Resumen de Somatic genomic alterations in lung adenocarcinoma: non-invasive molecular diagnosis and prognosis impact of driver mutations in non-tumoral airway cells
The main hypothesis of this thesis is that during the process of cancerification of the pulmonary epithelium, "driver-mutations" can appear not only in malignant cells but also in any cell of the pulmonary epithelium without necessarily producing clonal expansion. We also wanted to demonstrate that the use of cytological samples obtained by bronchial brushing is valid for the molecular study in patients with pulmonary adenocarcinoma. This thesis consists of 5 articles, two prospective cohorts of patients with resected adenocarcinoma where we could demonstrate the presence of oncogenes mutations in healthy tissue and its association with poor prognosis. A third article where we demonstrated that the cytological samples preserved in RPMI medium are sufficient to perform an extended molecular study. The last two articles are a comprehensive review of the etiopathogenesis of adenocarcinoma and an editorial on how immunological phenotypes affect the response to immunotherapy in patients with cancer and COPD.
