An evaluation of tissue polypeptide antigen (TPA) in the two bronchoalveolar lavage fractions of lung cancer patients

Background: It has been proven that cytokeratins (CKs) are useful tumor mar kers for the follow-up, treatment monitoring and prognosis evaluation of lu ng cancer and among these, tissue polypeptide antigen (IPA) plays an import ant role. Nevertheless, only a small number of studies have been reported a bout their diagnostic capacity. Bronchoalveolar lavage (BAL) can be divided into two fractions: bronchiolar (BF) and alveolar (AF). For the above reas ons, our aims were (1) to analyze the diagnostic usefulness of TPA in the B AL of lung cancer patients and (2) to observe if, in lung cancer patients, TPA levels in the two BAL fractions are different. This should mean that th e study of tumor markers in the BAL should be carried out in both fractions to increase their diagnostic capacity. Methods: We studied 289 BALs divided into two phases. In phase I, TPA was a nalyzed in the BAL of six groups of subjects (healthy persons, chronic bron chitis, asthma, respiratory infections, diffuse interstitial pulmonary dise ases and lung cancer). In phase II, TPA was studied in both BAL fractions o f a group of patients with lung cancer. Results: We observed that TPA levels were significantly higher in the BAL o f patients with bronchogenic neoplasias. In these patients, TPA was increas ed in the BF of the lavage in relation to the AF. In smoker patients with p ulmonary carcinomas, TPA was higher in the AF of the BAL than in the lavage of non-smokers. This did not occur in the BF. We found no relation between the TPA concentrations and cancer histology. Conclusions: We believe that TPA is a useful tumor marker with diagnostic c apacity and this capacity is increased when it is studied in the two BAL fr actions. Smoking habit may play a role in the secretion of tumor markers by the tumor cells.