Lung cancer is the leading cause of cancer related deaths worldwide. Several studies have evaluated the relationship between chronic bronchitis and lung cancer. Chronic obstructive pulmonary disease refers to chronic bronchitis and emphysema, a pair of two commonly co-existing diseases of the lungs. The leading cause of both lung cancer and COPD is well recognized in tobacco use. The aim of our study is to assess the capability of Image Cytometry to identify neoplastic lesions that occur in smokers using 5cER as diagnostic parameter that could help clinicians in lung cancer’s early detection, using a noninvasive way. In our study, the sputum of 116 smokers was collected. 5cER value confirmed both cancer and no-cancer diagnosis with sensitivity and specificity of 79% and 87%. Moreover, our aim is to identify possible markers and to understand if there is a correlation with ploidy status. Preliminary data show that same genes have positive correlation (r > 0,5) and same negative correlation (r < - 0,5). This study demonstrates that sputum sample and laboratory approach could represents a good field to investigate new target for new potential therapies in lung cancer.