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All Journal Jurnal Respirologi Indonesia
Teuku Zulfikar
Department of Pulmonology and Respiratory Medicine, Faculty of Medicine, Syiah Kuala University, Dr. Zainoel Abidin Hospital, Banda Aceh
Health Professions Medicine & Pharmacology

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Analysis of TGF-β1 Levels in Bronchoalveolar Lavage Fluid among Lung Cancer, Suspected, and Non-Cancer Patients Muhammad Khairul Afif; Herry Priyanto; Teuku Zulfikar
Jurnal Respirologi Indonesia Vol 46 No 3 (2026)
Publisher : Perhimpunan Dokter Paru Indonesia (PDPI)/The Indonesian Society of Respirology (ISR)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.36497/jri.v46i3.1112

Abstract

Background: Lung cancer remains the leading cause of cancer-related mortality worldwide and is often diagnosed at an advanced stage. TGF-β1 plays a pivotal role in carcinogenesis and may serve as a diagnostic biomarker. BALF represents a relevant medium for assessing biomarkers that reflect the tumor microenvironment. This study aimed to evaluate TGF-β1 levels in BALF and determine its diagnostic performance and optimal cut-off value for lung cancer. Methods: This cross-sectional analytical study was conducted at Dr. Zainoel Abidin General Hospital, Banda Aceh, from April to June 2025, involving 64 patients (34 lung cancer patients, 9 suspected lung cancer patients, and 21 non-cancer patients). BALF samples were obtained via bronchoscopy, and TGF-β1 levels were measured using ELISA. Statistical analyses included the Mann-Whitney U test and ROC curve analysis. Results: Median TGF-β1 levels were 66.24 pg/mL in the non-cancer group, 136.93 pg/mL in the suspected lung cancer group, and 200.25 pg/mL in the lung cancer group. The combined suspected/lung cancer group showed significantly higher levels than the non-cancer group (P=0.025). ROC analysis yielded an area under the curve (AUC) of 0.674 (95% CI=0.529-0.819; P=0.025). The optimal cut-off value was 105.63 pg/mL, with a sensitivity of 67.44%, specificity of 61.90%, positive predictive value of 78.38%, and negative predictive value of 48.15%. Conclusion: TGF-β1 levels in BALF demonstrate potential as a diagnostic biomarker for lung cancer with moderate performance. It may serve as a supportive “rule-in” test to strengthen clinical suspicion but is insufficient as a stand-alone diagnostic tool. Combining TGF-β1 with other biomarkers in a multiparametric diagnostic panel is recommended to improve diagnostic accuracy.
Association Between Mobile-Based Remote Monitoring and Chemotherapy Adherence Among Lung Cancer Patients in Aceh Province Ferry Dwi Kurniawan; Fajar Tara Winanda; Teuku Zulfikar; Budi Yanti; Irmaini Irmaini; Liza Salawati
Jurnal Respirologi Indonesia Vol 46 No 3 (2026)
Publisher : Perhimpunan Dokter Paru Indonesia (PDPI)/The Indonesian Society of Respirology (ISR)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.36497/jri.v46i3.1217

Abstract

Background: Chemotherapy adherence is essential for optimizing treatment outcomes in patients with lung cancer, yet maintaining adherence remains challenging because of treatment-related adverse effects and limited opportunities for continuous monitoring. Mobile-based remote monitoring applications may improve adherence by facilitating symptom reporting, treatment reminders, and communication between patients and healthcare providers. This study aimed to evaluate the association between the use of a mobile-based remote monitoring application and chemotherapy adherence among patients with lung cancer. Methods: A case-control study was conducted at the Pulmonology Clinic of Dr. Zainoel Abidin Hospital between October 2025 and January 2026. A total of 62 patients with lung cancer undergoing chemotherapy were enrolled, including 31 patients who used a mobile-based remote monitoring application (case group) and 31 patients who received standard care (control group). Chemotherapy adherence was assessed using the Indonesian version of the 8-item Morisky Medication Adherence Scale (MMAS-8). Data analysis used the chi-square test, with P<0.05 is significantly statistic. Results: Baseline demographic and clinical characteristics, including age, sex, smoking history, histopathological subtype, and disease stage, showed no association between the two groups (P>0.05). High chemotherapy adherence was observed in 22 patients (71.0%) in the application group compared with 7 patients (22.6%) in the control group, whereas low adherence was more frequent in the control group (61.3% vs. 12.9%). The use of the mobile-based remote monitoring application was significantly associated with improved chemotherapy adherence (P=0.001). Conclusion: The use of a mobile-based remote monitoring application was significantly associated with higher chemotherapy adherence among patients with lung cancer. By integrating treatment reminders, symptom monitoring, laboratory follow-up, and direct communication with healthcare providers, the application may improve patient engagement and support continuity of care. Mobile-based remote monitoring represents a promising strategy for enhancing chemotherapy adherence and should be further evaluated in larger multicenter studies with longer follow-up.
Co-Authors Budi Yanti Fajar Tara Winanda Ferry Dwi Kurniawan Herry Priyanto Irmaini Irmaini Liza Salawati Muhammad Khairul Afif