Bronchioloalveolar Carcinoma: a Transla-tional Perspective

摘要

In this issue of Oncology, Levy and colleagues provide a comprehensive review of bronchioloalveolar carcinoma [BAC], with a focus on the management of this rare disease, which represents 4% of all lung can-cers.[1] The definition of BAC was revised by the World Health Organization (WHO) in 2004, with changes made to the diagnostic criteria and classification. [2] BAC was defined as an adenocarcinoma of the lung that grows in a lepidic fashion along the alveolar septa without invasion of stroma, blood vessels, or pleura. BAC has been sub-classified into three types: nonmucinous, mucinous, and mixed. Because of the rarity of BAC and the recent change in its definition, risk factors associated with the development of BAC are poorly understood. Smoking has not always been thought to be a risk factor for BAC.[3,4] It is estimated that approximately 30% of patients with BAC are never-smokers, compared with 15% of patients with adenocarcinoma and 5% of patients with squamous cell carcinoma. [3] However, case control studies have demonstrated an association between BAC and intensity of cigarette smoking. [4] There is also the paradox that nonmucinous BAC, which is more prone to EGFR mutation, is more significantly associated with smoking habits than mucinous BAC, which is more prone to K-ras mutation. [5]