Increased collagenase activity in macrophages from bronchial lavage as a diagnostic marker of non-small cell lung cancer.
BACKGROUND
The roles of matrix metalloproteinases (MMPs) in cancer metastasis have been studied. Macrophages are considered to release MMPs in the tissues of patients with lung cancer.


METHODS
Intracellular collagenase activity was measured in CD14+ CD45+ cells from bronchial lavage fluid to establish a new diagnostic tool for lung cancer. Between August 2000 and November 2001 bronchoscopy and bronchial lavage were performed in 45 patients with abnormal shadows on the chest radiograph; 21 had lung cancer and 24 had non-malignant disease.


RESULTS
Collagenase activity in patients with primary lung cancer (5.54 (0.65)) or non-small cell lung cancer (NSCLC) (5.62 (0.71)) was significantly higher than in those with non-malignant disease (3.63 (0.78), p=0.006 and p=0.008, respectively). Only three of 18 patients in the low activity group were diagnosed as having cancer compared with 18 of 27 in the high activity group (p=0.001). This significance was not seen in non-smokers but it was apparent in smokers/ex-smokers. Excluding non-smokers improved the specificity of collagenase activity in differentiating cancer and non-malignant disease from 62.5% to 80.0%. The sensitivity of the test was 85.7% in all patients and 88.2% in smokers/ex-smokers.


CONCLUSIONS
Measurement of intracellular collagenase activity in macrophages in bronchial lavage fluid is a useful diagnostic tool for distinguishing between cancer and non-malignant diseases, especially in smokers and ex-smokers.
Hakoda
Y
Y
First Department of Internal Medicine, Tokyo Medical University, Nishishinjuku, Tokyo, Japan.
Ito
Y
Y
Nagate
A
A
Minemura
K
K
Utsumi
K
K
Aoshima
M
M
Ohyashiki
K
K
D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D014408:Biomarkers, Tumor / Q000378:metabolism*; D001992:Bronchoalveolar Lavage Fluid / Q000166:cytology*; D002097:C-Reactive Protein / Q000378:metabolism; D002289:Carcinoma, Non-Small-Cell Lung / Q000175:diagnosis*; D017364:Collagenases / Q000378:metabolism*; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000175:diagnosis*; D008264:Macrophages / Q000201:enzymology*; D008297:Male; D020782:Matrix Metalloproteinases / Q000378:metabolism*; D008875:Middle Aged; D012680:Sensitivity and Specificity; D012737:Sex Factors; D012907:Smoking / Q000378:metabolism
D014408:Biomarkers, Tumor; D002097:C-Reactive Protein; D017364:Collagenases; D020782:Matrix Metalloproteinases