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Kalkanis A, Papadopoulos D, Testelmans D, Kopitopoulou A, Boeykens E, Wauters E. Bronchoalveolar Lavage Fluid-Isolated Biomarkers for the Diagnostic and Prognostic Assessment of Lung Cancer. Diagnostics (Basel) 2022; 12. [PMID: 36552956 DOI: 10.3390/diagnostics12122949] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2022] [Revised: 11/18/2022] [Accepted: 11/22/2022] [Indexed: 11/29/2022] Open
Abstract
Lung cancer is considered one of the most fatal malignant neoplasms because of its late detection. Detecting molecular markers in samples from routine bronchoscopy, including many liquid-based cytology procedures, such as bronchoalveolar lavage fluid (BALF), could serve as a favorable technique to enhance the efficiency of a lung cancer diagnosis. BALF analysis is a promising approach to evaluating the tumor progression microenvironment. BALF's cellular and non-cellular components dictate the inflammatory response in a cancer-proliferating microenvironment. Furthermore, it is an essential material for detecting clinically significant predictive and prognostic biomarkers that may aid in guiding treatment choices and evaluating therapy-induced toxicities in lung cancer. In the present article, we have reviewed recent literature about the utility of BALF analysis for detecting markers in different stages of tumor cell metabolism, employing either specific biomarker assays or broader omics approaches.
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Castelli M, Salvati F, Cruciani A, Portalone L, Giannarelli D, Ferrini U. Comparative Analysis of CEA and SCC Serum Markers with IAP in Human Lung Cancer. Int J Biol Markers 2018; 4:45-50. [PMID: 2664020 DOI: 10.1177/172460088900400109] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Serum levels of carcinoembryonic antigen (CEA), squamous cell carcinoma antigen (SCC) and immunosuppressive acidic protein (IAP) were measured in 37patients with lung cancers, in 24 with non-cancer pulmonary diseases and in 24 normal controls. We evaluated the sensitivity, specificity and accuracy of these three markers alone and combined. The highest specificity was observed for SCC (83.3%) and the highest sensitivity for IAP (94.6%). The best accuracy was obtained with the combined determination of CEA and SCC. In cancer and non-cancer pulmonary diseases the best correlation was observed between CEA and SCC (r=0.30 in cancer and r=0.45 in non-cancer pulmonary diseases). Although the IAP test is not specific in the detection of lung cancer, its use may be helpful in monitoring the acute phase reactions that occur very frequently in this malignancy.
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Affiliation(s)
- M Castelli
- Regina Elena Cancer Institute, Department of Experimental Oncology, Rome, Italy
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Macchia V, Paduano D, Di Carlo A, Mariano A, Cecere C, Ferrante G. Serum and Tissue Levels of CEA, TPA, CA 125 and CA 15.3 in Patients with Lung Cancer. Int J Biol Markers 2018; 8:215-20. [PMID: 8138661 DOI: 10.1177/172460089300800403] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Forty-nine healthy subjects (Group I), 24 patients with benign lung diseases (Group II) and 48 patients surgically treated for lung cancer (Group III): 28 with squamous cell carcinoma (SCC) and 20 with adenocarcinoma (adenoca), were tested for the presence of carcinoembryonic antigen (CEA), tissue polypeptide antigen (TPA), cancer antigen CA 125 and antigen CA 15.3. The four markers were measured in the serum of the patients of the three groups and in the cytosol extract of tumoral and peritumoral tissues of Group III subjects. The mean levels of serum CEA and TPA were significantly higher in squamous cell carcinoma and in adenocarcinoma patients than in normal subjects. In benign lung disease serum CEA was equal and TPA slightly higher than in normal subjects. CA 125 was higher in the serum of patients with malignant diseases compared to normal or benign lung diseases but this difference was not statistically significant. Serum CA 15.3 levels were similar in all subjects studied. CA 125 in squamous cell carcinoma cytosol was much higher than in peritumoral cytosol whereas the other three markers were not significantly different in tumor cytosol or peritumoral cytosol. A direct correlation between serum and cytosol values was observed for CEA, but not for the other markers. The levels of the four markers in serum and cytosol did not correlate with the stage or grade of the tumors.
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MESH Headings
- Adenocarcinoma/blood
- Adenocarcinoma/immunology
- Adenocarcinoma/metabolism
- Adult
- Aged
- Aged, 80 and over
- Antigens, Neoplasm/blood
- Antigens, Neoplasm/metabolism
- Antigens, Tumor-Associated, Carbohydrate/blood
- Antigens, Tumor-Associated, Carbohydrate/metabolism
- Biomarkers, Tumor/blood
- Biomarkers, Tumor/metabolism
- Carcinoembryonic Antigen/blood
- Carcinoembryonic Antigen/metabolism
- Carcinoma, Squamous Cell/blood
- Carcinoma, Squamous Cell/immunology
- Carcinoma, Squamous Cell/metabolism
- Cytosol/immunology
- Cytosol/metabolism
- Female
- Humans
- Lung Neoplasms/blood
- Lung Neoplasms/immunology
- Lung Neoplasms/metabolism
- Male
- Middle Aged
- Peptides/blood
- Peptides/metabolism
- Prognosis
- Tissue Polypeptide Antigen
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Affiliation(s)
- V Macchia
- CNR Center of Endocrinology and Experimental Oncology, Faculty of Medicine and Surgery, University Federico II, Napoli, Italy
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Carpagnano GE, Lacedonia D, Palladino GP, Koutelou A, Martinelli D, Orlando S, Foschino-Barbaro MP. Could exhaled ferritin and SOD be used as markers for lung cancer and prognosis prediction purposes? Eur J Clin Invest 2012; 42:478-86. [PMID: 21955247 DOI: 10.1111/j.1365-2362.2011.02603.x] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
BACKGROUND Today an increasing interest is being generated by the study of lung cancer markers in the exhaled breath condensate (EBC), precisely because this sample seems to lend itself to lung cancer early screening and follow-up. Indeed, ferritin and superoxide dismutase (SOD) have recently been recognized to play a role in lung cancerogenesis and patients' survival. The aim of this study was to evaluate the clinical value and the prognostic power of exhaled ferritin and exhaled SOD in patients with lung cancer. MATERIAL AND METHODS Forty patients with nonsmall cell lung cancer (NSCLC) and 15 controls were enrolled in the study. All subjects under study underwent EBC collection and analysis of ferritin and SOD. A total of 36 patients were either given a follow-up of at least 25.5 months or followed up until death. RESULTS Exhaled ferritin and SOD resulted as being higher in NSCLC than in controls and as being influenced by the stage of cancer. A pronounced survival difference was found in the presence of exhaled ferritin 300 ng/mL and exhaled SOD > 13.5 U/μL. CONCLUSIONS In conclusion, although the results need to be confirmed on a larger and homogeneous population, we hypothesized that the notion of using the measurement of ferritin and SOD in the EBC could, if deemed feasible, have clinical implications in the monitoring of lung cancer and as an outcome predictor.
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Affiliation(s)
- Giovanna E Carpagnano
- Institute of Respiratory Disease, Department of Medical and Occupational Sciences, University of Foggia, Foggia, Italy.
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Charalabopoulos K, Karakosta A, Bablekos G, Golias C, Charalabopoulos A, Tsanou E, Peschos D, Zoganas L, Batistatou A. CEA levels in serum and BAL in patients suffering from lung cancer: correlation with individuals presenting benign lung lesions and healthy volunteers. Med Oncol 2007; 24:219-25. [PMID: 17848747 DOI: 10.1007/bf02698043] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2006] [Revised: 11/30/1999] [Accepted: 06/12/2006] [Indexed: 10/22/2022]
Abstract
BACKGROUND Carcinoembryonic antigen (CEA) is a tumor marker belonging to the immunoglobulin gene superfamily of adhesion molecules. CEA is synthesized by epithelial and tumor cells. In this study, CEA levels in sera and bronchoalveolar lavage fluid (BAL) were measured in patients with malignant lung cancer and benign lung diseases. METHODS In the present study CEA was measured in serum using IRMA methods and in bronchoalveolar lavage of individuals undergoing fiberoptic bronchoscopy. Fifty patients with lung cancer (G1), 20 patients with benign lung lesions (G2), and a control group consisted of 20 individuals (G3) were enrolled in the study. RESULTS We found that serum CEA levels were significantly higher in G1 compared to G2 and G3 (p < 0.01). No significant difference in serum CEA levels was found between smokers and nonsmokers in any of the three groups studied. CEA was significantly higher in G1 BAL (p < 0.05) compared to G2 and G3 BAL. Furthermore, a statistically significant difference was found in CEA levels in BAL between smokers and nonsmokers of G2. CONCLUSIONS CEA levels in BAL of normal individuals may be influenced by smoking and other factors that affect lung epithelial cell function. Thus, CEA measurement in BAL alone has little value in the diagnosis of malignancy. BAL CEA levels in smokers of G2 are found significantly higher compared with nonsmokers of the same group and healthy individuals. Smokers of G2 have to be followed up carefully for the possibility of lung cancer growth.
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Bearz A, Talamini R, Vaccher E, Spina M, Simonelli C, Steffan A, Berretta M, Chimienti E, Tirelli U. MUC-1 (CA 15–3 Antigen) as a Highly Reliable Predictor of Response to EGFR Inhibitors in Patients with Bronchioloalveolar Carcinoma: An Experience on 26 Patients. Int J Biol Markers 2007; 22:307-11. [DOI: 10.1177/172460080702200411] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Background Bronchioloalveolar carcinoma (BAC) is a histological subtype of non-small cell lung cancer (NSCLC), particularly of adenocarcinoma. Given its multifocality and the poor activity of chemotherapy, there is no established treatment for BAC, although promising results have been achieved with inhibitors of the epidermal growth factor receptor (EGFR). No tumor marker has been validated in the diagnosis and follow-up of lung cancer, in particular to predict the outcome of treatment with EGFR inhibitors. Purpose As CA 15–3 antigen serum levels are reported to be pathologically abnormal in adenocarcinoma of the lung, we chose this tumor marker to monitor treatment with EGFR inhibitors of patients affected by adenocarcinoma with BAC features or pure BAC. Patients and methods We collected data from 26 consecutive Caucasian patients with BAC, mostly women and never smokers, who received EGFR inhibitors. Results We noticed that all patients with normal CA 15–3 serum levels at baseline (15/26, 57.7%) showed a response to EGFR inhibitors, whereas all patients with abnormal CA 15–3 serum levels (11/26, 42.3%) did not. Conclusion Our data suggest that CA 15–3 levels might be a predictive factor for the response to EGFR inhibitors in patients with BAC.
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Affiliation(s)
- A. Bearz
- Division of Medical Oncology A, National Cancer Institute, Aviano (Pordenone) - Italy
| | - R. Talamini
- Epidemiology Unit, National Cancer Institute, Aviano (Pordenone) - Italy
| | - E. Vaccher
- Division of Medical Oncology A, National Cancer Institute, Aviano (Pordenone) - Italy
| | - M. Spina
- Division of Medical Oncology A, National Cancer Institute, Aviano (Pordenone) - Italy
| | - C. Simonelli
- Division of Medical Oncology A, National Cancer Institute, Aviano (Pordenone) - Italy
| | - A. Steffan
- Laboratory of Pathology, National Cancer Institute, Aviano (Pordenone) - Italy
| | - M. Berretta
- Division of Medical Oncology A, National Cancer Institute, Aviano (Pordenone) - Italy
| | - E. Chimienti
- Division of Medical Oncology A, National Cancer Institute, Aviano (Pordenone) - Italy
| | - U. Tirelli
- Division of Medical Oncology A, National Cancer Institute, Aviano (Pordenone) - Italy
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Abstract
OBJECTIVE Serum and bronchoalveolar lavage fluid (BALF) neuron-specific enolase (NSE) levels in lung cancer have been investigated widely; however, their diagnostic values have not yet been clarified. The authors investigated the diagnostic validity of NSE in BALF and serum in lung cancer. MATERIALS AND METHODS In this prospective case-control study, NSE levels in BALF (B-NSE) and serum (S-NSE) of 3 groups of subjects were analyzed: control subjects (group 1, n = 15), patients with chronic obstructive pulmonary disease (COPD; group 2, n = 15), and lung cancer (group 3, n = 35). RESULTS The differences in S-NSE and B-NSE levels between the groups were not significant (P > 0.05). S-NSE and B-NSE levels did not show any difference between smokers and nonsmokers, small cell lung cancer and nonsmall cell lung cancer patients, and stage I-II and stage III-IV patients in group 3 (P > 0.05). B-NSE or B-NSE/urea did not show any significance in comparison with S-NSE in the diagnosis and/or staging of malignancy (P > 0.05). S-NSE and B-NSE were well correlated with each other (r = 0.84, P = 0.000). The sensitivity of the S-NSE was 60% and the specificity was 40%. CONCLUSION The authors conclude that, although elevation of B-NSE is a well-known parameter in small cell lung cancer, it can also be elevated considerably in nonsmall cell lung cancer and COPD. Because of the significant correlation between S-NSE and B-NSE, it may be sufficient to measure S-NSE activity because it is easier and less invasive. However, NSE has no role in the exact diagnosis of lung cancer; it can only be investigated in a scientific setting.
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MESH Headings
- Adolescent
- Adult
- Aged, 80 and over
- Biomarkers, Tumor/analysis
- Biomarkers, Tumor/blood
- Blood Urea Nitrogen
- Bronchoalveolar Lavage Fluid/chemistry
- Bronchoscopy
- Carcinoma, Non-Small-Cell Lung/blood
- Carcinoma, Non-Small-Cell Lung/chemistry
- Carcinoma, Non-Small-Cell Lung/diagnosis
- Carcinoma, Non-Small-Cell Lung/enzymology
- Carcinoma, Small Cell/blood
- Carcinoma, Small Cell/chemistry
- Carcinoma, Small Cell/diagnosis
- Carcinoma, Small Cell/enzymology
- Case-Control Studies
- Diagnosis, Differential
- Female
- Hemoptysis/blood
- Hemoptysis/diagnosis
- Hemoptysis/enzymology
- Humans
- Lung Neoplasms/blood
- Lung Neoplasms/chemistry
- Lung Neoplasms/diagnosis
- Lung Neoplasms/enzymology
- Male
- Middle Aged
- Neoplasm Proteins/analysis
- Neoplasm Proteins/blood
- Neoplasm Staging
- Phosphopyruvate Hydratase/analysis
- Phosphopyruvate Hydratase/blood
- Prospective Studies
- Pulmonary Disease, Chronic Obstructive/blood
- Pulmonary Disease, Chronic Obstructive/diagnosis
- Pulmonary Disease, Chronic Obstructive/enzymology
- Sensitivity and Specificity
- Smoking/blood
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Affiliation(s)
- Demet Karnak
- Department of Chest Diseases, Ankara University School of Medicine, Turkey.
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Isitmangil T, Isitmangil G, Budak Y, Aydilek R, Celenk MK. Comparison of serum and bronchoalveolar lavage fluid sialic acid levels between malignant and benign lung diseases. BMC Pulm Med 2001; 1:4. [PMID: 11801197 PMCID: PMC64545 DOI: 10.1186/1471-2466-1-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2001] [Accepted: 12/18/2001] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND It is known that tissue and serum sialic acid levels may be altered by malignant transformation. In this study, sialic acid levels were determined in bronchoalveolar lavage fluid (BAL) and serum in two groups of patients with lung cancer and non-malignant diseases of the lung. METHODS Colorimetric methods were used for determination sialic acid in serum and in BAL samples. Flexible bronchoscopy was used to obtain the latter. RESULTS Sialic acid levels in bronchoalveolar lavage fluid and serum did not show any statistically significant difference between subjects with malignant and the non-malignant lung diseases (p > 0.05). Sialic acid levels were also unrelated to the stage and localization of the tumor (p > 0.05). CONCLUSIONS Sialic acid levels do not appear to be a good marker for discriminating malignant from non-malignant diseases of the lung.
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Affiliation(s)
- Turgut Isitmangil
- Department of Thoracic Surgery, GMMA Haydarpasa Training Hospital, Istanbul, Turkey
| | - Gulbu Isitmangil
- Department of Immunology, Yeditepe University School of Medicine, Istanbul, Turkey
| | - Yasemin Budak
- Department of Immunology, Yeditepe University School of Medicine, Istanbul, Turkey
| | - Recep Aydilek
- Department of Respiratory Diseases, GMMA Haydarpasa Training Hospital, Istanbul, Turkey
| | - Mehmet Kutlu Celenk
- Department of Respiratory Diseases, GMMA Haydarpasa Training Hospital, Istanbul, Turkey
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Prados C, Alvarez-Sala R, Gómez de Terreros FJ, Villamor J. [Tumor markers and bronchoalveolar lavage in lung cancer]. Arch Bronconeumol 1994; 30:273. [PMID: 8025809 DOI: 10.1016/s0300-2896(15)31082-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
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Abstract
Bronchoalveolar lavage (BAL) is a widely used clinical procedure. To determine if BAL could provide useful information in the detection of cancer, 850 lavages from 421 patients having BAL for a variety of indications, 50 lavages in patients with Hodgkin's disease and 20 patients with breast cancer undergoing bone marrow transplant were reviewed. BALs were performed with 5 successive 20 cc aliquots in a wedged position. The return from the first aliquot was processed separately from the subsequent four aliquots. Diff-Quik stained cytocentrifuge preparations and Papanicolaou stained millipore filter preparations were analyzed. Thirty-five patients had biopsy-proven lung cancer. In 24 (68.6%) of these, BAL revealed cells diagnostic of malignancy. There were no false positives. Six out of 50 Hodgkin's disease patients had Reed Sternberg cells detected on BAL, and 7/20 breast cancer patients had malignant cells on BAL prior to chemotherapy. In summary, the routine performance of BAL, an easily performed and well-tolerated procedure, may prove to be useful in the routine assessment of patients for cancer.
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Affiliation(s)
- S I Rennard
- Department of Internal Medicine, University of Nebraska Medical Center, Omaha 68198-2465
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Abstract
A patient with small cell lung cancer (SCLC) whose serum contained high levels of soluble interleukin-2 receptors is reported. Soluble interleukin-2 receptors in the supernatant of cultured SCLC cells obtained from the patient's pleural effusion while he had malignant pleuritis, increased almost linearly from the time of cell seeding. The expression of interleukin-2 receptors (Tac) on the SCLC cells were demonstrated by an immunofluorescence study. However, other lymphocytic markers, including OKT 11, OKT 4, OKT 8, B 1, and B 4, were not found on the cells with the exception of the natural killer cell marker, NKH-1. Southern blot analysis indicated the rearrangement of the T-cell receptor of the cancer cells. Moreover, monoclonal integration of human T-cell leukemia virus type 1 (HTLV-1) provirus in DNA from the cancer cells was also demonstrated. These observations suggest that some SCLC in HTLV 1 endemic areas are associated with HTLV-1.
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Affiliation(s)
- H Matsuzaki
- Second Department of Internal Medicine, Kumamoto University Medical School, Japan
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Abstract
To determine the clinical utility of airway carcinoembryonic antigen (CEA) concentrations to distinguish malignant from inflammatory airway disease in patients undergoing bronchoscopy, we determined CEA concentrations by enzyme immunoassay in bronchial washings recovered in 48 subjects, including 20 patients with central lung cancer, 18 patients with chronic bronchitis, and ten nonsmoking patients with a diagnosis of pneumonia or peripheral granuloma. Concentrations of CEA in bronchial washings were standardized by using the total protein concentration in recovered fluid (CEA/TP). Concentrations of CEA were significantly increased in bronchial washings recovered from both patients with chronic bronchitis and lung cancer compared with patients with pneumonia or granuloma (252 +/- 47 ng/mg and 199 +/- 64 ng/ml vs 62 +/- 11 ng/mg, SEM, p less than 0.005). Airway CEA concentrations in patients with chronic bronchitis were somewhat increased compared with concentrations recovered from a cancer-involved airway (252 +/- 47 ng/ml vs 199 +/- 64 ng/mg, SEM, p less than 0.05). Measurement of airway CEA concentrations is not useful in distinguishing malignant from inflammatory airway disease as airway concentrations of CEA may be markedly increased in patients with both conditions.
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Affiliation(s)
- L J Wesselius
- Department of Medicine, Kansas City Veterans Administration Medical Center, MO
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