Bronchoalveolar Lavage Fluid-Isolated Biomarkers for the Diagnostic and Prognostic Assessment of Lung Cancer

Abstract

Lung cancer is considered one of the most fatal malignant neoplasms because of its late detection. Detecting molecular markers in samples from routine bronchoscopy, including many liquid-based cytology procedures, such as bronchoalveolar lavage fluid (BALF), could serve as a favorable technique to enhance the efficiency of a lung cancer diagnosis. BALF analysis is a promising approach to evaluating the tumor progression microenvironment. BALF's cellular and non-cellular components dictate the inflammatory response in a cancer-proliferating microenvironment. Furthermore, it is an essential material for detecting clinically significant predictive and prognostic biomarkers that may aid in guiding treatment choices and evaluating therapy-induced toxicities in lung cancer. In the present article, we have reviewed recent literature about the utility of BALF analysis for detecting markers in different stages of tumor cell metabolism, employing either specific biomarker assays or broader omics approaches.

Keywords: biomarkers; bronchoalveolar lavage fluid; lung neoplasm; tumor microenvironment.

Figure 1

Example of a proteome from a bronchoalveolar lavage fluid sample in a lung cancer patient performed by two-dimensional gel electrophoresis and silver staining. Circled spots represent differentially expressed proteins between lung cancer and controls. Reprinted from [53] with permission from Elsevier.

Figure 2

Immunostaining for cell epitopes in macrophages from bronchoalveolar lavage fluid samples in a lung cancer patient and healthy control. Reprinted from [48] with permission from Elsevier.

Figure 3

Typical mass spectra from lung cancer patients (a) and controls (b) by direct infusion triple quadrupole time-of-flight mass spectrometry in bronchoalveolar lavage fluid for the detection of metabolite expressions. Reprinted from [73] with permission from Elsevier.