Airway microbiota in patients with synchronous multiple primary lung cancer: the bacterial topography of the respiratory tract

we analyzed the characteristics of the respiratory microbiome, which was collected from different sites and using different sampling methods. We used the Antakli modifications as the basic criteria for the definition of sMPLC. The details are as follows: (1) one lesion in each patient must be diagnosed as an adenocarcinoma; (2) that the lesions are in anatomically distinct regions; (3) that there are no systemic metastases; (4) that there is no mediastinal spread as confirmed by postoperative pathology; and (5) possessing two or more of the following: (i) one tumor diagnosed as an adenomatous tumor, i.e., minimally invasive carcinoma, or invasive AD[3], and another tumor diagnosed as either squamous carcinoma or small cell lung cancer; (ii) different driver gene mutations; and (iii) different biomarker patterns[11]. The inclusion criteria were as follows: (1) patients diagnosed with sMPLC, as previously described, and all lesions located in the right upper lobe (RUL); (2) aged ≥18 years; (3) no contraindications for pulmonary surgery, i.e., distant metastasis, bleeding tendency, blood clotting disorders, cardiopulmonary insufficiency, severe arrhythmia or hypertension, pulmonary hypertension, and acute respiratory infection; (4) no other prior therapies; (5) expected survival >2 months; (6) without a history of other primary malignant tumors; (7) agreeing to participate in this study. Exclusion criteria included patients with poorly controlled diabetes, prior cerebrovascular events, active second malignancy, uncontrolled concommitant illness, or other conditions that might affect their participation in the study. We used the Antakli modifications as the basic criteria for the definition of sMPLC [10]. The details are as follows: (1) one lesion in each patient must be diagnosed as an adenocarcinoma; (2) that the lesions are in anatomically distinct regions; (3) that there are no systemic metastases; (4) that there is no mediastinal spread as confirmed by postoperative pathology; and (5) possessing two or more of the following: (i) one tumor diagnosed as an adenomatous tumor, i.e., minimally invasive carcinoma, or invasive AD[3], and another tumor diagnosed as either squamous carcinoma or small cell lung cancer; (ii) different driver gene mutations; and (iii) different biomarker patterns[11]. The inclusion criteria were as follows: (1) patients diagnosed with sMPLC, as previously described, and all lesions located in the right upper lobe (RUL); (2) aged ≥18 years; (3) no contraindications for pulmonary surgery, i.e., distant metastasis, bleeding tendency, blood clotting disorders, cardiopulmonary insufficiency, severe arrhythmia or hypertension, pulmonary hypertension, and acute respiratory infection; (4) no other prior therapies; (5) expected survival >2 months; (6) without a history of other primary malignant tumors; (7) agreeing to participate in this study. Exclusion criteria included patients with poorly controlled diabetes, prior cerebrovascular events, active second malignancy, uncontrolled concommitant illness, or other conditions that might affect their participation in the study.

本研究分析了通过不同采样位点与不同采样方法获取的呼吸道微生物组（respiratory microbiome）的特征。我们以Antakli修正标准作为同步多原发性肺癌（synchronous multiple primary lung cancer, sMPLC）定义的基本依据，具体如下：(1) 每位患者的任一病灶均需确诊为腺癌；(2) 病灶位于解剖学上相互独立的区域；(3) 无全身转移征象；(4) 经术后病理证实不存在纵隔播散；(5) 满足以下任意两项及以上条件：(i) 一处肿瘤确诊为腺瘤性肿瘤，即微浸润癌或浸润性腺癌（AD）[3]，另一处肿瘤确诊为鳞状细胞癌或小细胞肺癌；(ii) 存在不同的驱动基因突变；(iii) 具有不同的生物标志物谱[11]。本研究的纳入标准如下：(1) 经上述标准确诊为sMPLC且所有病灶均位于右上肺叶（RUL）的患者；(2) 年龄≥18周岁；(3) 无肺部手术禁忌证，即无远处转移、出血倾向、凝血功能障碍、心肺功能不全、严重心律失常或高血压、肺动脉高压及急性呼吸道感染；(4) 未接受过其他前期治疗；(5) 预期生存期＞2个月；(6) 无其他原发性恶性肿瘤病史；(7) 自愿参与本研究。排除标准包括合并血糖控制不佳的糖尿病、既往脑血管事件、活动性第二原发恶性肿瘤、未控制的合并疾病，或其他可能影响本研究参与的其他状况。我们以Antakli修正标准作为sMPLC定义的基本依据[10]，具体如下：(1) 每位患者的任一病灶均需确诊为腺癌；(2) 病灶位于解剖学上相互独立的区域；(3) 无全身转移征象；(4) 经术后病理证实不存在纵隔播散；(5) 满足以下任意两项及以上条件：(i) 一处肿瘤确诊为腺瘤性肿瘤，即微浸润癌或浸润性腺癌（AD）[3]，另一处肿瘤确诊为鳞状细胞癌或小细胞肺癌；(ii) 存在不同的驱动基因突变；(iii) 具有不同的生物标志物谱[11]。本研究的纳入标准如下：(1) 经上述标准确诊为sMPLC且所有病灶均位于右上肺叶（RUL）的患者；(2) 年龄≥18周岁；(3) 无肺部手术禁忌证，即无远处转移、出血倾向、凝血功能障碍、心肺功能不全、严重心律失常或高血压、肺动脉高压及急性呼吸道感染；(4) 未接受过其他前期治疗；(5) 预期生存期＞2个月；(6) 无其他原发性恶性肿瘤病史；(7) 自愿参与本研究。排除标准包括合并血糖控制不佳的糖尿病、既往脑血管事件、活动性第二原发恶性肿瘤、未控制的合并疾病，或其他可能影响本研究参与的其他状况。