Mehmet Akif İnan Training and Research Hospital, Departman of Chest Diseases, Şanlıurfa, Turkey.
Akdeniz University, Faculty of Medicine, Department of Chest Diseases, Antalya, Turkey.
Int J Clin Pract. 2021 Dec;75(12):e14918. doi: 10.1111/ijcp.14918. Epub 2021 Sep 30.
Lung cancer is both the most common seen malignity and cause of cancer-related deaths worldwide. Adenosine deaminase (ADA) is a hydrolytic enzyme that catalyses the conversion of adenosine to inosine in the purine metabolism pathway. Studies examining ADA levels in bronchoalveolar lavage (BAL) fluids of patients with lung malignancy are very limited in the literature. Our aim examine the clinical significance of ADA levels in BAL fluids of patients with lung malignancy.
A total of 89 patients undergoing fiberoptic bronchoscopy (FOB) with different indications from December 2017 to December 2018 were included in this study. The patients were divided into two groups as malignancy and non-malignancy groups. Demographic, laboratory data and ADA levels in bronchoalveolar lavage (BAL) were compared between the two groups. In addition, ADA levels in BAL were compared among the histopathological subtypes of patients in the malignant group.
The mean age of the patients was 58.2 ± 14.5 years with 86% of male gender. ADA enzyme levels were statistically higher in the malignant patient group compared with the non-malignant group (37.2 [17.6-71] vs 17.1 [9-35.3], P < .001). When the patients in the malignant group were compared in terms of ADA levels according to their histopathological types, a statistically significant difference was obtained in small cell carcinoma patients (49 [12.5-75.3], P = .005).
ADA levels in BAL may be a diagnostic biomarker in lung malignancies. In patients where a biopsy cannot be taken or histopathological typing cannot be performed because of tissue insufficiency, ADA levels in BAL can be an auxiliary parameter in making malignancy / histopathological diagnosis accompanied by radiological and clinical findings.
肺癌是全球最常见的恶性肿瘤和癌症相关死亡原因。腺苷脱氨酶（ADA）是一种水解酶，可在嘌呤代谢途径中将腺苷转化为肌苷。文献中关于肺癌患者支气管肺泡灌洗液（BAL）中 ADA 水平的研究非常有限。我们旨在探讨 ADA 水平在肺癌患者 BAL 液中的临床意义。
本研究纳入了 2017 年 12 月至 2018 年 12 月间因不同适应证接受纤维支气管镜检查（FOB）的 89 例患者。患者分为恶性肿瘤组和非恶性肿瘤组。比较两组患者的一般资料、实验室数据和 BAL 中 ADA 水平。此外，还比较了恶性肿瘤组患者的组织病理学亚型之间 BAL 中 ADA 水平的差异。
患者的平均年龄为 58.2±14.5 岁，其中 86%为男性。与非恶性肿瘤组相比，恶性肿瘤组患者的 ADA 酶水平明显升高（37.2[17.6-71] vs 17.1[9-35.3]，P<0.001）。当根据组织病理学类型比较恶性肿瘤组患者的 ADA 水平时，小细胞癌患者的差异具有统计学意义（49[12.5-75.3]，P=0.005）。
BAL 中的 ADA 水平可能是肺癌的诊断生物标志物。在因组织不足无法进行活检或组织病理学分型的情况下，BAL 中的 ADA 水平可作为伴随影像学和临床发现的恶性肿瘤/组织病理学诊断的辅助参数。
