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

Background: Changes in the bronchoalveolar lavage fluid (BALF) cell profile may reflect immunologic reactions of the lung in pulmonary malignancies. Objective: Our aim was to analyse the BALF cell profile in peripheral lung cancer. Methods: This study was a retrospective analysis of BALF samples containing tumor cells from patients with confirmed peripheral lung cancer (140 cases). Routine analysis and lymphocyte phenotyping by an immunoperoxidase technique with the monoclonal antibodies CD3, CD20, CD4, CD8, CD57, CD1, CD25, CD71 and HLA-DR were performed. The data were compared with those from healthy persons. Results: We found a significantly lower proportion of macrophages (60%), and significantly elevated proportions of lymphocytes (24%) and neutrophils (13%) in cases with cancer when compared with controls. The proportion of eosinophils was higher in the cancer patients (2.4%), though not significantly. Regarding the lymphocyte phenotypes, we found a significantly elevated proportion of T cells (86%), a relatively low CD4/CD8 ratio (1.7 ± 1.3), and a relatively higher percentage of HLA-DR+ lymphocytes (6.6%) in patients with cancer. There were no significant differences between smokers and nonsmokers in the cancer patients. In more than half of the cases, a positive staining for epithelial membrane antigen was found. Conclusion: Our observations confirm the possible participation of lymphocytes (activated and suppressor subtypes) and eosinophils in the response against tumor in peripheral airways.