title: Sputum-based molecular biomarkers for the early detection of lung cancer: limitations and promise.
abstract: Lung cancer is the leading cause of cancer deaths, with an overall survival of 15% at five years. Biomarkers that can sensitively and specifically detect lung cancer at early stage are crucial for improving this poor survival rate. Sputum has been the target for the discovery of non-invasive biomarkers for lung cancer because it contains airway epithelial cells, and molecular alterations identified in sputum are most likely to reflect tumor-associated changes or field cancerization caused by smoking in the lung. Sputum-based molecular biomarkers include morphology, allelic imbalance, promoter hypermethylation, gene mutations and, recently, differential miRNA expression. To improve the sensitivity and reproducibility of sputum-based biomarkers, we recommend standardization of processing protocols, bronchial epithelial cell enrichment, and identification of field cancerization biomarkers.
authors.affiliation: Department of Medicine, Division of Pulmonary, Critical Care and Sleep Medicine. 462 First Avenue, NBV 7N24, New York, NY 10016, USA. william.rom@nyumc.org.
authors.forename: Connie E
authors.initials: CE
authors.lastname: Kim
authors.forename: Kam-Meng
authors.initials: KM
authors.lastname: Tchou-Wong
authors.forename: William N
authors.initials: WN
authors.lastname: Rom