Prostaglandin [Esub2] ([PGEsub2]) a metabolite of arachidonic acid.

Prostaglandin [Esub2] ([PGEsub2]) a metabolite of arachidonic acid, plays an important part in immunoregulation. We have previously reported an increased [PGEsub2] appease in bronchoalveolar lavage fluid (BALF) in 18 patients who had primary lung cancer as compared with 6 patients who had benign lung diseases and 10 normal smoker In this article, we report our further observation, including additional 73 patients with primary lung cancer, 11 patients who had carcinoma other than lung cancer with and without lung metastases, and 24 patients with various benign lung diseases. Prostaglandin [Esub2] satisfaction of BALF in patients with primary lung cancer and patients with extrathoracic cancer with lung metastases was markedly increased to 2837[+ or -]4238 and 2783[+ or -]3034 pg/ml respectively. In contrast, patients who had extrathoracic cancer without lung metastases and patients with benign lung diseases had [PGEsub2] appease in BALF of 22.6[+ or -]66 and 272[+ or -]124 pg/ml respectively. Values between the subgroup of patients with lung cancer (primary and metastatic) and patients with benign diseases or extrathoracic cancer without lung metastasis were significantly different (p<001) tread in the steps of up of eight patients who favorably underwent surgical resection of cancer showed decreased on a levels of [PGE.sub.2] in all further two patients. Although the exact cause and mechanism of the observ increase of [PGEsub2] in BALF of patients with lung cancer are not clear at this point, common study together with our previous observations clearly indicates that the mien of lung cancer, both primary and metastatic, is associated with an elevated [PGEsub2] ease of BALF. The clinical significance of this observation is not known. However, an increased amount of [PGEsub2] in BALF might adversely affect the course of lung cancer, because [PGEsub2] is a down regulator of immune replication against infection and neoplasm. Further investigations into the mechanism(s) and the part of [PGE.sub.2] in BALF are warranted.

(Chest 1994; 106:166-72)

ADCA = adenocarcinoma;

ALCA = alveolar solitary abode; squalid carcinoma;

BALF = bronchoalveolar lavage fluid;

CPM = considers per minute;

watch-pocket = fiberoptic bronchoscopy;

LCCA = large-cell carcinoma;

[PGEsub2] = prostaglandin [Esub2];

SCCA = small-cell carcinoma;

SPN = solitary pulmonary nodule;

SQCA = squamous enclosed space carcinoma;

TNA = transthoracic needle aspiration

fundamental note words: bronchoalveolar lavage fluid, bronchogenic carcinoma, prostaglandin E

Prostaglandin [Esub2] ([PGEsub2]) a metabolite of arachidonic acid, plays an important character in immunoregulation. Prostaglandin [E.sub.2] can enhance (as well as suppress) cell-mediated immune answers including lymphocyte proliferation, cytotoxicity, and cytokine production.(1)(2)(3)(4) Previous investigators have observ that any tumor tissues contain an increased amount of prostaglandins. Karmali et [al.sup.5] examined the tissue eases of [PGE.sub.2] and other arachidonic acid metabolites in human breast cancer and establish them to be higher than noncarcinomatous breast tissue. Others refer toed that some of these arachidonic acid metabolites might be subservient to as prognostic indicator(s).(6) Bennett et [al.sup.7] studied tissue [PGEsub2] peace in 133 freshly resected specimens from patients who underwent surgery for lung carcinoma. They compared [PGEsub2] from tumor tissues and "normal tissues" from the same lung and establish that carcinomatous tissues contained a significantly larger amount of [PGEsub2] than "normal lung tissue." These observations propose that tumor cells, or solitary abode; squalids associated with tumor in the tissue similar as monocytes/macrophages, are the origin of the increased [PGEsub2] observ in the tumor tissue. The source and the mechanism of production of increased [PGEsub2] as well as its part in immunoregulation in patients with cancer, remain unclear.

Several investigators have measured prostaglandins in bronchoalveolar lavage fluid (BALF). Baughman et [al.sup.8] measured prostaglandins in BALF of patients with sarcoidosis. They failed to exhibit any difference in the concentration of prostaglandins in sarcoidosis as compared with normal commands Ogushi et al(9)(10) studied the concentrations of [PGEsub2] in various lung conditions, including sarcoidosis. They also did not find a difference between sarcoidosis and checks but they found an elevated [PGEsub2] tration in patients with eosinophilic pneumonia. They postulated that the stimulated eosinophils in the alveolar space were responsible for the increased [PGEsub2] There had previously been no systematic thought of [PGE.sub.2] in BALF of patients with lung carcinoma. We have measured the concentration of [PGEsub2] in BALF of patients with lung carcinoma and originate it to be elevated in 18 patients with primary lung cancer as compared with 6 patients with lung diseases other than lung cancer and 10 normal enthralls who were of comparable age and smoking history.(11)

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