Molecular evaluation of lymph nodes biopsied by echobronchoscopy for TNM staging of patients with Lung Adenocarcinoma

• Grant number: 19/04416-3
• Support Opportunities: Regular Research Grants
• Duration: November 01, 2020 - October 31, 2022
• Field of knowledge: Biological Sciences - Genetics - Human and Medical Genetics
• Principal Investigator: Leila Antonangelo
• Grantee: Leila Antonangelo
• Host Institution: Faculdade de Medicina (FM). Universidade de São Paulo (USP). São Paulo , SP, Brazil
• Associated researchers: Caroline Silvério Faria ; Ellen Caroline Toledo do Nascimento ; Evandro Sobroza de Mello ; Flavia Regina Rotea Mangone ; Leslie Domenici Kulikowski ; Maria Aparecida Nagai ; Ricardo Mingarini Terra ; Rosana Oliveira da Rocha ; Vera Luiza Capelozzi ; Viviane Rossi Figueiredo

Abstract

Lung cancer is the third most common cancer in the world, and has become a public health problem in recent decades, a fact related to the increase in population life expectancy and the strong positive correlation between cancer and age. Non-small cell lung cancer (NSCLC) is the most incident, responsible for 70 to 85% of cases. The Adenocarcinoma subtype is the most frequent and is characterized by low response to treatment, 50% metastasis at diagnosis and 5 year survival in only 15% of patients. The involvement of mediastinal lymph nodes in NSCLC is a key component for staging and a strong predictor of recurrence, since malignant changes in lymph nodes make surgical treatment unfeasible because it indicates disease dissemination with reduction in survival. With the improvement of the endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA), a minimally invasive technique, it is possible to biopsy mediastinal lymph nodes with sensitivity, specificity and accuracy of 81%, 100% and 93%, respectively, and the obtained material can be used for genomic analysis. Currently, several genes and techniques have been studied to detect metastases precociously, to improve patient's prognosis. In this context, the present study aims to identify molecular alterations in mediastinal lymph nodes biopsied by EBUS-TBNA through a panel of hotspots of 26 genes related to solid tumors, including the NSCLC, using the New Generation Sequencing technique (NGS), and comparing the findings with those expressed by the primary tumor. Our hypothesis is that genomic alterations may precede the metastatic lymph node phenotype, allowing a more precise TNM staging, and also to evaluate the implication of the findings on patient's survival. (AU)