The role bronchial washing of TNF-a as prognostic biomarker of advance stage of NSCLC

Non-Small Cell Lung Cancer (NSCLC) is the most common type of lung cancer, accounting for approximately 85% of all cases. Despite advancements in treatment, the prognosis remains poor, particularly in advanced stages. Tumor Necrosis Factor-alpha (TNF-α), a key pro-inflammatory cytokine, has been implicated in cancer progression and prognosis. This study aims to evaluate TNF-α levels as a prognostic biomarker in NSCLC. This prospective cohort study included NSCLC patients diagnosed at RSUP Dr. Wahidin Sudirohusodo Makassar from April 2022 to March 2023. TNF-α levels were measured in bronchoalveolar lavage (BAL) samples using the Enzyme-Linked Immunosorbent Assay (ELISA). Patients were monitored for disease progression and one-year survival. Data were analyzed to assess the correlation between TNF-α levels and clinical outcomes. A total of 66 NSCLC patients and 22 control subjects were included. TNF-α levels were significantly higher in NSCLC patients compared to controls (p < 0.05). Elevated TNF-α levels were associated with advanced tumor stage (p = 0.001) and lower overall survival rates (p = 0.003). Patients with high TNF-α levels showed a shorter progression-free survival compared to those with lower levels. Multivariate analysis confirmed TNF-α as an independent prognostic factor for NSCLC. TNF-α levels serve as a potential prognostic biomarker in NSCLC, correlating with disease progression and survival outcomes. Incorporating TNF-α assessment into clinical practice may improve prognostic evaluations and guide personalized treatment strategies. Further studies with larger cohorts and longer follow-up are needed to validate these findings.