Immunoglobulin Content in the Bronchial Washings of Patients with Benign and Malignant Pulmonary Disease

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Abstract
The bronchial washings of 58 patients with benign and neoplastic conditions involving the lungs were evaluated for immunoglobulin content. Levels in the washings from the diseased lung were compared with those from the normal contralateral lung. In normal patients and those with either bilateral inflammatory disease or unilateral bronchiectasis or tuberculosis, the mean variation in IgA/K and IgG/K ratios between diseased and uninvolved lungs was minimal. In unilateral pneumonitis, however, IgG/K was markedly elevated (P<0.01). Significant changes in the IgA/K occurred on the affected side in patients with cancer. In the group with squamous-cell cancer, the mean elevation was 4.6 times that of contralateral lung (P<0.005), whereas with adenocarcinoma and undifferentiated carcinoma, the rise was 6.4 and 2.8 times, respectively (P<0.01 and P<0.01). Thus, carcinoma appears to alter local immunoglobulin production in the affected lung as compared to its normal counterpart. (N Engl J Med 295:694–698, 1976)