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Lung cancer patients are diagnosed at late stages when curative treatments are no longer possible; thus, molecular biomarkers for noninvasive detection are urgently needed. In this sense, we previously identified and validated an epigenetic 4-gene signature that yielded a high diagnostic performance in tissue and invasive pulmonary fluids. We analyzed DNA methylation levels using the ultrasensitive digital droplet PCR in noninvasive samples in a cohort of 83 patients. We demonstrated that BCAT1 is the candidate that achieves high diagnostic efficacy in circulating DNA derived from plasma (area under the curve: 0.85). Impact of potentially confounding variables was also explored.

AIM: Endobronchial valve placement is a safe alternative to surgery in patients with persistent pulmonary air leak. The aim of our study is to describe our experience in a series of patients with persistence air leak who underwent endobronchial valve placement. MATERIAL AND METHODS: We conducted a retrospective study that included patients with persistent air leak treated by means of endobronchial valve placement in two tertiary hospitals. The pulmonary area responsible of the air leak was located by means of collapsing the target bronchi with a catheter with a balloon. Once located, the endobronchial valve was placed in the target bronchi under bronchoscopy guidance. RESULTS: We included 6 patients (sex 6 males, age (mean): 64.8 years). Air leaks were secondary to pneumothorax in 3 (42.8%) cases and lung cancer surgery in 2 patients. The mean time of drainage prior to valve placement was 19.3 days. The mean number of valves placed per patient was 2 (range 1-3). Air leaks were resolved in all patients. Mean time before valve removal was 68.5 days. No severe adverse events were found during or after the valve placement. One patient developed granulation tissue by the bronchial valve. CONCLUSIONS: Endobronchial valve placement is a safe and effective alternative to surgery in patients with persistent air leak.