Analysis of mutations in K-ras and p53 genes in sputum and plasma samples

Sputum and plasma can provide noninvasive materials to investigate biomarkers for cancer detection and diagnosis. Mutations in the K-ras oncogene and p53 suppressor gene have been frequently found in sputum and plasma samples collected not only from lung cancer patients but also in those of patients prior to presenting clinical symptoms of lung cancer, suggesting that they may also provide useful biomarkers from early lung cancer diagnosis. However, the detection of these mutations has been complicated by the fact that they often occur in only a small fraction of epithelial cells among sputum cells, and of cell-free DNA present in plasma. This chapter describes methods to isolate low fraction epithelial cells from sputum and cell-free DNA from plasma samples obtained from lung cancer patients and to identify low fraction K-ras and p53 mutations in these samples.