So far, the monoclonal hypothesis of tumor occurrence and development cannot be justified. The genetic diversity selection hypothesis for the occurrence and development of lung cancer links Mendelian genetics with Darwin's theory of evolution, suggesting that the genetic diversity of tumor cell populations with polyclonal origins-monoclonal selection-subclonal expansion is the result of selection pressure. Normal cells acquire mutations in oncogenic driver genes and have a selective advantage over other cells, becoming tumor initiating cells; In the interaction with the tumor microenvironment (TME), the vast majority of initiating cells are recognized and killed by the human immune system. If immune escape occurs, the incidence of malignant tumors will greatly increase, and subclonal expansion, intratumour heterogeneity, etc. will occur. This article proposed the hypothesis of genetic diversity selection and analyzed its clinical significance. .
【中文题目：肺癌发生发展的遗传多样性选择假说 ——分子进化与临床意义】 【中文摘要：到目前为止，阐述肿瘤发生发展的单克隆假说不能自圆其说。遗传多样性选择假说将孟德尔遗传学与达尔文进化论联系起来，认为多克隆起源-单克隆选择-亚克隆扩张的肿瘤细胞群遗传多样性是选择压力的结果。正常细胞获得致癌驱动基因突变，相对于其他细胞具有选择优势，成为肿瘤启动细胞；在与肿瘤微环境（tumor microenvironment, TME）的互动中，绝大多数启动细胞会被人体自身免疫系统识别并杀灭，如果发生免疫逃逸，恶性肿瘤的发生率会极大增加，并发生亚克隆扩张、肿瘤内异质性等。本文提出遗传多样性选择假说，并分析其临床意义。 】 【中文关键词：肺肿瘤；遗传多样性；选择；分子进化；临床意义】.
Keywords: Clinical significance; Genetic diversity; Lung neoplasms; Molecular evolution; Selection.