MEASUREMENTS OF HORMONAL PEPTIDES THE BRONCHOALVEOLAR FLUID AS TUMOR-MARKERS OF LUNG-CANCER

A large number of lung cancers contains and releases a variety of neur opeptides such as adrenocorticotropic hormone (ACTH) and beta-endorphi n (beta-EP). Although the plasma levels of these peptides have been ex tensively investigated as possible markers that may help in the early diagnosis of the disease, the data collected have shown their limited clinical usefulness. The present study was undertaken to evaluate whet her corticotropin-releasing hormone (CRH), ACTH or beta-EP levels in t he bronchoalveolar lavage (BAL) fluid of patients with lung cancer mig ht have been more helpful. To accomplish this, bronchial lavages were carried out in 25 patients affected by lung cancer (17 squamous carcin omas, 4 adenocarcinomas, 2 small cell carcinomas, and 2 not classified ) and 18 controls. After centrifugation, BAL fluid was extracted using cartridges of SepPak C-18 and CRH, ACTH and beta-EP levels were measu red by radioimmunoassay. CRH and ACTH BAL levels in patients with lung cancer were not significantly different from those of controls, beta- EP concentrations in the BAL fluid were about 200-fold higher than tho se of ACTH and showed a downward trend (p=0.08, Mann-Whitney test) in patients with cancer. No histologic tumor type was associated with par ticularly elevated levels of any of the peptides measured, not even th e two patients with small cell carcinoma, a tumor type which tends to release higher peptide levels. Therefore we conclude that measurements of CRH, ACTH and/or beta-EP in the BAL fluid are not useful diagnosti c tumor markers of lung cancer.