Abstract

Lung cancer is the leading cause of cancer-related death. Due to the poor prognosis, intensive research continues for early diagnosis and treatment. High Mobility Group Box (HMGB) proteins are nonhistone nuclear proteins with very different functions in the cell. HMGB1 can be released into the extracellular matrix, where it performs important functions in inflammation and carcinogenesis, such as promoting angiogenesis, preventing apoptosis, and promoting tissue invasion and metastasis. Patients who underwent bronchoscopy due to lung pathologies in Private Medical Park Gaziantep Hospital Thoracic Surgery Clinic were included in the study. Age, gender, bronchoscopy biopsy, cytology results, and clinicopathological evaluation results were obtained by scanning the patient files. Samples were obtained from the lavage fluid taken for Bronchoalveolar (BAL) cytology from patients who underwent bronchoscopy due to lung pathologies. After cytological evaluation, the remaining samples were stored at -80 °C. HMGB1 levels were measured from these samples [1]. Statistical analyzes were performed using SPSS for Windows 15.0 software. Before the study, approval was obtained from the SANKO University Clinical Research Ethics Committee. A total of 95 patients, 33 (34.7%) female, and 62 (65.3%) males, with a mean age of 59±15.2 (Range 17-86) were included in the study. When the final pathology results were evaluated together with clinical findings, 29 (30.5%) patients were diagnosed with primary lung cancer, 12 (12.6%) with metastatic lung cancer, 7 with COPD, and 47 with pneumonia. There was no statistically significant difference between the clinicopathological diagnosis groups in terms of hmgb1 level measured in bronchoalveolar lavage fluid (p=0.306). Clinicopathological diagnosis groups were grouped as malignant or benign. Benign lesions were detected in 54 (56.8%) patients, and malignant lesions were found in 41 (43.2%) patients. In terms of malignant and benign lesions, the level of hmgb1 measured in the bronchoalveolar lavage fluid was not statistically significant (p=0.146). When cytology was used to differentiate the lesions, 88 (92.6%) were reported as malignant and 7 (7.4%) as benign [2]. It was not statistically significant in terms of cytological results and hmgb1 level measured in bronchoalveolar lavage fluid (p=0.819). The sensitivity of cytology was 17%, the specificity was 100%, and the accuracy was 74.7%.

Methods such as endobronchial biopsy, bronchial lavage, transbronchial needle aspiration biopsy, and cytological brushing performed during bronchoscopy are used in the diagnosis of lung cancer. In addition to the studies arguing that the additional benefit of bronchial lavage cytology in the diagnosis is not very significant, there are also studies with the opposite view. In recent years, many studies have shown that there is a relationship between HMGB1 and cancer development. However, HMGB1 has no clear significance in the diagnosis and prognosis of cancer yet. Early diagnosis of NSCLC is very important in reducing the mortality of the disease. Therefore, the search for an ideal marker for early diagnosis continues. In our study, HMGB1 levels were measured in bronchoalveolar lavage fluid, but its diagnostic value was not determined.