary metastasis lung cancer. All of them were underwent surgery between April 2003 and December 2013 at the Department of the Thoracic Surgery at West China Hospital in Sichuan province of China. Genomic DNA from lung cancers from individual patients was analyzed by six microsatellites (D2S1363, D6S1056, D7S1824, D10S1239, D15S822, and D22S689) with PCR to identify discordant allelic variation.
RESULTS: In the group of metachronous lung tumor, 3 of 5 patients who were different histological types and one of 5 patients with the same histological type showed “contradictory trend”. The other one showed “unique trend”. In the second group (intrapulmonary metastasis lung tumor), one of 7 patients showed “contradictory trend” and the others showed “unique trend”.
CONCLUSIONS: With polymorphic microsatellite markers, “different trends”, which are the “unique trend” that represents metastasis cancers and the “contradictory trend” that represents primary multiple tumors, are useful in discrimination of multiple primary lung cancer and intrapulmonary metastasis lung cancer even diagnosed with the histopathological evaluation.