Evaluation Of VEGF-D In Bronchoaleolar Lavage Fluid For Lung Cancer Diagnosis

Fiberoptic bronchoscopy is currently the most commonly used methods to distinguish lung cancer from benign diseases. Patients suspected of malignancy often undergo fiberoptic bronchoscope examination and bronchial washing are traditionally used. Changes of cytokines in bronchoalveolar lavage fluid (BALF) reflect immunologic reactions of the lung in pulmonary malignancies. Thus, detection of biomarkers in BALF might serve as an important adjunct to bronchoscopy for differential diagnosis of lung cancer. In our previous study, we found that the level of vascular endothelial growth factor (VEGF) was significantly increased in both serum and BALF among patients with lung cancer. Moreover, measurement of VEGF concentration in BALF might be helpful for lung cancer diagnosis. VEGF-D, a member of the VEGF family, specifically modulates many endothelial cell functions, especially involving angiogenesis and lymphangiogenesis of different human cancers. However, to the best of our knowledge, the expression of VEGF-D in BALF of lung cancer patients has not yet been examined. Based on the above evidence, the present study was designed to assess the usefulness of VEGF-D in BALF for differential diagnosis of lung cancer.ObjectiveTo investigate the expression and evaluation of vascular endothelial growth factor-D (VEGF-D) in bronchoalveolar lavage fluid(BALF) for lung cancer diagnosis.MethodsBALF samples were acquired from 81 patients,40 with benign lung diseases,41 with lung cancer, while 17 with lung squamous cell carcinomas,17 with lung adenocarcinoma,7 with small cell lung cancer. The expressions of VEGF-D in BALF was measured using sandwich enzyme-linked immune sorbent assays (ELISA). And the evaluation of VEGF-D in BALF for lung cancer diagnosis was investigated.Results1.In the BALF samples, the levers of VEGF-D in lung cancer group was 107.1±6.7 pg/ml, while lung benign disease group was 95.7±5.2pg/ml. The levers of VEGF-D in lung cancer group in BALF was higher than lung benign disease group. However, there was no statistical significance between the two groups (P> 0.05).2. In the BALF samples, the levers of VEGF-D in lung benign disease group was 95.7±5.2pg/ml. The levers of VEGF-D in BALF in lung squamous carcinomas group, lung adenocarcinoma group, and small cell lung cancer group were 120.4±10.6 pg/ml, 107.9±10.49 pg/ml, and 76.86±12.31 pg/ml, respectively. The levers of VEGF-D in BALF was higher in lung squamous carcinomas group than in lung benign disease group. There was statistical significance between the two groups (P<0.05). The levers of VEGF-D in BALF was higher in lung adenocarcinoma group than in lung benign disease group. However, there was no statistical significance between the two groups (P>0.05). The levers of VEGF-D in BALF was higher in lung benign disease group than in small cell lung cancer group. There was no statistical significance between the two groups (P>0.05).3. When the cut-off value of VEGF-D in BALF was 104pg/ml, the diagnostic accuracies of VEGF-D in BALF (0.6581) for discrimination between patients with squamous cell carcinoma and benign diseases were pretty good in Receiver Operating Characteristic (ROC curve) analysis, with the corresponding sensitivity of 64.7% and specificity of 60%, respectively.ConclusionDetecting the expression levels of VEGF-D in BALF contributes to the diagnosis of lung squamous carcinoma. The sensitivity and specificity were high.