Objective To explore the application value of SHOX2 and RASSF1A methylation in bronchoalveolar lavage fluid (BALF) in the diagnosis and prognostic assessment of lung cancer.

Methods Patients undergoing bronchoscopy at Huaihua Cancer Hospital from November 2020 to June 2023 were enrolled as study subjects, and the clinical data were collected. SHOX2 and RASSF1A methylation levels in BALF samples were detected by polymerase chain reaction (PCR). The Kappa consistency test, receiver operating characteristic (ROC) curve and the area under the curve (AUC) were used to evaluate the diagnostic value of SHOX2/RASSF1 methylation for lung cancer, and the Kaplan-Meier survival curves and Cox regression were employed to evaluate the prognostic value.

Results A total of 108 subjects were included in the study, comprising 68 in the lung cancer group and 40 in the control group. Methylation testing showed a high degree of agreement with histopathological diagnosis [Kappa = 0.718, 95% CI (0.589, 0.847)]. The diagnostic efficacy of SHOX2/RASSF1A positivity for lung cancer was 0.879, higher than the AUC values for SHOX2 and RASSF1A positivity alone (0.865 and 0.723, respectively). Survival curve analysis revealed that the survival rate of patients positive for SHOX2/RASSF1A was lower than that of patients negative for both SHOX2 and RASSF1A (P < 0.05). Univariate Cox analysis indicated that SHOX2 and RASSF1A methylation were significantly associated with overall survival(OS) in lung cancer patients, whereas multivariate Cox analysis suggested that SHOX2 and RASSF1A methylation were not independent risk factors for OS.

Conclusion Detection of SHOX2/RASSF1A methylation in BALF has high sensitivity and specificity in the diagnosis of lung cancer and is associated with the prognostic survival of lung cancer patients, and can serve as an auxiliary indicator for early diagnosis and prognostic evaluation of lung cancer.

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