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Review | Open Access

Bronchoalveolar lavage fluid assessment facilitates precision medicine for lung cancer

Hantao Zhang1,2,*, Dan Deng2,*, Shujun Li2, Jing Ren3, Wei Huang2, Dan Liu3, Weiya Wang1 ( )
Department of Pathology, West China Hospital, Sichuan University, Chengdu 610000, China
West China Biobank, West China Hospital, Sichuan University, Chengdu 610000, China
Department of Respiratory and Critical Care Medicine, Clinical Research Center for Respiratory Disease, West China Hospital, Sichuan University, Chengdu 610000, China

*These authors contributed equally to this work.

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Abstract

Lung cancer is the most common and fatal malignant disease worldwide and has the highest mortality rate among tumor-related causes of death. Early diagnosis and precision medicine can significantly improve the survival rate and prognosis of lung cancer patients. At 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 heterogeneity. Liquid biopsy is a method for detecting circulating biomarkers in the blood and other body fluids containing genetic information from primary tumor tissues. Bronchoalveolar lavage fluid (BALF) is a potential liquid biopsy medium that is rich in a variety of bioactive substances and cell components. BALF 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 biopsy. In this review, the current research on BALF in the diagnosis, treatment, and prognosis of lung cancer is summarized. The advantages and disadvantages of different components of BALF, including cells, cell-free DNA, extracellular vesicles, and microRNA are introduced. In particular, the great potential of extracellular vesicles in precision diagnosis and detection of drug-resistant for lung cancer is highlighted. In 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.

Keywords

Lung cancerextracellular vesiclesprecision medicineliquid biopsybronchoalveolar lavage fluid

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Cancer Biology & Medicine
Volume 21 Issue 3,
March 2024
Pages 230-251
DOI: 10.20892/j.issn.2095-3941.2023.0381
Cite this article:
Zhang H, Deng D, Li S, et al. Bronchoalveolar lavage fluid assessment facilitates precision medicine for lung cancer. Cancer Biology & Medicine, 2024, 21(3): 230-251. https://doi.org/10.20892/j.issn.2095-3941.2023.0381

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Received: 27 September 2023
Accepted: 24 November 2023
Published: 29 December 2023
©2024 The Authors.

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