The article presents a clinical case of diagnosis and successful surgical treatment of a giant epidermoid cyst of the anterior surface of the neck with an unusual magnetic resonance pattern in the form of calibrated spherical structures. The issues of differential diagnosis of epidermoid cyst and dermoid cyst and the reasons for the formation of intracavitary spheres are addressed

Purpose of the study: to experimentally study the morphological features of the reaction of diaphragm tissue to porous titanium nickelide in comparison with medical felt.Materials and methods. A series of experiments was carried out on 20 rats. The animals were divided into two comparison groups: in the main group (n = 10), the reaction of diaphragm tissue to an implant made of titanium nickelide was studied; in the control group (n = 10), an implant made of medical felt (fluoroplastic-4) was used. Animals were removed from the experiment 14, 30, 60 and 90 days after surgery. A histological study of the reaction of the diaphragm tissue to the implant was carried out, as well as the structural behavior of the material under study.Results. Macroscopically, after 14 days in the main group, a local adhesive process was noted. In the long term, the implant was covered with a thin connective tissue film without signs of inflammation. In the control group, after 14 days, phenomena of inflammatory infiltration with organ involvement were observed. After 30 days, the inflammatory infiltrate persisted with the formation of a connective tissue capsule. The implant increased in size with deformation, swelling, and in the long term, disintegration of the structure. Histologically, on the 14th day in both groups, granulation tissue formed between the implant and the diaphragm. By the 30th day in the main group, the number and thickness of collagen fibers increased, they filled the porous structure of the material. In the control group, the appearance of giant multinucleated cells was noted between the felt fibers, which are indicators of the body's tissue reaction to foreign material. On the 60th day in the main group, a regenerate of mature connective tissue formed around the implant, filling the pores of the material and spreading to the muscle fibers of the diaphragm. In the control group, a picture of productive granulomatous inflammation with phenomena of biodegradation of the material was observed.Conclusion. The results of the experiment demonstrated the absolute advantage of titanium nickelide in reconstructive surgery of the diaphragm. At the same time, the disadvantages of using medical felt associated with the body’s reaction to the material as a foreign body and the tendency to resorption are noted.

OBJECTIVE:To evaluate the quality of life before and after video-assisted thoracoscopic plication of relaxed dome of diaphragm.MATERIAL AND METHODS:The study included 17 patients operated on for unilateral relaxation of diaphragm. We analyzed quality of life in preoperative period, 1, 3, 6 and 12 months after surgery using the SF-36 and EuroQ-5D-5L questionnaires. To assess the impact of abnormality on respiratory function, we estimated diaphragm position, spirometry data and SGRQ scores.RESULTS:FVC increased by 16.5% after 1 month, 19.5% after 6 months and 20.1% after 12 months. In addition, FEV1 significantly increased (by 12.6% after 1 month, 10.1% after 6 months and 12.7% after 12 months). Mean values of diaphragm elevation in postoperative period decreased by 25.5-25.6%. According to the SF-36 and EuroQ-5D-5L questionnaires, physical and psychological health components significantly increased within a month after surgical treatment. According to the SGRQ questionnaire, influence of disease on overall status decreased a month after surgery as evidences by lower total score (p<0.05).CONCLUSION:Objective and survey data revealed significant improvement in quality of life after surgery. A trend towards higher quality of life was demonstrated by all questionnaires in a month after surgery.

Early prediction and prevention of recurring illness is critical for improving the survival rates of patients with non-small cell lung cancer (NSCLC). Previously, we demonstrated that the presence of premalignant epithelial changes in the small bronchi distant to the primary tumor is associated with NSCLC progression: isolated basal cell hyperplasia (iBCH) indicates a high risk of distant metastasis, BCH combined with squamous metaplasia (BCH SM ) - a high risk of locoregional recurrence. Here, we aimed to identify germline single nucleotide variants (SNVs) and insertions and deletions (InDels) associated with distant metastasis and locoregional recurrence in cases with iBCH and BCH (SM )using whole-exome sequencing of 172 NSCLC patients. The rs112065068 of the TGOLN2 gene was identified only in iBCH patients and was associated with a high risk of distant metastasis ( P < .001) and worse metastasis-free survival (HR = 4.19 (95 %CI 1.97 -8.93); P < .001). This variant was validated in a group of 109 NSCLC patients using real-time PCR and Sanger sequencing analyses. To our knowledge, this study is the first to identify a germline variant associated with NSCLC distant metastasis.

The aim of investigation was to study experimentally the morphological features of tissue integration of two-layer titanium nickelide (TiNi) knitwear when replacing thoracoabdominal defects.Materials and methods. The experiments were carried out on 40 Wistar rats. The experimental animals were divided into two comparison groups: in Group A (n = 20) the defect was replaced using a two-layer knitted tape made of TiNi, in Group B (n = 20) a polypropylene mesh implant was used. The technique of the operation and the peculiarities of keeping the animals did not differ. Animals were taken out after 14, 30, 60 and 90 days of experiment. The macroscopic structural features at the site of implant fixation to tissues and at the sites of contact with underlying organs were studied, and the inflammatory process was assessed. The histological and electron microscopic study was carried out with an assessment of the features of tissue integration through the mesh structure of knitwear.Results. Thirty days after the surgery in four cases of Group B the appearance of the chest wall deformation at the site of implant fixation was noted, in one case the deformation site was located along the lateral edge of the abdominal wall. Among the animals of Group A no such changes were recorded. The histological and electron microscopy examination revealed that the porous structure of the TiNi wire, as well as the biomechanical and biochemical properties of the two-layer metal knitwear, ensure optimal integration of the endoprosthesis in the body tissues, forming an elastic frame close to natural. In Group B, on the contrary, the reaction of the body caused by the implanted polypropylene prosthesis was characterized by more pronounced fibrosis, and tissue integration through the mesh structure of the implant was not observed.Conclusion. Two-layer TiNi knitwear in the replacement of complex structures of the thoracoabdominal zone showed promising results, which opens up prospects for further clinical research.

The purpose of a study: to study the immediate results and surgical aspects of angio- and bronchoplastic lobectomy for non-small cell lung cancer in elderly and senile patients, as well as to identify the features of their perioperative support.Material and methods. The results of treatment of 63 patients with non-small cell lung cancer older than 60 years after angio- and/or bronchoplastic lobectomy were analyzed. The average age of the patients was (71.4 ± 5.1) years old. The oldest patient at the time of surgery was 82 years old. The majority (93.6%) of patients had one or more concomitant diseases, among them bronchopulmonary and cardiovascular pathologies were most often detected.Results. Postoperative complications were recorded in 22 (34.9%) patients, mortality was 6.35%. The incidence of complications that did not require surgical correction was 6.3%. Prolonged air discharge through the drainage was registered in 11.1% of patients. In 2 cases (3.2%), prolonged air release and delayed expansion of the lung led to the formation of residual pleural cavity with infection. Critical complications were recorded in 4 cases (6.3%), and in 4 (6.3%) patients they caused a lethal outcome. Among them, the leading place is occupied by the failure of the bronchial suture and cardiac arrhythmias.Conclusion. Angio- and bronchoplastic anatomical resections in patients of the older age group are accompanied by a number of technical features and specifics of perioperative curation due to age-related changes and comorbidities.

Leiomyosarcoma of the diaphragm is an extremely rare disease. No more than 20 cases have been described so far. All patients needed reconstruction of the dome of the diaphragm, including with the use of implants. The article presents a clinical case of treatment of a 40-year-old woman with giant leiomyosarcoma of the left diaphragmic cupola.The extirpation of the tumor as a single block with the diaphragm and the pericardial wall was performed, followed by the restoration of the abdominal obstruction with nickel-titanium metal knitwear.

The mechanism of the relationship between pretumor changes in the bronchial respiratory epithelium and the risk of progression of non-small cell lung cancer (NSCLC) remains unclear. It has been suggested that the relationship between reactive changes in the bronchial mucosa and NSCLC progression may be caused by the functional status of monocytic-macrophage cells as important participants in infammation, which determines both the risk of premalignant changes in the epithelium and malignant progression. The purpose of the study was to investigate the phenotypic profle of peripheral blood monocytes and macrophages induced from monocytes in vitro depending on the state of respiratory epithelium in NSCLC patients. Material and Methods . The study included 39 patients with newly diagnosed NSCLC. Based on the morphological examination of small bronchi taken at the distance of 3–5 cm from the tumor, patients were divided into the following groups depending on the type of pretumor changes: no pretumor changes (n=6), isolated basal cell hyperplasia (BCH) (n=13), combination of BCH and squamous metaplasia (SM) (n=3), combination of unchanged epithelium and focal BCH (n=17). The phenotypic features of peripheral blood monocytes and in vitro -induced macrophages were assessed before treatment using fow cytometry. Results . The state of the respiratory epithelium in NSCLC patients prior to the start of anticancer treatment was associated with the phenotypic features of peripheral blood monocytes, but not with the profle of macrophages induced from them. Distortion of the response of induced macrophages to the polarizing stimuli was observed in NSCLC patients: the cultured cells responded to both M1 and M2 inducers (LPS and IL-4, respectively) with a phenotype shift to M2, while the CD206 marker expression varied depending on the presence and type of pretumor changes. Conclusion . The phenotypic profle of peripheral blood monocytes was associated with the state of the respiratory epithelium in NSCLC patients before anti-tumor treatment, but not with the phenotypic features of induced macrophages.

OBJECTIVE To study the possibilities of the ERAS program and immediate results in high-risk patients undergoing lung resection. MATERIAL AND METHODS The prospective study included 76 high-risk patients. All patients required lobar resection for various lung diseases. The risk of postoperative complications and mortality was stratified using the Thoracoscore and Thoracic Revised Cardiac Risk Index systems, as well as the American Society of Anesthesiologists Outcome Prediction Scale. At all perioperative stages, we assessed the possibilities for accelerated recovery and postoperative complications using the Thoracic Morbidity and Mortality System. RESULTS Patients were characterized by multiple comorbidities requiring long-term and individual preoperative correction. This prevented adherence to a single protocol at the outpatient stage. We intraoperatively observed severe adhesive process up to complete obliteration of pleural cavity that complicated the use of minimally invasive technologies. Lung tissue was characterized by emphysematous lesions and reduced elasticity that caused prolonged air release and formation of residual cavities. These features required two pleural drains in 42 (52.3%) cases that increased hospital-stay. Multimodal analgesia and early activation with rehabilitation were optimal elements of ERAS. Various postoperative abnormalities developed in 31 (40.8%) patients, mortality rate was 7.9% (n=6). Minor and serious complications prevailed (21 (27.6%) cases). Their correction was effective and not accompanied by fatal outcomes. Critical complications occurred in 10 (13.1%) patients and caused fatal outcomes in 6 (7.9%) cases. CONCLUSION ERAS protocol among high-risk patients in thoracic surgery is possible in the form of separate elements included in perioperative support.

OBJECTIVE:To analyze postoperative outcomes and perioperative management of patients with post-intensive care tracheal stenosis and previous COVID-19 pneumonia.MATERIAL AND METHODS:There were 8 patients with post-intensive care tracheal stenosis and previous COVID-19 pneumonia aged 34-61 years between January 2021 and April 2021. Lung damage CT-3 was observed in 2 (25%) patients, CT-4 - in 5 (62.5%) patients. In one case, COVID-19 pneumonia with lung damage CT-2 joined to acute cerebrovascular accident. Post-tracheostomy stenosis was detected in 7 (87.5%) cases, post-intubation stenosis - in 1 patient. Duration of invasive mechanical ventilation ranged from 5 to 130 days. In 75% of cases, tracheal stenosis was localized in the larynx and cervical trachea. Two patients admitted with tracheostomy. In one case, an extended tracheal stenosis was combined with atresia of infraglottic part of the larynx. One patient had tracheal stenosis combined with tracheoesophageal fistula (TEF). Length of tracheal stenosis was 15-45 mm. Tracheomalacia was observed in 4 (50%) patients. All patients had severe concomitant diseases.RESULTS:To restore airway patency, we used circular tracheal resection with anastomosis, laryngotracheoplasty and endoscopic methods. Tracheal resection combined with TEF required circular tracheal resection with disconnection of fistula. Adequate breathing through the natural airways was restored in all patients. There was no postoperative mortality. Three patients with baseline tracheal stenosis had favorable postoperative outcomes after circular tracheal resection. Four patients are at the final stage of treatment after laryngotracheoplasty and tracheal stenting.CONCLUSION:Patients after invasive mechanical ventilation for COVID-19 pneumonia are at high risk of cicatricial tracheal stenosis and require follow-up. Circular tracheal resection ensures early rehabilitation and favorable functional results. Laryngotracheoplasty is preferred if circular tracheal resection is impossible. This procedure ensures adequate debridement of tracheobronchial tree and respiratory support. Endoscopic measures are an alternative for open surgery, especially for intrathoracic tracheal stenosis and intractable tracheobronchitis.

Purpose of the study was to assess the impact of the COVID-19 pandemic on the direct work of the surgical service providing specialized care for patients with lung cancer. Material and methods. The study is based on the results of work for the period 2020–2021 of two departments providing basic surgical care for patients with lung cancer in the Tomsk Region. The impact of the spread of the virus in the region on the number of operations performed for lung cancer were assessed. In the postoperative period, the number and nature of common and associated with infection with COVID-19 complications were analyzed, both in a hospital setting and after discharge. Results. A decrease in the number of patients with lung cancer treated during a pandemic was noted, and a tendency for a decrease in the number of operations up to a complete cessation of work during periods of an increase in the spread of the virus was indicated. Infectious complications associated with infection with COVID-19 after surgical treatment of lung cancer were confirmed in 11 patients, of whom bilateral pneumonia developed in 9 cases (81.8%), mortality in 3 (27.3%) cases. Conclusion. The outbreak of the COVID-19 pandemic has led to a decrease in the volume of surgical care for all localizations of neoplasms, including lung cancer. Infection of a patient at different times after surgical treatment is accompanied by an extremely high risk of developing viral pneumonia and death.

OBJECTIVE:To study the immediate results of angio- and bronchoplastic lobectomies for non-small cell lung carcinoma (NSCLC) in patients over 70 years old.MATERIAL AND METHODS:Thirty-one extended angio- and/or bronchoplastic lobectomies were performed in patients with NSCLC over 70 years old between January 2015 and December 2020. Mean age of patients was 74.5 ± 3.2 years. NSCLC stage IA was found in 5 (16.1%) cases, IB - 11 (35.5%), IIA - 12 (38.7%), IIB - 3 (9.7%) patients. Squamous cell carcinoma was diagnosed in 19 (61.3%) patients, adenocarcinoma - in other ones (n=12). All patients had concomitant diseases with predominance of cardiorespiratory pathology. Severity of postoperative complications was assessed according to the Clavien - Dindo grading system.RESULTS:Mean Charlson index was 5.34 ± 1.46 scores. ASA grade III was observed in 21 patients, grade IV - in 10 patients. Postoperative complications occurred in 12 (38.7%) patients, mortality rate was 6.4%. Prolonged air discharge through pleural drainage tubes (12.9%) and paroxysms of atrial fibrillation (16.1%) were the most common complications. Cardiac arrhythmia is a serious and fatal complication.CONCLUSION:Anatomical lung resections for NSCLC in patients over 70 years old have certain features of surgical technique and postoperative management. Prevention and prediction of postoperative complications along with rational perioperative management are of priority importance for increasing the safety of these interventions. Angio- and/or bronchoplastic lobectomy should be considered as the only surgical option characterized by high quality and satisfactory immediate results. This procedure is an adequate alternative to pneumonectomy.

Diagnosis of diaphragmatic injury is difficult in some cases. Symptoms of chronic posttraumatic diaphragmatic hernia are very diverse and associated with dysfunctions of the displaced abdominal organs and compression of thoracic organs. Previous blunt or open chest and abdominal trauma, as well as visible scars as a result of injury should be considered. Treatment concept assumes surgical correction of posttraumatic diaphragmatic hernia. Choice of surgical approach and type of intervention are determined individually. Despite the global trend towards minimally invasive endoscopic surgery, there are few reports on thoracoscopic correction of posttraumatic phrenic hernia. The authors report a rare case of thoracoscopic correction of posttraumatic diaphragmatic hernia in an 81-year-old man in 62 years after abdominal injury. Assuming degenerative changes in tissues and risk of defect enlargement following suture eruption, we used titanium nickelide reinforcing protectors. Video-assisted double port thoracoscopic access allowed minimally traumatic and successful correction of diaphragmatic hernia, that ensured early medical and social rehabilitation of the patient.

Background. Breast cancer (BC) is the most common female malignancy worldwide. partner and localizer of BRCA2 gene (PALB2) is directly involved in DNA damage response. germline mutation in PALB2 has been identified in breast cancer and familial pancreatic cancer cases, accounting for approximately 1–2% and 3–4%, respectively. the goal of this report was to describe new PALB2 mutation in a young Yakut breast cancer patient with family history of cancer. Material and methods. Genomic DNA were isolated from blood samples and used to prepare libraries using a capture-based target enrichment kit, Hereditary Cancer Solution™ (SOPHIA GENETICS, Switzerland), covering 27 genes (ATM, APC, BARD1, BRCA1, BRCA2, BRIP1, CDH1, CHEK2, EPCAM, FAM175A, MLH1, MRE11A, MSH2, MSH6, MUTYH, NBN, PALB2, PIK3CA, PMS2, PMS2CL, PTEN, RAD50, RAD51C, RAD51D, STK11, TP53 and XRCC2). paired-end sequencing (2 × 150 bp) was conducted using NextSeq 500 system (Illumina, USA). Results. Here we describe a case of a never-before-reported mutation in the PALB gene that led to the early onset breast cancer. We report the case of a 39-year-old breast cancer Yakut woman with a family history of pancreatic cancer. Bioinformatics analysis of the NGS data revealed the presence of the new PALB2 gene germinal frameshift deletion (NM_024675:exon1:c.47dela:p.K16fs). in accordance with dbPubMed ClinVar, new mutation is located in codon of the PALB2 gene, where the likely pathogenic donor splice site mutation (NM_024675.3:c.48+1delG) associated with hereditary cancer-predisposing syndrome has been earlier described. Conclusion. We found a new never-before-reported mutation in PALB2 gene, which probably associated with early onset breast cancer in Yakut indigenous women with a family history of pancreatic cancer.

The aim of the research. The aim of the study was to conduct a comparative analysis of the immediate results of organ-preserving anatomical resections and pneumonectomy in elderly and senile patients with lung cancer. Material and methods. The study included 126 patients over 60 years of age, who were divided into 2 groups depending on the extent of the surgical intervention performed. Group A was represented by 63 patients who underwent organ-preserving anatomical resections and group B enrolled 63 patients after pneumonectomy. The groups were formed through retrospective analysis of prospective data obtained from the electronic registry. In all cases, the comorbid background was assessed, as well as options for preoperative correction of the concomitant pathology. In the postoperative period, the number and severity of complications were assessed using the TMM (Thoracic Morbidity and Mortality) System, and an intergroup comparative statistical analysis was performed. Results. According to the results of the study, postoperative complications among patients in group A were recorded in 22 (34.9%) cases, mortality was established in 4 (6.35%) patients. In group B, the number of complications and mortality were registered in 18 (28.6%) and 6 (9.52%) cases, respectively. Among the complications registered in group A, the most common were prolonged air discharge through the drainage and cardiac arrhythmias. In the group after pneumonectomy, complications associated with arrhythmia also prevailed, while the complication occurred statistically more often. Among the lethal outcomes in both groups, the main cause was progressive cardiovascular insufficiency against the background of arrhythmia, as well as failure of the bronchus stump and suture. Conclusion. Despite the absence of reliable differences in the total number of complications and mortality in the groups, there is a clear trend towards a higher frequency of fatal complications in the group after pneumonectomy. A feature was noted in the continuing risk of mortality, regardless of the severity of the complication. Among patients after organ-preserving anatomical resections, reversible deviations from the normal course in the postoperative period prevail. In addition, this extent of surgical intervention provides for better functionality and quality of life to elderly and senile patients.

ОБОСНОВАНИЕ Хирургические технологии являются единственным эффективным способом лечения при релаксации диафрагмы (РД). Их основная идея — иммобилизовать диафрагму в низком и относительно плоском положении, низвести органы брюшной полости в нормальную позицию и устранить компрессию органов грудной клетки. ЦЕЛЬ ИССЛЕДОВАНИЯ Представить опыт двухпортовой видеоассистированной торакоскопической пликации релаксированной диафрагмы с использованием протекторов из пористого сплава никелида титана. МАТЕРИАЛ И МЕТОДЫ Проведено одноцентровое проспективное нерандомизированное исследование в период с июня 2018 г. по июнь 2021 г. По протоколу пролечены 14 больных с тотальной РД, которым выполнена видеоторакоскопическая френопликация. РЕЗУЛЬТАТЫ Средний возраст больных 59±11,2 года; средний индекс массы тела (ИМТ) 28,17±5,7 кг/м2. Идиопатический характер РД установлен у 11 (78,6%) пациентов, у остальных диагностирована травма диафрагмального нерва при кардиохирургических операциях. Индекс коморбидности Чарлсона составил 2 балла у 5 (35%) исследуемых, 3 балла у 6 (43%), 4 балла у 3 (21%). ASA I определен у 1 больного, II — у 10, III — у 3. Правосторонняя френопликация выполнена в 8 случаях, левосторонняя — в 6. Экстубация проведена в операционной у 11 (78,6%) пациентов. Болевой синдром в 1-е послеоперационные сутки составил в среднем 4,4±0,5 балла, во 2-е — 3,9±0,5 балла, в 3-и — 3,2±1,0 балла, в 4-е — 2,8±1,1 балла, в 5-е — 2±0,7 балла. Средняя продолжительность дренирования плевральной полости составила 2,8±1,1 сут. Послеоперационные осложнения I и II степени тяжести по классификации Clavien—Dindo зафиксированы у 2 (14,3%) пациентов. До операции у всех больных наблюдались низкие формированная жизненная емкость легких (ФЖЕЛ) и объем форсированного воздуха за 1-ю секунду (ОФВ1) с высоким показателем элевации диафрагмы (ЭД). После операции случаи ухудшения состояния отсутствовали, у 78,6% пациентов отметили улучшение, рецидивов не выявлено. Установлено статистически значимое увеличение средних значений ФЖЕЛ через 1 мес после операции на 16,5%, через 6 мес — на 19,5%, через 12 мес — на 20,1% относительно исходных дооперационных значений; ОФВ1 через 1 мес после операции — на 12,6%, через 6 мес — на 10,1%, через 12 мес — на 12,7%, а также достоверное снижение средних значений ЭД относительно исходных показателей на 25,6%. Выявлена обратная корреляция между ФЖЕЛ, ОФВ1 и ЭД. ЗАКЛЮЧЕНИЕ В исследовании наблюдали хороший клинический результат лечения при РД и улучшение функции внешнего дыхания. Необходимы многоцентровые проспективные рандомизированные исследования по оценке безопасности и эффективности видеоторакоскопической френопликации, уточнению показаний к операции и протоколов периоперационного ведения больных.

The report presents a brief historical outline of spontaneous rupture of the esophagus, modern data on the incidence of the disease, difficulties in diagnosis and treatment, as well as the high incidence of complications and mortality in this pathology. A case of successful staged treatment of a patient with spontaneous rupture of the esophagus complicated by purulent mediastinitis and pleural empyema, who was admitted 6 days after the onset of the disease, is described. The surgical tactics and features of the postoperative management of the patient are described in detail.

Macrophages are key components of the innate immune system. The variability of the macrophage’s participation in tumor progression, determined by their functional polarization, opens up a wide prospect for modulating their functional profile, primarily in the direction of increasing antitumor activity.The purpose of the studywas to provide up-to-date data on the process of macrophage polarization, mechanisms of its regulation, polarization markers and induction factors.Material and methods. A search was made for available literature sources published in Web of Science, Scopus and other databases. more than 160 sources devoted to the study of the process of macrophage polarization were found, of which 121 were included in this review.Results. This review presents data on the molecular mechanisms and gene signatures associated with M1 and M2 polarization of macrophages. We displayed information on metabolic, phenotypic characteristics and cytokine profile of M1- and M2-macrophages, as well as highlighted data on polarization factors and targets of their action.Conclusion. The information presented in the review can serve as an information base for the development of experimental and clinical approaches for editing the functional profile of macrophages in order to control their involvement in various pathological processes.

Stepwise change of the bronchial epithelium, from basal cell hyperplasia (BCH) across squamous metaplasia (SM) and dysplasia to carcinoma in situ, is a precancerous process preceding lung squamous cell carcinoma. The premalignant changes may stop or spontaneously regress up to normal epithelium; however, underlying mechanisms are still not understood. Previously, we suggested that combinations of bronchial lesions detected in the small bronchi of lung cancer patients distant from the primary lung tumor may reflect the different "scenarios" of the precancerous process (Denisov et al., 2019, 2020). This study aimed to identify germline genetic variants (SNPs and CNVs) associated with different premalignant lesions in the bronchial epithelium. The study included 111 (58.8±8.6 years old) patients with NSCLC (T1-4N0-3M0): 47 cases with isolated BCH, 39 cases with BCH and SM and 25 cases with normal epithelium. Premalignant lesions were identified in hematoxylin and eosin-stained sections of FFPE samples of small bronchi distant (3-5 cm) from the tumor. Blood samples were sequenced on a NextSeq 500 (Illumina) using SureSelect XT Human All Exon v7 kit (Agilent). Data were analyzed using GATK pipeline, CNV calling was performed by ClinCNV. Patients with the same premalignant bronchial lesions displayed common genetic variants. In particular, patients with BCH harbored the SNP in the gene involved in the F-actin assembly and CNVs at 17p11, 22q11, and 20p13 chromosome regions that include different lncRNAs, immune regulatory, and inositol kinase genes. Patients with BCH and SM had the CNV in the 6p21 region that contains major histocompatibility complex genes. Our findings indicate that germline genetic variants may influence the precancerous process in the bronchial epithelium preceding lung squamous cell carcinoma.