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Formalin-fixed paraffin embedded (FFPE) tissue specimens are available for a subset of the NLST participants who developed lung cancer during the trial. Donor blocks were obtained from local pathology laboratories and tissue cores (0.6mm) were extracted from them to construct tissue microarrays (TMA). Tissue cores were sampled from primary main invasive tumor histology, secondary tumor histology, carcinoma in situ, adjacent normal lung tissue, metastatic lesion from lymph node(s) and/or distant sites, benign (un-involved) lymph node, proximal and/or distal bronchi.

In total, tissue materials were collected from 438 lung cancer cases. All have cores arrayed across nine TMAs, one of which only contains tissue collected after neoadjuvant treatment. 434 of these also have loose cores available for nucleic acid extraction. On average, each TMA contains 504 cores from 48 subjects.

Applications for access to these specimens can be submitted under the PLCO Etiologic and Early Marker Studies Program (EEMS). The application review process opens twice a year, once in the winter and once in the summer. For more information about EEMS and to initiate an application visit the PLCO EEMS Application page. When filling out the application, specify “NLST Tissue” under the case definition.