小时候觉得癌症这个词离自己很远很远，知道它很可怕，但实际上并不知道它具体是什么，只天真的觉得它永远也不会出现在我的身边。
高三时大奶从被检出肝癌晚期到去世不到两周，她在去世的前两天都不是特别清楚自己的病情，直到去世的前一天病情的加重，她才明白。
从高三到硕士毕业，7年的时间，大姑和婶婶接连也因为癌症去世。而爷爷今天也被检出贲门癌。爷爷是一个闲不住的人，虽然80多岁了，种地比我们家都多，大概是从4月份的时候开始吃东西容易打嗝，以前他每次从地里干完活回家总要吃两个馒头，现在基本吃不了馒头，只能吃些面条和粥。家里人一直劝他去医院检查，他总是不愿意去，最近才被说服去医院检查，却没想道是癌症。
真的很害怕，以前觉得不会出现在身边的癌症，却不断地夺走亲人的生命。我虽然是研究生命科学的，经常关注癌症相关方面的研究，但是我还是不知道为什么现在的癌症越来越多，我经常怀疑我每天的研究有什么意义，在面对真正的癌症时有什么帮助，似乎大多时候我们依然无能为力！
但是，没有这些基础研究的推动，临床上治疗又怎么能提升？
一句话评价
用尽量简短的一句话说清文章亮点或者你的推荐理由。越短越好
文章信息
题目：Tracking the Evolution of Non–Small-Cell Lung Cancer
杂志：The new england journal of medicine
时间：June 1, 2017
链接: https://www.nejm.org/doi/full/10.1056/NEJMoa1616288
figure
文章介绍：
BACKGROUND
Among patients with non–small-cell lung cancer (NSCLC), data on intratumor heterogeneity and cancer genome evolution have been limited to small retrospective cohorts. We wanted to prospectively investigate intratumor heterogeneity in relation to clinical outcome and to determine the clonal nature of driver events and evolutionary processes in early-stage NSCLC.
METHODS
In this prospective cohort study, we performed multiregion whole-exome sequencing on 100 early-stage NSCLC tumors that had been resected before systemic therapy. We sequenced and analyzed 327 tumor regions to define evolutionary histories, obtain a census of clonal and subclonal events, and assess the relationship between intratumor heterogeneity and recurrence-free survival.
RESULTS
We observed widespread intratumor heterogeneity for both somatic copy-number altera- tions and mutations. Driver mutations in EGFR, MET, BRAF, and TP53 were almost always clonal. However, heterogeneous driver alterations that occurred later in evolution were found in more than 75% of the tumors and were common in PIK3CA and NF1 and in genes that are involved in chromatin modification and DNA damage response and repair. Genome doubling and ongoing dynamic chromosomal instability were associated with intratumor heterogeneity and resulted in parallel evolution of driver somatic copy-number alterations, including amplifications in CDK4, FOXA1, and BCL11A. Elevated copy-number heterogeneity was associated with an increased risk of recurrence or death (hazard ratio, 4.9; P=4.4×10−4), which remained significant in multivariate analysis.
CONCLUSIONS
Intratumor heterogeneity mediated through chromosome instability was associated with an increased risk of recurrence or death, a finding that supports the potential value of chromosome instability as a prognostic predictor. (Funded by Cancer Research UK and others; TRACERx ClinicalTrials.gov number, NCT01888601.)
每日文献摘要：第17篇 2019年11月05日 周二
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