The patient was diagnosed with right lung adenocarcinoma (Fig. 1A) with mediastinal metastasis and rib metastasis at T3N2M1 stage IVA, positive for tp53 and negative for epidermal growth factor receptor/anaplastic lymphoma kinase/ROS proto-oncogene 1, receptor tyrosine kinase/Kirsten rat sarcoma viral oncogene combined with chronic obstructive pulmonary disease (COPD), pulmonary bullous. The gene discussed is TP53; the disease is chronic obstructive pulmonary disease.