Evidence map›Paper›PMID 34422992›Full record

ArticleAnnals of translational medicine2021

Cell-free DNA from bronchoalveolar lavage fluid (BALF): a new liquid biopsy medium for identifying lung cancer.

Daxiong Zeng, Cangguo Wang, Chuanyong Mu, Meiqin Su, Jingyu Mao, Jianan Huang, Jiayue Xu, Lin Shao, Bing Li, Haiyan Li and 3 more

Open access · diamondAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Annals of translational medicine, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 17 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
17citing papers in PubMed, 1 pooled it
1.8field-weighted citation impact, top 15% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

17 citing papers in PubMed, 1 synthesis or guideline pooled it, 32 citations in OpenAlex.

  1. Pooled it
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  16. Combinatorial Power of cfDNA, CTCs and EVs in Oncology.Diagnostics (Basel, Switzerland) · 2022
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

13 authors at 3 institutions in 1 country.

Daxiong ZengDepartment of Respiratory Medicine, Dusu Lake Hospital to Soochow University, Suzhou, China.
Cangguo WangDepartment of Respiratory Medicine, The First Affiliated Hospital of Soochow University, Suzhou, China.
Chuanyong MuDepartment of Respiratory Medicine, The First Affiliated Hospital of Soochow University, Suzhou, China.
Meiqin SuDepartment of Respiratory Medicine, The First Affiliated Hospital of Soochow University, Suzhou, China.
Jingyu MaoDepartment of Respiratory Medicine, The First Affiliated Hospital of Soochow University, Suzhou, China.
Jianan HuangDepartment of Respiratory Medicine, The First Affiliated Hospital of Soochow University, Suzhou, China.
Jiayue XuBurning Rock Biotech, Guangzhou, China.
Lin ShaoBurning Rock Biotech, Guangzhou, China.
Bing LiBurning Rock Biotech, Guangzhou, China.
Haiyan LiBurning Rock Biotech, Guangzhou, China.
Bingsi LiBurning Rock Biotech, Guangzhou, China.
Jun ZhaoDepartment of Thoracic Surgery, The First Affiliated Hospital of Soochow University, Suzhou, China.
Junhong JiangDepartment of Respiratory Medicine, Dusu Lake Hospital to Soochow University, Suzhou, China.
Burning Rock Biotech (China) · CNSoochow University · CNFirst Affiliated Hospital of Soochow University · CN

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundDifferentiating malignant lung tumors from benign pulmonary nodules is a great challenge. While the analysis of bronchoalveolar lavage fluid (BALF) is used for diagnosing infections and interstitial lung diseases, there is limited evidence to support its use for lung cancer diagnosis. This study aimed to interrogate the potential of using BALF cell-free DNA (cfDNA) to discriminate malignant lesions from benign nodules.

methodsFifty-three patients with solid pulmonary nodules (≤2 cm) were prospectively enrolled, including 21 confirmed with benign disease and 32 with malignant tumors. Mutations were profiled for 30 tumor tissues and 40 BALFs. Paired BALFs and plasma from 48 patients underwent DNA methylation profiling. A methylome-based classification model was developed for BALF and plasma separately.

resultsAmong the 30 patients with paired tissues and BALFs, 96.7% and 70% had alterations detected from their tissues (79 alterations) and BALFs (53 alterations), respectively. Using tissues as references, BALFs revealed 14 new alterations and missed 41. BALF mutation displayed a sensitivity of 71%, specificity of 77.8%, and accuracy of 72.5% in detecting lung cancer. BALF methylation achieved an accuracy of 81.3%, with both sensitivity and specificity being 81%. Plasma methylation showed a 66.7% sensitivity, 71.4% specificity, and 68.8% accuracy. BALF methylation also demonstrated 82.4% sensitivity in stage I patients. Parallel bronchoscopy, lavage cytology, and bronchial brushing demonstrated an inferior sensitivity of 23%, 3.1%, and 9.7%, respectively, compared with BALF methylation and mutation (P<0.0001).

conclusionsBALF cfDNA can serve as a liquid biopsy media for both mutation and methylation profiling, demonstrating better sensitivities in distinguishing small malignant tumors from benign nodules than conventional methods. KEYWORDS: Lung cancer diagnosis; pulmonary nodule; bronchoalveolar lavage fluid (BALF); methylation; genomic mutation.

Identifiers

PMID34422992
PMCPMC8339831
OpenAlexW3183064084

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.