Lymphocyte Subsets in Bronchoalveolar Lavage Fluid and in Circulating Blood in Epidermoid Bronchogenic Carcinoma

Abstract

Alveolar macrophages, lymphocyte and granulocyte percentages, together with OKT3 + , OKT4+, OKT8+ lymphocyte subsets and OKT4+/OKT8+ ratio, were evaluated in bronchoalveolar lavage (BAL) fluid and in peripheral venous blood (PVB) of neoplastic and nonneoplastic subjects, in order to assess these aspects of immunity in neoplastic disease and to find out if the modifications in the bronchoalveolar environment are correlated to the ones in the circulation blood. BAL was performed in 30 patients undergoing fiberoptic bronchoscopy to ascertain the presence of lung cancer. Twelve of them had positive findings for epidermoid bronchogenic carcinoma, while in the remaining subjects the diagnosis was not confirmed. The 30 examined subjects were then grouped according to their smoking habit. In PVB, no significant difference was seen between neoplastic and nonneoplastic subjects, whereas in BAL the neoplastic patients showed a significant increase of lymphocytes OKT3 + and OKT8 + . This tends to confirm that PVB is not a good indicator of organ immunity and may justify the reduced activity of alveolar macrophages in subjects affected by bronchogenic neoplasia. Between smokers and nonsmokers, lymphocyte subsets showed more significant differences than between neoplastic and nonneoplastic subjects (decrease of T4+ lymphocytes, increase of T8+ lymphocytes and, therefore, reduction of T4/T8 ratio); there were also scalar variations in the three groups (smokers with cancer, smokers without cancer and nonsmokers without cancer). Thus, the possible autonomous role of cigarette smoke and the presence of neoplasia in the immunity alterations of the alveolar environment with final joint effects were confirmed. These data may indicate a possible correlation between cigarette smoking, immunological alterations in BAL and the onset of bronchogenic carcinoma

Immune Cells in Bronchoalveolar Lavage in Peripheral Lung Cancer – Analysis of 140 Cases

“…In previous studies an increased proportion of T c/s cells has been found in TIL [1, 4, 5]and in BALF [6, 7, 8]whereas a decrease was observed in the peripheral blood [6, 12]. In our study, the proportion of these cells in the BALF from patients with lung cancer was also higher, and the CD4/CD8 ratio tended to be relatively low compared with healthy nonsmokers.…”

“…In our study, the proportion of these cells in the BALF from patients with lung cancer was also higher, and the CD4/CD8 ratio tended to be relatively low compared with healthy nonsmokers. Other investigators found a significantly lower CD4/CD8 ratio in the BALF from cancer patients compared with healthy controls [6, 7, 8]. The participation of CD8+ cells in tumor killing activity has been confirmed by Fujisawa et al [31]and Burger et al [32].…”

“…The analysis of tumor-infiltrating cells is likely the most accurate way of studying cancer immunology; BAL might not reflect the real changes in the site of cancer. In most studies the affected lobe was lavaged [7, 8, 15, 16], but in one study the changes were not different whether the affected lung or the uninvolved lung was lavaged [7]. …”

“…It may be useful in surveying the immunological status of the lung. There are only few reports on the BALF cell profile in patients with primary lung cancer [6, 7, 8]. Changes in the BALF cell profile may reflect immunologic reactions of the lung in pulmonary malignancies.…”