title: Magnetic enrichment of bronchial epithelial cells from sputum for lung cancer diagnosis.
abstract: BACKGROUND
  Sputum is an easily accessible diagnostic material for lung cancer early detection by cytologic and molecular genetic analysis of exfoliated airway epithelial cells. However, the use of sputum is limited by its cellular heterogeneity, which includes >95% macrophages and neutrophils and only about 1% bronchial epithelial cells. We propose to obtain concentrated and purified bronchial epithelial cells to improve early detection of lung cancer in sputum samples.
  
  
  METHODS
  Sputum was collected from patients with stage I nonsmall-cell lung cancer, cancer-free smokers, and healthy nonsmokers. Magnetic-assisted cell sorting (MACS) with anti-CD14 and anti-CD16 antibody beads were used to enrich bronchial epithelial cells by depleting macrophages and neutrophils from sputum. Fluorescence in situ hybridization (FISH) analysis for detection of FHIT deletion and cytology were evaluated in the enriched specimens.
  
  
  RESULTS
  The bronchial epithelial cells were concentrated to 40% purity from 1.1% of the starting population, yielding an average of 36-fold enrichment and at least 2.3 x 10(5) cells per sample. Detecting FHIT deletions for lung cancer diagnosis produced 58% sensitivity in the enriched sputum, whereas there was 42% sensitivity in the unenriched samples (P = .02). Cytologic examination of the enriched sputum resulted in 53% sensitivity, as compared with 39% sensitivity in unenriched sputum (P = .03). Furthermore, only 2 cytocentrifuge slides of the unenriched sputum were needed for the analyses, as compared with up to 10 cytocentrifuge slides required from the unprocessed specimens.
  
  
  CONCLUSIONS
  The enrichment of bronchial epithelial cells could improve the diagnostic value of sputum and the efficiency of genetic and cytologic analysis of lung cancer.
authors.affiliation: Department of Pathology, University of Maryland School of Medicine, 10 South Pine St., MSTF 7th Fl., Baltimore, MD 21201-1192, USA.
authors.forename: Qi
authors.initials: Q
authors.lastname: Qiu
authors.forename: Nevins W
authors.initials: NW
authors.lastname: Todd
authors.forename: Ruiyun
authors.initials: R
authors.lastname: Li
authors.forename: Hong
authors.initials: H
authors.lastname: Peng
authors.forename: Zhenqiu
authors.initials: Z
authors.lastname: Liu
authors.forename: Harris G
authors.initials: HG
authors.lastname: Yfantis
authors.forename: Ruth L
authors.initials: RL
authors.lastname: Katz
authors.forename: Sanford A
authors.initials: SA
authors.lastname: Stass
authors.forename: Feng
authors.initials: F
authors.lastname: Jiang
mesh_terms: D017766:Acid Anhydride Hydrolases / Q000235:genetics; D001980:Bronchi / Q000473:pathology*; D004847:Epithelial Cells / Q000473:pathology; D017353:Gene Deletion; D006801:Humans; D018189:Immunomagnetic Separation; D017404:In Situ Hybridization, Fluorescence; D008175:Lung Neoplasms / Q000175:diagnosis* / Q000235:genetics / Q000473:pathology; D009363:Neoplasm Proteins / Q000235:genetics; D013183:Sputum / Q000166:cytology*; D000099170:Bis(5'-adenosyl)triphosphatase
chemical_list: D017766:Acid Anhydride Hydrolases; D009363:Neoplasm Proteins; D000099170:Bis(5'-adenosyl)triphosphatase