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Technical Briefs |
Departments of
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Surgery and
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Pathology and Laboratory Medicine, and
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Digestive Disease Center, Medical University of South Carolina, Charleston, SC 29425;
aaddress correspondence to this author at: Hollings Cancer Center, Medical University of South Carolina, 86 Jonathan Lucas St., Room 313, PO Box 250956, Charleston, SC 29425; fax 843-792-3940
| The first 20% of the full text of this article appears below. |
Non-small cell lung cancer (NSCLC) is the most common cancer-related cause of death for both men and women in the US. Standard therapies for patients with NSCLC include surgery, chemotherapy, and radiation therapy, and the stage of disease dictates choice of therapy. The current staging system for lung cancer uses the American Joint Committee on Cancer TNM system, and its goal is to classify patients into groups based on the extent of disease. This system relies heavily on the pathologic evaluation of the primary tumor (T), regional nodes (N), and distant metastases (M). Patients in whom mediastinal lymph nodes (MLNs) are involved (N2 or N3) are classified with stage III disease (1) and are generally considered inoperable.
The recent identification of genes overexpressed in lung cancer (2)(3)(4) combined with advances in real-time reverse transcription-PCR (RT-PCR) provide the opportunity to establish sensitive and specific ways to analyze MLNs. In addition, molecular biology approaches using real-time RT-PCR are well suited to the analysis of lymph node tissue procured through minimally invasive procedures such as endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA). This technique enables reliable biopsy of MLNs without the need for general anesthesia or surgery (5). Given the advantages of EUS-FNA, we investigated the possibility that metastatic disease could be reliably detected in MLNs of NSCLC patients by real-time RT-PCR.
To define the ability of real-time RT-PCR to detect metastatic NSCLC in MLNs, we procured by EUS-FNA nine MLNs containing metastatic NSCLC (five adenocarcinomas, one large cell carcinoma, one squamous cell carcinoma, and two uncharacterized carcinomas). For negative controls, we collected 30 cervical lymph nodes obtained by surgical resection. Protocols for tissue procurement and patient consent governing all aspects of this study were reviewed and approved by the
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  L Paleari, A Cesario, P Granone, R M. D'Angelillo, and P Russo Early detection of cancer: lessons from lung cancer CT screening Thorax, June 1, 2008; 63(6): 566 - 566. [Full Text] [PDF]
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 L. Paleari, P. Granone, A. Grozio, A. Cesario, and P. Russo Commentary: Early Diagnosis of Lung Cancer: Where Do We Stand? Oncologist, December 1, 2007; 12(12): 1433 - 1436. [Full Text] [PDF]
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M. Mitas, J. S. Almeida, K. Mikhitarian, W. E. Gillanders, D. N. Lewin, D. D. Spyropoulos, L. Hoover, A. Graham, T. Glenn, P. King, et al. Accurate Discrimination of Barrett's Esophagus and Esophageal Adenocarcinoma Using a Quantitative Three-Tiered Algorithm and Multimarker Real-time Reverse Transcription-PCR Clin. Cancer Res., March 15, 2005; 11(6): 2205 - 2214. [Abstract] [Full Text] [PDF]
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L. Xi, J. D. Luketich, S. Raja, W. E. Gooding, V. R. Litle, M. C. Coello, S. D. Finkelstein, M. L. Chestney, R. J. Landreneau, S. J. Hughes, et al. Molecular Staging of Lymph Nodes from Patients with Esophageal Adenocarcinoma Clin. Cancer Res., February 1, 2005; 11(3): 1099 - 1109. [Abstract] [Full Text] [PDF]
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Y.-P. Sher, J.-Y. Shih, P.-C. Yang, S. R. Roffler, Y.-W. Chu, C.-W. Wu, C.-L. Yu, and K. Peck Prognosis of Non-Small Cell Lung Cancer Patients by Detecting Circulating Cancer Cells in the Peripheral Blood with Multiple Marker Genes Clin. Cancer Res., January 1, 2005; 11(1): 173 - 179. [Abstract] [Full Text] [PDF]
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 M. Mitas, L. Hoover, G. Silvestri, C. Reed, M. Green, A. T. Turrisi, C. Sherman, K. Mikhitarian, D. J. Cole, M. I. Block, et al. Lunx Is a Superior Molecular Marker for Detection of Non-Small Lung Cell Cancer in Peripheral Blood J. Mol. Diagn., November 1, 2003; 5(4): 237 - 242. [Abstract] [Full Text] [PDF]
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