Molecular alterations in spontaneous sputum of cancer-free heavy smokers: results from a large screening program

Ekaterina Baryshnikova, Annarita Destro, Maurizio Valentino Infante, Silvio Cavuto, Umberto Cariboni, Marco Alloisio, Giovanni Luca Ceresoli, Romano Lutman, Giorgio Brambilla, Giuseppe Chiesa, Gianni Ravasi, Massimo Roncalli

Research output: Contribution to journalArticlepeer-review


Purpose: The high mortality rate for lung cancer is likely to be reduced by the development of a panel of sensitive biological markers able to identify early-stage lung cancers or subjects at high risk. The aim of this study was to establish the frequency of K-ras and p53 mutations and p16INK4A, RASSF1A, and NORE1A hypermethylation in sputum of a large cohort of cancer-free heavy smokers and to assess whether these markers are suitable for a routine use in the clinical practice for the early diagnosis of pulmonary cancer. Experimental Design: Sputum samples were collected from 820 heavy smokers. Inclusion criteria consisted of radiologic and cytologic absence of pulmonary lesions, age at least 60 years, male gender, and a smoking history of at least 20 pack-years. Results: The analysis identified 56 individuals (6.9%) with one molecular alteration. p53 mutation and p16INK4A, RASSF1A, and NORE1A methylation frequencies were 1.9%, 5.1%, 0.8%, and 1.0%, respectively; no K-ras mutations were found. One patient with p53 mutations was diagnosed with an early-stage lung cancer after 3-years of follow-up. The molecular analysis of bronchoscopy samples confirmed in half of the cases alterations present in sputum without revealing additional molecular changes. Conclusions: Genetic and epigenetic abnormalities can be detected in cancer-free heavy smokers. Although the predictive value of the cancer risk is still to be established as it requires not less than 5 years of follow-up, p53 and p16INK4A are more promising candidates than K-ras, RASSF1A, and NORE1A for the pulmonary molecular screening of heavy smokers healthy individuals.

Original languageEnglish
Pages (from-to)1913-1919
Number of pages7
JournalClinical Cancer Research
Issue number6
Publication statusPublished - Mar 15 2008

ASJC Scopus subject areas

  • Cancer Research
  • Oncology


Dive into the research topics of 'Molecular alterations in spontaneous sputum of cancer-free heavy smokers: results from a large screening program'. Together they form a unique fingerprint.

Cite this