Cytochemical examination of alveolar macrophages (AM) obtained by bronchoalveolar lavage (BAL) was performed in healthy volunteers (11 non-smokers and 11 smokers) and in 9 patients with squamous lung carcinoma (all of them smokers or ex-smokers) in order to analyze its peculiarities related to the smoking habit and to lung malignancy. Assessment of non-specific esterases: alpha-naphthyl acetate esterase (ANAE) and butyrate esterase (BUT), chloroacetate esterase (CHL), acid phosphatase (AcP), intracellular glycogen (PAS reaction), lipids (Sudan black B reaction-SBB) and iron (Perl's reaction) was performed by a semiquantitative cytochemical method (1). A significant correlation was obtained between BUT and stage of squamous lung carcinoma (varying between I and IV) (r = 0.52, p < 0.05). There was a correlation between BUT and Perl's in healthy controls (r = 0.76, p < 0.05). The same type of correlation was observed in control smokers (r = 0.64, p < 0.05), in addition to a correlation between CHL and AcP (r = 0.69, p < 0.05). There was no significant BUT/Perl's correlation in patients with squamous cell lung carcinoma (r = 0.23, p > 0.05), but significant AcP/CHL correlation as was observed in control smokers (r = 0.73, p < 0.05), and a "new" type of correlation was shown to exist between ANAE and SBB (r = 0.77, p < 0.05). In spite of the unresolved nature of lung cancer, correlation analysis of cytochemical parameters in AM might have an important part in the analysis of their relative contribution to the development of smoking-related disorders and lung malignancies.

Bronchoalveolar lavage (BAL) was performed in 48 subjects: 22 healthy controls, 13 patients with pulmonary sarcoidosis Stage I and 13 patients with lung cancer. All diagnoses were pathologically and clinically confirmed. Cytocentrifuge preparations were made, air-dried and stained for cytochemical examination of alveolar macrophages (AM) using indexing and scoring methods for the evaluation of esterase activity, intracellular amounts of glycogen, lipids and iron. Significant differences were found in the cytochemical examination of enzyme activity of AM and intracellular metabolic and ionic state, depending on pathological processes and smoking habits. There was a linear correlation between alpha naphthyl esterase activity and iron content in AM in patients with squamous cell lung carcinoma and in patients with pulmonary sarcoidosis, which makes it possible to assign individual patients to one of the groups. Cytochemical examination of BAL specimens might be of great significance for the prevention and early diagnosis of various malignant and non-malignant lung diseases.

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