Bronchoalveolar Lavage Proteomics in Patients with Suspected Lung Cancer

Abstract

Lung cancer configures as one of the deadliest types of cancer. The future implementation of early screening methods such as exhaled breath condensate analysis and low dose computed tomography (CT) as an alternative to current chest imaging based screening will lead to an increased burden on bronchoscopy units. New approaches for improvement of diagnosis in bronchoscopy units, regarding patient management, are likely to have clinical impact in the future. Diagnostic approaches to address mortality of lung cancer include improved early detection and stratification of the cancers according to its prognosis and further response to drug treatment. In this study, we performed a detailed mass spectrometry based proteome analysis of acellular bronchoalveolar lavage (BAL) fluid samples on an observational prospective cohort consisting of 90 suspected lung cancer cases which were followed during two years. The thirteen new lung cancer cases diagnosed during the follow up time period clustered, based on liquid chromatography-mass spectrometry (LC-MS) data, with lung cancer cases at the time of BAL collection. Hundred and thirty-tree potential biomarkers were identified showing significantly differential expression when comparing lung cancer versus non-lung cancer. The regulated biomarkers showed a large overlap with biomarkers detected in tissue samples.

Clinical Application of Mass Spectrometry‐Based Proteomics in Lung Cancer Early Diagnosis

“…Concerning the control group used, 5 studies used normal tissue collected during surgery from the same subjects, 8 used patients with pulmonary nodules or other comorbidities (i.e., chronic obstructive pulmonary disease, interstitial lung disease, bronchiectasis, heart failure, asthma, chronic cough, and pulmonary nodule [18] ), 6 did not indicate any control groups. Moreover, not all the studies indicated the patient smoking habits.…”

“…For instance, bronchoalveolar lavage or pleural effusions, that are routinely used for disease staging in surgery, are too invasive for screening purposes. [18,89] Blood, exhaled breath condensate and urine are instead all easy to collect. The majority of the biomarker discovery research conducted in recent years has been devoted to the analysis of biomarkers isolated from serum or plasma, thanks to the fact that blood sampling can be carried out following a highly standardized method, reproducible, easy to perform worldwide, which is also applicable to the longitudinal analysis of samples, for tumor recurrence monitoring.…”

In‐Depth Proteomic Analysis of Human Bronchoalveolar Lavage Fluid toward the Biomarker Discovery for Lung Cancers

“…BALF has its merit in that it can provide a variety of information including immunologic, inflammatory, and infectious processes that occur at the lung parenchyma . Recent studies have demonstrated potential usefulness of cancer‐associated proteins, nucleic acid, and extracellular vesicles in the BALF for early detection and molecular characterization of lung cancer …”

Advances in the analysis of “less‐conventional” human body fluids: An overview of the CE‐ and HPLC‐MS applications in the years 2015–2017

“…A LC‐MS/MS approach allowed Carvalho et al. to study the proteomics of BALf in an observational cohort of 90 patients with suspected lung cancer (seven suspicious; 47 with no lung cancer suspicion, 36 lung cancer) undergoing diagnostic bronchoscopy. Diagnosis was based on both BAL cytology and tumor histology.…”