Epithelial-to mesenchymal transition (EMT) plays a crucial role in tumor progression and onset of metastases. Particularly, the role of E-cadherin and N-cadherin has to be still well investigated in lung cancer patients (LCP). The aim of our research is to study EMT in biologic fluids of lung cancer patients and to correlate them with tumor behaviour (histologic findings and prognosis).
One hundred LCP and a control group with benign lung diseases undergoing lung resection will be enrolled in the study. Only patients receiving R0 resection will be part of the study. We will collect preoperatively the bronchoalveolar lavage (BAL), pleural lavage (PL) and peripheral blood (PB); BAL and PL will be processed for cytology and biomolecular assays, PB for biomolecular assays. PL is performed with instillation of 300 ml of sterile saline solution in the chest cavity and collection of at least 70 ml of fluid. Standard histology of the surgical specimen will be performed. All patients will undergo standard clinical follow-up. PB withdrawal will be performed for biomolecular analyses preoperatively, at 1 week, 3, 6, 12 months and 2 years. Biomolecular assays will include real-time quantitative PCR for mRNA of E-cadherin and N-cadherin and will be calculated relative changes in gene expression. The results will be compared with the qualitative and quantitative neoplastic circulating-free DNA in the peripheral blood and with data from non ¿ neoplastic patients.
We hypothesis that in the biologic fluids of LCP the gene expression of E-cadherin and N-cadherin will be inversely represented (high level of E-cadherin in less aggressive tumor and high level of N-cadherin in more aggressive cancer with) and that this may predict prognosis; furthermore we believe that exists a correlation between levels of E-cadherin and N-cadherin with the neoplastic circulating-free DNA present in the PB of LCP and that it may contribute to early detection of recurrences.
