الفهرس 
Lung CancerOnly 14 pages are availabe for public view
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Abstract
Lung cancer is a highly invasive, rapidly metastasizing and prevalent cancer and it is the most common cause of malignancy related death worldwide. A major factor in the high mortality of lung cancer patients is the presence of metastatic tumors in approximately two-thirds of patients at the time of diagnosis, so detection of lung cancer at earlier stages could potentially increase survival rates. Immune responses against intracellular and surface tumor antigens are well documented in patients with lung cancer. In particular, the complement system is activated in lung tumor cells. Complement is a central component of innate immunity that plays an essential role in immune surveillance and homeostasis. Lung tumors activate the classical complement pathway and generate our marker in this study,(C4d), a degradation product of this pathway. Moreover, our results suggest that the determination of C4d may be of value for the diagnosis and prognosis of lung cancer. The present study aimed to evaluate the role of Complement Activation Product (C4d) as a diagnostic aid for lung cancer and to predict its diagnostic levels in bronchoalveolar lavage fluid and in sputum supernatant of patients diagnosed with lung cancer. This study is a prospective observational cross sectional controlled study that carried out in Chest Department, Tanta University Hospitals on 40 case divided into 2 groups: group 1: 25 patients with bronchogenic carcinoma, diagnosed by histopathological examination of tissue biopsy obtained by bronchoscopy. group 2: 15 non malignant individuals indicated for bronchoscopy for other causes. Exclusion criteria: • Patients on current treatment or previously received treatment for lung cancer (chemotherapy or radiotherapy). • Multiple organ dysfunction as renal failure, hepatic failure and cardiac failure. • Patients with contraindications for Bronchoscope as: 1. Cardiovascular diseases as decompensated heart failure, recent acute myocardial infarction (in the last 6 months), unstable angina. 2. Po2 < 60% and Pco2 > 50 %. 3. Uncorrectable shock. The following were done for all subjects: • Full history taking, complete physical examination, plain chest x-ray and CT, ECG, complete blood count, prothrombine time (PT) and erythrocyte sedimentation rate (ESR). • Total protein in bronchoalveolar lavage fluid (BALF) is measured. • Bronchoalveolar lavage fluid and sputum were collected for measuring the level of C4d. Results: The results of our study revealed the followings: There was no statistically significant difference between the two studied groups as regard to age, sex, smoking index. There was no statistically significant difference between the two studied groups as regard to clinical presentation (cough, expectoration, fever, hemoptysis and dyspnea). There was statistically significant difference between the two studied groups as regard to total leucocytic count with significant increase in group 2. There was statistically significant difference between the two studied groups as regard to erythrocyte sedimentation rate with significant increase in group1. There was no statistically significant difference between the two studied groups as regard to heamoglobin concentration, platelets count and prothrombin time. As regard to total protein in bronchoalveolar lavage (BAL), there was statistically significant difference between the two studied groups with significant increase in group1. As regard to C4d in bronchoalveolar lavage (BAL), there was statistically significant difference between the two studied groups with significant increase in group1. As regard to C4d in sputum supernatant, there was statistically significant difference between the two studied groups with significant increase in group1. There was positive correlation between C4D in BAL and C4D in sputum, total protein in BAL and ESR 1hr. As regard C4D in sputum, there was positive correlation between it and total protein in BAL and ESR 1hr. Regarding Total protein in BAL, there was positive correlation between it and ESR 1hr.