The concentrations of five tumor markers in both BAL fractions in lung cancer patients in relation to cigarette smoking

BACKGROUND: Lung cancer is the leading cause of death from cancer. Tobacco is related to the development of this type of tumor due to genetic alterations and to the secretion of certain biological markers. Bronchogenic carcinomas secrete a series of biological substances known as tumor markers. Some of these markers, such as carcinoembryonic antigen, neuron-specific enolase, tissue polypeptide antigen (TPA), tissue polypeptide-specific antigen (TPS) and CYFRA 21.1, possess clear clinical value when analyzed in bronchoalveolar lavage (BAL) of patients with lung malignancies, particularly when they are analyzed in the two BAL fractions, bronchial (BF) and alveolar (AF), being more increased in the BF. For this reason, we intend to demonstrate that smokers with cancer secrete more biological substances in the BF and that the concentrations of these markers are higher in the BAL of smokers than in that of non-smokers. METHODS: The five aforementioned tumor markers were studied in the two BAL fractions of 52 lung cancer patients (46 smokers and 6 non-smokers). We performed BAL using 150 ml of 0.9% saline solution divided in three aliquots of 50 ml. The fluid obtained from the first 50 ml was the BF. The liquid from the other two aliquots was the AF. The five tumor marker concentrations were calculated in accord with the indications of the laboratory. RESULTS: The TPA and TPS levels in the BAL of lung cancer patients were more increased in the BF than in the AF, even when the patients were divided into smokers and non-smokers. When we compared smokers with non-smokers, the smokers had higher levels of TPS in the BF and of TPA in the AF. CONCLUSIONS: Thus, we believe that the cellular alterations produced by tobacco are responsible for the secretion of these tumor markers.