Diagnostic value of epidermal growth factor, cancer antigen 125, and cancer antigen 15-3 in bronchoalveolar lavage fluid of lung cancer

Abstract

Aim: In the present study, we assessed the diagnostic value of epidermal growth factor (egf) and cancer antigens 125 (ca125) and 15-3 (ca15-3) in bronchoalveolar lavage fluid (balf) of lung cancer from 79 enrolled patients with suspected lung cancer.

Methods: All patients underwent fibrescopic examination, during which balf samples were collected. Levels of egf, ca125, and ca15-3 were determined in balf using commercially available test kits.

Results: The results showed that levels of egf in balf were significantly higher in patients with lung cancer than in patients with benign diseases (p < 0.01); no significant differences for ca125 (p = 0.67) or ca15-3 (p = 0.43) in balf were observed between the lung cancer patients and the non-cancer control subjects. With a cut-off value of 27.22 pg/mL, egf showed a sensitivity of 63.6% and a specificity of 65.7% in predicting the malignant nature of pulmonary disease.

Conclusions: The study findings suggest that levels of egf are significantly increased in balf from patients with lung cancer than in balf from patients with benign disease. Detection of the level of egf in balf is proposed as a noninvasive test to identify patients at high risk for lung cancer.

Keywords: Lung cancer; bronchoalveolar lavage fluid; cancer antigen 125; cancer antigen 15-3; epidermal growth factor.

FIGURE 1

Levels of epidermal growth factor (EGF) in bronchoalveolar lavage fluid. (A) Levels of EGF were significantly higher in patients with lung cancer than in patients with benign conditions (**p < 0.01 by t-test; the horizontal lines mark mean values). (B) Similarly, subgroup analysis by tumour histology in lung cancer patients showed statistical differences in EGF levels (**p < 0.01 and *p < 0.05 by t-test). SCC = squamous cell carcinoma; ADC = adenocarcinoma; SCLC = small-cell lung cancer.

FIGURE 2

Levels of cancer antigen 125 (CA125) and 15-3 (CA15-3) in bronchoalveolar lavage fluid. (A) Levels of CA125 were not significantly higher in patients with lung cancer than in patients with benign conditions [p = nonsignificant (ns) by t-test]. (B) Levels of CA15-3 were not significantly different in patients with lung cancer than in patients with benign conditions (p = ns by t-test). Horizontal lines mark mean values.

FIGURE 3

Correlations of epidermal growth factor (EGF), cancer antigen 125 (CA125), and cancer antigen 15-3 (CA15-3) in bronchoalveolar lavage fluid. (A) A significant statistical correlation was observed between EGF and CA125. (B,C) No significant statistical correlation was found between EGF and CA15-3 or between CA125 and CA15-3.

FIGURE 4

A receiver operating characteristic curve was plotted to evaluate the threshold value of epidermal growth factor (EGF) in differentiating lung cancer from benign conditions. At a cut-off value of 27.22 pg/mL, EGF reached a sensitivity of 63.6% [95% confidence interval (CI): 47.8% to 77.6%] and a specificity of 65.7% (95% CI: 47.8% to 80.9%). AUC = area under the curve.