Cytology of bronchoalveolar lavage fluid in diagnosis and treatment of pediatric lung diseases

doi:10.3760/cma.j.issn.1007-1245.2023.08.004

Abstract

Abstract:

Lung diseases have significant impact on children's health. The application of bronchoscopy plays a key role in the diagnosis and treatment of children with pulmonary diseases, especially in severe and refractory pediatric patients. Analysis of bronchoalveolar lavage fluid (BALF) has improved the diagnostic level of lung diseases. Present researchs focus on the main components of BALF and their relationship with diseases. The characteristics of BALF have not been fully elucidated due to different disease mechanisms. This review provides a summary of the recent researches on the cytology of BALF and lung diseases in children, and provides more evidences for the diagnosis and treatment of pediatric lung diseases.

Key words:

Bronchoalveolar lavage fluid, Metabolomics, Proteomics, Cell classification, Lung diseases, Children

摘要：

肺部疾病对儿童生命健康有很大影响，支气管镜技术在儿童急危重症及难治性疾病中的应用对于儿童肺疾病诊治有了长足进展，支气管肺泡灌洗液（BALF）的分析对提高肺疾病的诊断水平有重要作用；BALF主要成分和疾病关系是目前研究的热点，由于不同疾病的发病机制不同，BALF特点尚未被完全阐明。本文通过对儿童BALF中细胞学与肺疾病的相关研究进行综述，为儿科肺部疾病诊治提供更多依据。

关键词:

支气管肺泡灌洗液, 代谢组学, 蛋白组学, 细胞分类, 肺部疾病, 儿童

Ma Kun, Wang Daobin, Li Shujun.

Cytology of bronchoalveolar lavage fluid in diagnosis and treatment of pediatric lung diseases [J]. International Medicine and Health Guidance News, 2023, 29(8): 1049-1052.

马坤王道斌李树军.

支气管肺泡灌洗液中细胞学对儿童肺部疾病诊治研究进展 [J]. 国际医药卫生导报, 2023, 29(8): 1049-1052.

References

[1] Shanthikumar S,Burton M,Saffery R,et al.Single-cell flow cytometry profiling of BAL in children[J].Am J Respir Cell Mol Biol,2020,63(2):152-159.DOI:10.1165/rcmb. 2019- 0453MA.
[2] Gendeh BS,Gendeh HS,Purnima S,et al.Inhaled foreign body impaction: a review of literature in malaysian children[J].Indian J Pediatr,2019,86(Suppl 1):20-24.DOI:10.1007/s12098-018-2824-8.
[3] 徐旻皓,湛美正,叶乐平.气管支气管内支架置入术在儿科中的临床应用现状及展望[J].国际呼吸杂志,2017,37(11):868-872.DOI:10.3760/cma.j.issn.1673-436X.2017.11.014.
[4] 王丽萍,陈守平,黄玉瑛,等.软式支气管镜在儿童呼吸系统疾病中的应用[J].中国当代儿科杂志,2017,19(11):1174-1179.DOI:10.7499/j.issn.1008-8830.2017.11.010.
[5] Selimovic A,Mujicic E,Milisic S,et al.The significance of bronchoalveolar lavage fluid cytology in diagnosing lung infiltrates in children[J].Med Arch,2016,70(1):27-30.DOI:10.5455/medarh.2016.70.27-30.
[6] 中华医学会呼吸病学分会.肺部感染性疾病支气管肺泡灌洗病原体检测中国专家共识(2017年版)[J].中华结核和呼吸杂志,2017,40(8):578-583.DOI:10.3760/cma.j.issn.1001-0939.2017.08.007.
[7] Domagala-Kulawik J.The relevance of bronchoalveolar lavage fluid analysis for lung cancer patients[J].Expert Rev Respir Med,2020,14(3):329-337.DOI:10.1080/17476348.2020.1708720.
[8] Efared B,Ebang-Atsame G,Rabiou S,et al.The diagnostic value of the bronchoalveolar lavage in interstitial lung diseases[J].J Negat Results Biomed,2017,16(1):4.DOI:10.1186/s12952-017-0069-0.
[9] Bowler RP,Wendt CH,Fessler MB,et al.New strategies and challenges in lung proteomics and metabolomics.An official american thoracic society workshop report[J].Ann Am Thorac Soc,2017,14(12):1721-1743.DOI:10.1513/AnnalsATS.201710-770WS.
[10] 朱春梅,钱婧,曹玲,等.127例儿童支气管肺泡灌洗液细胞类型特点及临床意义分析[J].中国医刊,2016,51(11):60-63.DOI:10.3969/j.issn.1008-1070.2016.11.017.
[11] Liu Y,Zhang X,Wang Y,et al.The role of granulocyte macrophage colony stimulating factor in hospitalized children with Mycoplasma pneumoniae pneumonia[J].J Infect Chemother,2018,24(10):789-794.DOI:10.1016/j.jiac.2018.06.003.
[12] Faverio P,Aliberti S,Ezekiel C,et al.Influenza A/H1N1 severe pneumonia: novel morphocytological findings in bronchoalveolar lavage[J].Interdiscip Perspect Infect Dis,2014,2014:470825.DOI:10.1155/2014/470825.
[13] Chen XM,Sun L,Yang K,et al.Cytopathological analysis of bronchoalveolar lavage fluid in patients with and without HIV infection[J].BMC Pulm Med,2022,22(1):55.DOI:10.1186/s12890-022-01851-0.
[14] Zaman SS,Seykora JT,Hodinka RL,et al.Cytologic manifestations of respiratory syncytial virus pneumonia in bronchoalveolar lavage fluid: a case report[J].Acta Cytol,1996,40(3):546-551.DOI:10.1159/000333913.
[15] Hu Y,Zheng L,Pan D,et al.Special staining of the liquid-based cytopathology test in bronchoalveolar lavage fluid for diagnosis of invasive pulmonary aspergillosis with nonneutropenic patients[J].Can Respir J,2020,2020:8243473.DOI:10.1155/2020/8243473.
[16] Cheng L,Liu K,Luo X,et al.Co-infection of Pneumocystis jirovecii pneumonia and pulmonary CMV in a infant with X-linked severe combined immunodeficiency[J].Diagn Cytopathol,2021,49(9):E340-E343.DOI:10.1002/dc.24763.
[17] Liu X,Hou XF,Gao L,et al.Indicators for prediction of Mycobacterium tuberculosis positivity detected with bronchoalveolar lavage fluid[J].Infect Dis Poverty,2018,7(1):22.DOI:10.1186/s40249-018-0403-x.
[18] Davidson KR,Ha DM,Schwarz MI,et al.Bronchoalveolar lavage as a diagnostic procedure: a review of known cellular and molecular findings in various lung diseases[J].J Thorac Dis,2020,12(9):4991-5019.DOI:10.21037/jtd-20-651.
[19] Najafi N,Demanet C,Dab I,et al.Differential cytology of bronchoalveolar lavage fluid in asthmatic children[J].Pediatr Pulmonol,2003,35(4):302-308.DOI:10.1002/ppul.10266.
[20] Ben Tkhayat R,Taytard J,Corvol H,et al.Benefits and risks of bronchoalveolar lavage in severe asthma in children[J].ERJ Open Res,2021,7(4):00332-2021.DOI:10.1183/23120541.00332-2021.
[21] Teague WG,Lawrence MG,Shirley DT,et al.Lung lavage granulocyte patterns and clinical phenotypes in children with severe, therapy-resistant asthma[J].J Allergy Clin Immunol Pract,2019,7(6):1803-1812.e10.DOI:10.1016/j.jaip.2018.12.027.
[22] Shanthikumar S,Colenutt S,Cole T,et al.Clinical utility of bronchoalveolar lavage in pediatric oncology patients[J].Pediatr Infect Dis J,2022,41(11):899-903.DOI:10.1097/INF.0000000000003648.
[23] Ryu WK,Moon Y,Park MH,et al.A preliminary study on the prognostic impact of neutrophil to lymphocyte ratio of the bronchoalveolar lavage fluid in patients with lung cancer[J].Diagnostics (Basel),2021,11(12):2201.DOI:10.3390/diagnostics11122201.
[24] Ahmad AH,Brown BD,Andersen CR,et al.Retrospective review of flexible bronchoscopy in pediatric cancer patients[J].Front Oncol,2021,11:770523.DOI:10.3389/fonc.2021.770523.
[25] Kadota N,Nakahira N,Miyauchi M,et al.Usefulness of bronchoalveolar lavage (BAL) in the diagnosis of pulmonary alveolar proteinosis[J].QJM,2022,115(11):767-768.DOI:10.1093/qjmed/hcac168.
[26] Meyer KC,Raghu G,Baughman RP,et al.An official american thoracic society clinical practice guideline: the clinical utility of bronchoalveolar lavage cellular analysis in interstitial lung disease[J].Am J Respir Crit Care Med,2012,185(9):1004-1014.DOI:10.1164/rccm.201202- 0320ST.
[27] Wei L,Zhao J,Bao J,et al.The characteristics and clinical significance of mucin levels in bronchoalveolar lavage fluid of patients with interstitial lung disease[J].J Investig Med,2019,67(4):761-766.DOI:10.1136/jim-2018-000785.
[28] Sim SY,Choi YR,Lee JH,et al.In-depth proteomic analysis of human bronchoalveolar lavage fluid toward the biomarker discovery for lung cancers[J].Proteomics Clin Appl,2019,13(5):e1900028.DOI:10.1002/prca. 201900028.
[29] Carvalho AS,Moraes MCS,Hyun Na C,et al.Is the proteome of bronchoalveolar lavage extracellular vesicles a marker of advanced lung cancer?[J].Cancers (Basel),2020,12(11):3450.DOI:10.3390/cancers12113450.
[30] DeBoer EM,Wagner BD,Popler J,et al.Novel application of aptamer proteomic analysis in cystic fibrosis bronchoalveolar lavage fluid[J].Proteomics Clin Appl,2019,13(3):e1800085.DOI:10.1002/prca.201800085.
[31] Liang L,Hu M,Chen Y,et al.Metabolomics of bronchoalveolar lavage in children with persistent wheezing[J].Respir Res,2022,23(1):161.DOI:10.1186/s12931-022-02087-6.
[32] Nambiar S,Bong How S,Gummer J,et al.Metabolomics in chronic lung diseases[J].Respirology,2020,25(2):139-148.DOI:10.1111/resp.13530.