Surgery has been the most effective form of therapy for bronchioalveolar carcinoma (BAC). Some patients will recur after surgery in multiple areas of the lung while others will remain free of disease. This study seeks to identify molecular “biomarkers” that will help predict which patients are likely to recur. To achieve this goal, the genetic profiles of tissues taken from patients with BAC that developed recurrence will be compared with patients that did not. The Mayo Clinic has a large database of patients diagnosed with lung cancer between 1997 and 2002. Among this group of 5,628 patients, 296 patients have a diagnosis of BAC and 413 have a different type called adenocarcinoma although the cells have some BAC characteristics. Cases of BAC within the database that presented as a single nodule and then progressed to either multi-nodule disease or metastasis will be analyzed and compared to BAC cases that did not recur following treatment.

Selection of biomarkers in this study is based on the hypothesis that BAC recurrence and metastasis results from the loss of control of many regulatory pathways within the cell that affect its growth. These pathways consist of complicated sequences of enzymes that interact to produce a specific result such as programmed cell death. Failure of these normal cell mechanisms can cause cancerous transformation and are due to gene abnormalities. This study will use techniques such as DNA microarray chips and tissue microarrays that will profile the genes of the cells and allow a comparison to be made between BAC cells that recur and those that do not. Genes that are expressed differentially between the two types will be tested for the potential to be used as predictive biomarkers. This will offer the prospect of being able to screen patients to determine the best candidates for surgery.