Dectection of occult mediastinal lymph node mestastases

  • Wallace, Michael B, (PI)

Project: Research project

Description

DESCRIPTION (provided by applicant):
Non-small cell lung carcinoma (NSCLC) is the most common cause of cancer death
in the United States. The presence of metastatic disease in the mediastinal
lymph nodes of NSCLC patients has profound prognostic and therapeutic
implications. For instance, patients with documented disease in mediastinal
lymph nodes are typically not candidates for surgical treatment, and are often
treated with a combination of chemotherapy and radiotherapy. Current methods
for detection of disease in mediastinal lymph nodes either lack sensitivity
(computed tomography, positron emission tomography), or are invasive requiring
general anesthesia (mediastinoscopy, thoracoscopy). We believe that endoscopic
ultrasound-guided fine needle aspiration (EUS-FNA) of mediastinal lymph nodes
in combination with real-time RT-PCR has the potential to dramatically improve
lung cancer staging. One limitation of EUS-FNA is that it currently relies on
cytologic analysis of the specimen. Such an analysis is dependent on a skilled
cytopathologist and lacks sensitivity. The identification of genes overexpressed in lung cancer combined with recent advances in molecular
biology provides the opportunity to establish a more sensitive, and specific
way to analyze EUS-FNA samples. In Section 6c. Preliminary Studies, we present
preliminary data that real-time RT-PCR provides the ability to precisely
determine the expression levels of lung cancer-associated mRNA, facilitating
the sensitive detection of NSCLC. Furthermore, we present evidence of lung
cancer-associated gene overexpression in EUS-FNA samples from patients with
presumed NSCLC. The hypothesis of the proposed research is that real-time
RT-PCR detection of lung cancer cells in EUS-FNA specimens of mediastinal
lymph nodes in NSCLC patients is associated with clinical outcome. The
successful development and validation of such a molecular diagnostic assay is
likely to have a significant clinical impact. In the R21 component of this
grant application we will analyze a preliminary cohort of patients and
controls so that criteria for the interpretation of test results can be
established. In the R33 component of the grant application these criteria will
be prospectively evaluated and correlated with clinical outcome in a second,
larger cohort of patients.
StatusFinished
Effective start/end date9/1/0211/30/08

Funding

  • National Institutes of Health: $324,729.00
  • National Institutes of Health: $318,987.00
  • National Institutes of Health: $318,831.00
  • National Institutes of Health: $317,384.00
  • National Institutes of Health: $143,727.00

Fingerprint

Fine Needle Biopsy
Non-Small Cell Lung Carcinoma
Lymph Nodes
Lung Neoplasms
Real-Time Polymerase Chain Reaction
Mediastinal Diseases
Mediastinoscopy
Thoracoscopy
Molecular Pathology
Organized Financing
Neoplasm Staging
Lymph
Combination Drug Therapy
Genes
Radiotherapy
Anesthesia
Polymerase Chain Reaction
Messenger RNA
Research
Neoplasms

ASJC

  • Medicine(all)