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Detection of Pre-Invasive Lung Cancer: Technical Aspects of the LIFE Project

Laboratory of Experimental Pathology, National Institute of Environmental Sciences, NIH, Research Triangle Park, NC 27709, USA, flake{at}niehs.nih.gov

M. Patricia Rivera

Multidisciplinary Thoracic Oncology Program, UNC Hospitals, Chapel Hill, NC 27514, USA

William K. Funkhouser

Multidisciplinary Thoracic Oncology Program, UNC Hospitals, Chapel Hill, NC 27514, USA

Susan J. Maygarden

Multidisciplinary Thoracic Oncology Program, UNC Hospitals, Chapel Hill, NC 27514, USA

Kellen L. Meadows

Laboratory of Molecular Carcinogenesis, National Institute of Environmental Sciences, NIH, Research Triangle Park, NC 27709, USA

Elizabeth H. Long

Social and Scientific Systems, Incorporated, Durham, NC 27703, USA

Pat S. Stockton

Laboratory of Experimental Pathology, National Institute of Environmental Sciences, NIH, Research Triangle Park, NC 27709, USA

Tina C. Jones

Laboratory of Experimental Pathology, National Institute of Environmental Sciences, NIH, Research Triangle Park, NC 27709, USA

Hyeon Woo Yim

Laboratory of Molecular Carcinogenesis, National Institute of Environmental Sciences, NIH, Research Triangle Park, NC 27709, USA

Robbert J.C. Slebos

Departments of Cancer Biology and Otolaryngology, Vanderbilt-Ingram Cancer Center, Vanderbilt University Medical Center, Nashville, TN 37232, USA

Jack A. Taylor

Laboratory of Molecular Carcinogenesis, National Institute of Environmental Sciences, NIH, Research Triangle Park, NC 27709, USA, Epidemiology Branch, National Institute of Environmental Health Sciences (NIEHS), National Institutes of Health (NIH), Department of Health and Human Services (DHHS), Research Triangle Park, NC 27709, USA

Lung cancer is the leading cause of cancer deaths in both men and women in the United States. The LIFE (Light Induced Fluorescence Endoscopy) Project was initiated at the University of North Carolina Medical Center in November, 1999, for the dual purposes of (1) detecting pre-invasive lung cancer in high-risk patients and (2) studying the molecular biology of pre-invasive lesions of the bronchus for possible development of molecular biomarkers. Of the 47 patients enrolled, all were current or former tobacco smokers, except for 1. Fluorescence endoscopy was utilized, in addition to white light bronchoscopy, to increase the detection of intraepithelial lesions. Adjacent biopsies were submitted for permanent and frozen sections, respectively, from four predetermined sites as well as from any abnormal areas. The snap-frozen specimens were cryostat sectioned, and the mucosal epithelial cells laser capture microdissected for DNA analysis. The great majority of specimens yielded sufficiently abundant and intact DNA to accomplish the molecular objectives. Histologic concordance of adjacent permanent and frozen sections was equivalent to the concordance of adjacent permanent sections, suggesting that frozen section diagnosis was adequate for the research purpose of correlating histology with molecular analysis.

Key Words: Pre-invasive lung cancer • bronchial dysplasia • fluorescence endoscopy • frozen sections • laser capture microdissection.

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