PURPOSE: Differentiation of peripheral lung cancer from benign lung pathology (BLP) through assessment of Carcinoembrogenic Antigen (CEA) and Ca-125 in bronchoalveolar lavage (BAL) and serum.
METHODS: Fifty-four patients were prospectively studied. Twenty-one with BLP and no smoking history, 13 active smokers and 20 with non small cell lung cancer. Serum and BAL concentration of CEA and CA-125 were evaluated in every patients. Statistical analysis was performed by the Kruskall-Walliis test.
RESULTS: Mean CEA was 37.5, 25.19 and 19.64 ng/ml in cancer patients, smokers and BPP respectively, p< 0.05 between BPP/smokers and cancer. CEA had a sensibility of 60 %, specificity of 95 % a positive predictive value of 92 % and a negative predictive value of 71 % relative risk of 12. Mean Ca-125 was 30.06, 29.42 and 23.36 U/ml in cancer patients, smokers and BPP patients respectively,p < 0.05 between BPP/smokers and cancer patients with sensitivity of 60 %, specificity of 52 %, positive predictive value of 58 % and relative risk of 1.25. Mean CEA in BAL was 29.35, 22.50 and 24.58 ng/mg of protein in cancer patients, smokers and BPP patients respectively, p >0.05. Mean Ca-125 in BAL was 28.58, 22.36 and 25.85 U/mg of protein in cancer patients, smokers and BPP patients respectively with no statistical significance either. BAL among cancer patients showed a group over the percentil 90 with CEA over 85.6 and Ca-125 over 4300 U/gm of protein (specificity of 93.5 % and 87% respectively).
CONCLUSION: The sera CEA and CA-125 values are similar to those reported else were and the values found in BAL are not useful for the diagnosis of a peripheral lung cancer, however the cut off point found in the percentil 90 could be of certain value in diagnosing those patients with peripheral lung cancer.
CLINICAL IMPLICATIONS: This is the first time that a cut off point the tumoral markers levels is established in BAL in order to diagnose peripheral lung cancer.
DISCLOSURE: Rodrigo Machuca, None.