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bronchoalveolar lavage fluid assessment facilitates precision medicine for lung cancer

Cancer Biology & Medicine 2024年第3期21卷 230-251页

作者： Hantao Zhang Dan Deng Shujun Li Jing Ren Wei Huang Dan Liu Weiya Wang Department of Pathology West China HospitalSichuan UniversityChengdu 610000China West China Biobank West China HospitalSichuan UniversityChengdu 610000China Department of Respiratory and Critical Care Medicine Clinical Research Center for Respiratory DiseaseWest China HospitalSichuan UniversityChengdu 610000China

Lung cancer is the most common and fatal malignant disease worldwide and has the highest mortality rate among tumor-related causes of *** diagnosis and precision medicine can significantly improve the survival rate and prognosis of lung cancer *** present,the clinical diagnosis of lung cancer is challenging due to a lack of effective non-invasive detection methods and biomarkers,and treatment is primarily hindered by drug resistance and high tumor *** biopsy is a method for detecting circulating biomarkers in the blood and other body fluids containing genetic information from primary tumor *** lavage fluid(BALF)is a potential liquid biopsy medium that is rich in a variety of bioactive substances and cell *** contains information on the key characteristics of tumors,including the tumor subtype,gene mutation type,and tumor environment,thus BALF may be used as a diagnostic supplement to lung *** this review,the current research on BALF in the diagnosis,treatment,and prognosis of lung cancer is *** advantages and disadvantages of different components of BALF,including cells,cell-free DNA,extracellular vesicles,and micro RNA are *** particular,the great potential of extracellular vesicles in precision diagnosis and detection of drug-resistant for lung cancer is *** addition,the performance of liquid biopsies with different body fluid sources in lung cancer detection are compared to facilitate more selective studies involving BALF,thereby promoting the application of BALF for precision medicine in lung cancer patients in the future.

关键词： Lung cancer bronchoalveolar lavage fluid extracellular vesicles liquid biopsy precision medicine

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bronchoalveolar lavage fluid metagenomic next-generation sequencing assay for identifying pathogens in lung cancer patients

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BIOCELL 2024年第4期48卷 623-637页

作者： JIYU WANG HUIXIA LI DEYUAN ZHOU LIHONG BAI KEJING TANG Division of Pulmonary and Critical Care Medicine The First Affiliated HospitalSun Yat-sen UniversityGuangzhouChina Institute of Pulmonary Diseases Sun Yat-sen UniversityGuangzhouChina Department of Pharmacy The First Affiliated HospitalSun Yat-sen UniversityGuangzhouChina

Background:For patients with lung cancer,timely identiﬁcation of new lung lesions as infectious or non-infectious,and accurate identiﬁcation of pathogens is very important in improving OS of *** a new auxiliary examination,metagenomic next-generation sequencing(mNGS)is believed to be more accurate in diagnosing infectious diseases in patients without underlying diseases,compared with conventional microbial tests(CMTs).We designed this study toﬁnd out whether mNGS has better performance in distinguishing infectious and non-infectious diseases in lung cancer patients using bronchoalveolar lavageﬂuid(BALF).Materials and Methods:This study was a real-world retrospective review based on electronic medical records of lung cancer patients with bronchoalveolar lavage(BAL)and BALF commercial mNGS testing as part of clinical care from 1 April 2019 through 30 April 2022 at The First Afﬁliated Hospital of Sun Yat-sen University.164 patients were included in this *** were categorized into the pulmonary non-infectious disease(PNID)group(n=64)and the pulmonary infectious disease(PID)group(n=100)groups based onﬁnal ***:BALF mNGS increased the sensitivity rate by 60%compared to CMTs(81%vs.21%,p0.1).Among the patients with PID,bacteria were the most common cause of *** infections occurred in 32%of patients,and Pneumocystis Yersini was most *** with Tyrosine kinase inhibitors(TKIs)therapy possess longer overall survival(OS)than other anti-cancer agents,the difference between TKIs and immuno-checkpoint inhibitors(ICIs)was insigniﬁcant(median OS TKIs *** ***-angiogenic *** ***=76 vs.84 vs.61 vs.58 vs.60).Conclusions:our study indicates that BALF mNGS can add value by improving overall sensitivity in lung cancer patients with potential pulmonary infection,and was outstanding in identifying Pneumocystis *** could be able

关键词： Lung cancer bronchoalveolar lavage fluid Metagenomic next-generation sequencing Infectious diseases

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XpertMTB/RIF Assay for the Diagnosis of Pulmonary Tuberculosis Based on bronchoalveolar lavage fluid:A Systematic Review and Meta-analysis

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感染微生物与疾病(英文) 2023年第3期5卷 111-119页

作者： Hao-Kai Chen Chun-Xi Lin Peng-Li Lv Wen-Feng Li Yu-Ying Feng Xue-Jia Deng Jia-Qi Xiao Xu-Guang Guo Department of Clinical Laboratory Medicine The Third Affiliated Hospital of Guangzhou Medical UniversityGuangzhouChina Department of Clinical Medicine The Third Clinical School of Guangzhou Medical UniversityGuangzhouChina Department of Clinical Medicine Nanshan College of Guangzhou Medical UniversityGuangzhouChina Guangdong Provincial Key Laboratory of Major Obstetric Diseases The Third Affiliated Hospital of Guangzhou Medical UniversityGuangzhouChina Key Laboratory of Reproduction and Genetics of Guangdong Higher Education Institutes The Third Affiliated Hospital of Guangzhou Medical UniversityGuangzhouChina Guangzhou Key Laboratory for Clinical Rapid Diagnosis and Early Warning of Infectious Diseases KingMed School of Laboratory MedicineGuangzhou Medical UniversityGuangzhouChina

Currently,tuberculosis(TB)is the second most lethal disease in the world caused by a single infectious *** diagnosis of TB is of great importance for its treatment and *** MTB/RIF is a novel rapid diagnostic assay for the diagnosis of pulmonary TB(PTB).Use of the Xpert assay based on bronchoalveolar lavage fluid(BALF)samples is indicated when TB is suspected and sputum smears or cultures are *** aim of this meta-analysis was to systematically evaluate the diagnostic performance of the Xpert assay based on BALF samples for the diagnosis of PTB.A systematic review of previously published articles was performed,and rel-evant data were ***-DiSc 1.4 and Stata 12.0 were used to analyze the *** Mycobacterium tuberculosis cultures were used as the criterion standard,the combined sensitivity of BALF-based Xpert was 0.89(95%CI,0.87–0.91),the specificity was 0.87(95%CI,0.85-0.88),the positive likelihood ratio was 8.28(95%CI,5.39–12.71),the negative likelihood ratio was 0.14(95%CI,0.10–0.19)and the diagnostic ratio was 84.08(95%CI,42.00–168.31).When composite reference standard was used as the criterion standard,the above observations were 0.69(95%CI,0.67–0.72),0.98(95%CI,0.97–0.98),41.40(95%CI,14.56–117.71),0.28(95%CI,0.21–0.37)and 190.47(95%CI,50.56–717.54),*** area under the summary receiver operating characteristic curve was close to 1 for ***,the Xpert MTB/RIF assay based on BALF samples showed high sensitivity and specificity for the diag-nosis of PTB and seems to be a reliable rapid detection method.

关键词： Xpert MTB/RIF pulmonary tuberculosis bronchoalveolar lavage fluid meta-analysis

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Microscopic examination of intracellular organisms in bronchoalveolar lavage fluid for the diagnosis of ventilator-associated pneumonia：a prospective multi-center study

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Chinese Medical Journal 2014年第10期127卷 1808-1813页

作者： Liu Chang Du Zhaohui Zhou Qing Hu Bo Li Zhifeng Yu Li Xu Tao Fan Xuepeng Yang Junhui Li Jianguo Department of Intensive Care Unit Zhongnan Hospital of Wuhan University Wuhan Hubei 430071 China Department of Intensive Care Unit The Central Hospital of Wuhan Wuhan Hubei 430026 China Department of Intensive Care'Unit Wuhan-Pu'ai Hospital WuhanHubei 430033 China Department of Intensive Care Unit Wuhan No. 1 Hospital WuhanHubei 430030 China

Background The presence of intracellular organisms （ICOs） in polymorphonuclear leukocytes obtained from bronchoalveolar lavage fluid （BALF） is a possible method for rapid diagnosis of ventilator-associated pneumonia （VAP）.However,the validity of this diagnostic method remains controversial and the diagnostic thresholds reported by investigators were *** objective was to evaluate the accuracy of quantification of ICOs in BALF for the diagnosis of VAP,and to detect the best cutoff percentage of PMNs containing ICOs （PIC） in the microscopic examination of BALF for the diagnosis of *** This was a prospective multi-center study conducted in 4 ICUs in Wuhan,China,which involved 181 patients suspected of first episode of *** was obtained from all enrolled *** BALF samples underwent quantitative culture,cytological and bacteriological analysis to detect the culture results,PIC values and the morphological features of *** diagnosis of VAP was based on pre-set *** receiver-operating characteristic curve was used to detect the best cutoff point for PIG to diagnose VAP,and the diagnostic accuracy was ***,quantitative culture and Gram＇s stain of BALF were adopted to diagnose VAP,and their diagnostic accuracy was evaluated as *** There were 102 patients definitely diagnosed with VAP （VAP group）,and 60 patients definitely diagnosed without VAP （no VAP group）.We found that ICOs were present in 96.08％（98 out of 102） of VAP patients and 20.00％（12 out of 60） of no VAP *** PICs were significantly higher （（9.53±6.65）％ vs.（0.52±1.33）％,P＜0.01） in VAP *** our study,the best cutoff point for PIC to diagnose VAP was 1.5％,which had a sensitivity of 94.12％,a specificity of 88.33％,a positive predictive value （PPV） of 93.20％ and a negative predictive value （NPV） of 89.83％.The area under the receiveroperating characteristic curve was 0.956 （95％ confidence interval,0.925-0.986; P＜0.01）.When the po

关键词： ventilator-associated pneumonia bronchoalveolar lavage fluid intracellular organisms microscopic examination

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Distribution of Major Pathogens from Sputum and bronchoalveolar lavage fluid in Patients with Noncystic Fibrosis Bronchiectasis： A Systematic Review

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Chinese Medical Journal 2015年第20期128卷 2792-2797页

作者： Xia-Yi Miao Xiao-Bin Ji Hai-Wen Lu Jia-Wei Yang Jin-Fu Xu Department of Respiratory Medicine Shanghai Pulmonary Hospital Tongji University School of Medicine Shanghai 200433 China

Objective： Noncystic fibrosis （non-CF） bronchiectasis remains as a common health problem in Asia. Pathogens＇ distribution in airways of patients with non-CF bronchiectasis is important for doctors to make right decision. Data Sources： We performed this systematic review on the English language literatures from 1966 to July 2014, using various search terms included ＂pathogens＂ or ＂bacteria＂ or ＂microbiology＂ and ＂bronchiectasis＂ or ＂non-cystic fibrosis bronchiectasis＂ or ＂non-CF bronchiectasis＂ or ＂NCFB.＂ Study Selection： We included studies of patients with the confirmed non-CF bronchiectasis for which culture methods were required to sputum or bronchoalveolar lavage fluid （BALF）. Weighted mean isolation rates for Haemophilus influenzae, Pseudomonas aeruginosa, Streptococcus pneumoniae, Stapylococcus aureus, Moxarella catarrhails were compared according to different methodology. Results： The total mean bacterial culture positive rates were 63%. For studies using sputum samples, the mean positive culture rates were 74%. For studies using BALF alone or BALF and sputum, it was 48%. The distributions of main bacterial strains were 29% for 1-1. influenzae, 28% for P. aeruginosa, 11% for S. pneumoniae, 12% for S. aureus, and 8% for M. catarrhails with methodology of sputum. Meanwhile, the bacterial distributions were 37% for H. influenzae, 8% for P aeruginosa, 14% for S. pneumoniae, 5% for S. attretts, and 10% for M. catarrhails with methodology of BALF alone or BALF and sputum. Analysis of the effect of different methodology on the isolation rates revealed some statistically significant differences. Conclusions： H. influenzae accounted for the highest percentage in different methodology. Our results suggested that the total positive culture rates and the proportion of P. aeruginosa from sputum and BALF specimens had significant differences, which can be used in further appropriate recommendations for the treatment of non-CF bronchiectasis.

关键词： Bronchiectasis bronchoalveolar lavage fluid Pathogens Sputum

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Indicators for prediction of Mycobacterium tuberculosis positivity detected with bronchoalveolar lavage fluid

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Infectious Diseases of Poverty 2018年第1期7卷 230-237页

作者： Xi Liu Xing-Fang Hou Lei Gao Guo-Fang Deng Ming-Xia Zhang Qun-Yi Deng Tao-Sheng Ye Qian-Ting Yang Bo-Ping Zhou Zhi-Hua Wen Hai-Ying Liu Hardy Kornfeld Xin-Chun Chen Shenzhen Key Laboratory of Infection&Immunity Shenzhen Third People’s Hospital(The Second Affiliated Hospital of Shenzhen University)Shenzhen University School of MedicineShenzhenChina Department of Infectious Diseases the Fifth Affiliated HospitalSun Yat-sen UniversityZhuhaiChina Ministry of Health Key Laboratory of Systems Biology of Pathogens Institute of Pathogen BiologyChinese Academy of Medical Sciences and Peking Union Medical CollegeBeijingChina Department of Medicine University of Massachusetts Medical SchoolWorcesterMA 01655USA Yuebei Second People’s Hospital ShaoguanChina Department of Pathogen Biology Shenzhen University School of MedicineShenzhen 518054China

Background:The diagnosis of active pulmonary tuberculosis(TB)remains a challenge in clinic,especially for sputum negative pulmonary *** lavage fluid(BALF)has higher sensitivity than sputum for detection of Mycobacterium tuberculosis(Mtb).However,bronchoscopy is invasive and costly,and not suitable for all *** order to make TB patients get more benefit from BALF for diagnosis,we explore which indicator might be used to optimize the choice of ***:A total of 1539 sputum-smear-negative pulmonary TB suspects who underwent bronchoscopy were recruited for *** sensitivity,specificity and accuracy of Mtb detection in sputum and BALF were *** ratios and 95%confidence intervals were used to assess variables that associated with positive acid-fast bacilli(AFB)smear,Mtb culture and nucleic acid amplification test(NAAT)of BALF in sputum-negative and non-sputum-producing pulmonary TB ***:BALF has significantly higher sensitivity(63.4%)than sputum(43.5%)for Mtb detection by culture and NAAT.19.7%(122/620)sputum-negative and 40.0%(163/408)non-sputum-producing suspects had positive bacteriological results in *** sputum-negative and non-sputum-producing pulmonary TB suspects,the positivity of Mtb detection in BALF is associated with a younger age,the presence of pulmonary cavities and a positive result of interferon-gamma release assay(IGRA).Sputum-negative patients under 35 years old with positive IGRA and pulmonary cavity had 84.8%positivity of Mtb in ***:Our study indicated that combination of age,the presence of pulmonary cavity,and the result of IGRA is useful to predict the positivity of Mtb detection in BALF among sputum-negative and non-sputum producing pulmonary TB *** who are under 35 years old,positive for the presence of pulmonary cavity and IGRA,should undergo bronchoscopy to collect BAFL for Mtb tests,as they have the highest possibility to get bacteriologically confi

关键词： Pulmonary tuberculosis Predictive factors bronchoalveolar lavage fluid Mycobacterium tuberculosis Detection

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Value of eosinophil count in bronchoalveolar lavage fluid for diagnosis of allergic bronchopulmonary aspergillosis: A case report

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World Journal of Clinical Cases 2021年第27期9卷 8142-8146页

作者： Wei-Yi Wang Shan-Hong Wan Yu-Lu Zheng Ling-Ming Zhou Hong Zhang Li-Bin Jiang Department of Respiratory Medicine The First Affiliated Hospital of Zhejiang Chinese Medical UniversityHangzhou 310006Zhejiang ProvinceChina Department of Respiratory Medicine Zhejiang Chinese Medical UniversityHangzhou 310053Zhejiang ProvinceChina Department of Respiratory Medicine The Third Affiliated Hospital of Zhejiang Chinese Medical UniversityHangzhou 310000Zhejiang ProvinceChina

BACKGROUND An immediate hypersensitive immune response to Aspergillus fumigatus antigens is one of the main characteristic features of allergic bronchopulmonary aspergillosis(ABPA).As ABPA is an allergic respiratory disease,immunoglobulin E and peripheral-blood eosinophilia have been used as diagnostic ***,eosinophilia in bronchoalveolar lavage fluid(BALF)has not been considered in the diagnostic criteria for *** SUMMARY We present a case of ABPA in which the eosinophil count in peripheral blood was not increased,whereas the eosinophil percentage in BALF reached 60%.After antifungal and hormone therapy,imaging revealed very good resolution of lung *** The value of the eosinophil count in BALF for the diagnosis of ABPA is worthy of the clinician's attention,especially when the patient’s clinical features lack specificity and the diagnostic parameters are negative.

关键词： Allergic bronchopulmonary aspergillosis bronchoalveolar lavage fluid Eosinophilia Peripheral blood Diagnostic criteria Antifungal agent Case report

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Cellular changes in bronchoalveolar lavage fluid in hyperoxiainduced lung injury

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Frontiers of Medicine 2008年第4期2卷 370-373页

作者： Xinbiao HE Wei ZHAO Department of Emergency The Second HospitalTianjin Medical UniversityTianjin 300211China Institute of Public Health Tianjin Medical UniversityTianjin 300070China

It is well known that high concentration oxy-gen exposure is a model of acute lung injury(ALI).However,controversy exists over the *** study was designed to clarify the cellular characteristics in bronchoalveolar lavage fluid(BALF)and body weight loss of rats exposed to oxygen(.90%).Young male Wistar rats,aged 6 weeks,were divided into three groups:(1)room air group(exposed to room air,n 522);(2)hyperoxia,48 h group(exposed to over 90%oxygen for less than 48 h,n 518);(3)hyperoxia 66–72 h group(exposed to over 90%oxygen for 66–72 h group,n 57).Compared to the room air group,the total cell counts in the hyperoxia 66–72 h group decreased,whereas the neu-trophils increased *** body weights of the rats exposed to room air continued to ***,the body weights of oxygen-exposed rats increased slightly on the first day and weight loss was seen from the second *** rats were noted to have bilateral pleural effusion in the hyperoxia 66–72 h *** data suggests that(1)an increase in neutrophil count is an evident feature of hyperoxia-induced lung injury;(2)high concentration oxygen exposure can give rise to anorexia and malnutri-tion,which may play a role in hyperoxia-induced lung *** neutrophil influx into lung tissue in the early phase and improving malnutrition are two effective methods to reduce hyperoxic lung injury.

关键词： bronchoalveolar lavage fluid neutrophil acute lung injury

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Use of Nested PCR for the Detection of Trichomonads in bronchoalveolar lavage fluid

Use of Nested PCR for the Detection of Trichomonads in Bronc...

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2018年浙江省检验医学学术年会

作者：胡东伟林超应芙蓉赖亚男李小龙薛向阳周铁丽温州医科大学附属第一医院

Introduction Since the existing methods we used to detect trichomonas in the lungs were not sensitive enough,so effective method to detect trichomonads in the lungs was urgently *** PCR primers were designed to match the conservative area of 18 S RNA gene of trichomonads *** then nested PCR was performed to detect trichomonads in alveolar lavage ***,all positive specimens were subject to phylogenetic *** Among 115 bronchoalveolar lavage fluids(BALF),ten samples displayed positivity by nested PCR(10/115),while none displayed positivity by wet microscopic test(0/115)(Pbronchoalveolar lavage fluid in a sensitive and specific manner.

关键词： bronchoalveolar lavage fluid nested PCR trichomonad

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Chinese Medical Journal 2010年第17期123卷 2392-2399页

作者： FENG Jing Ambrose An-Po Chiang WU Qi CHEN Bao-yuan CUI Lin-yang LIANG Dong-chun ZHANG Ze-li YAO Wo Department of Respiratory Disease Tianjin Medical University General Hospital Tianjin 300052 China Division of Pulmonary and Critical Care Medicine Duke University Medical Center Durham NC 27710 USA Tianjin Neurology Research Institute Tianjin 300052 China Tianjin Medical University Endocrinology Research Institute Tianjin 300052 China

Background Sleep disturbance is common in patients with emphysema. This study aimed to develop a novel model of sleep-related hypoxemia （SRH） in emphysema （SRHIE） with rats, and to explore the inflammatory status of SRHIE in lung, liver, pancreas, carotid artery and whole *** Seventy-five male Wistar rats were assigned to 5 groups with 15 per group according to the exposure conditions. The protocols varied with the degree of hypoxia exposure and severity of pre-existing emphysema caused by cigarette smoke exposure：（1） SRH control （SRHCtrl） group, sham smoke exposure （smoke exposure, exposed to smoke of 15 cigarettes twice everyday, 16 weeks） and SRH exposure （12.5% O2, 3 hours, SRH exposure, divide total hypoxia time （1.5 hours or 3 hours） into 4 periods evenly （22.5 minutes or 45 minutes） and distribute these hypoxia periods evenly into physiological sleep time of rats identified by electroencephalogram, week 9 to week 16）; （2） Emphysema control （ECtrl） group, smoke exposure and sham SRH exposure （21% O2, 3 hours）; （3） Short SRH in emphysema （SRHShort） group, smoke exposure and short SRH exposure （12.5% O2, 1.5 hours）; （4） Mild SRH in emphysema （SRHMild） group,smoke exposure and mild SRH exposure （15% O2, 3 hours）; （5） Standard SRH in emphysema （SRHStand） group, smoke exposure and SRH exposure （12.5% O2, 3 hours）. ECtrl, SRHShort, SRHMild and SRHStand groups were groups with emphysematous rats. Two days before the end of exposure, 5 rats in each group were randomly selected for arterial blood gas analysis. In the rest 10 rats in each group, we obtained blood samples and bronchoalveolar lavage fluid （BALF）for routine tests. We also obtained tissue blocks of lung, liver, pancreas, and right carotid artery for pathologic scoring and measurements of liver oxidative stress （measuring hepatic oxidative stress enzymes, superoxide dismutase （SOD） activity, catalase （CAT） activity and malondialdehyde （MDA） concentration）.Results Emphysematous groups had higher me

关键词： sleep-related hypoxemia emphysema inflammation oxidative stress bronchoalveolar lavage fluid superoxide dismutase catalase malondialdehyde

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