For flow cytometry, BAL cells were treated with Fc Block (clone Fc1.3216, BD Pharmingen, CA, USA) prior surface marker staining and DAPI (Invitrogen, Thermo Fisher scientific, CA, USA) for dead cell exclusion. Antibodies used were anti-human CD45-BV510 (clone HI30, BD Horizon, CA, USA), CD3-FITC (clone UCHT1, BD Pharmingen, CA, USA), CD4-PE-Cy7 (clone SK3, BD Pharmingen, CA, USA), CD8-ECD (clone SFCI21Thy2D3, Beckman Coulter, CA, USA) and CD279-APC (PD-1) (clone MIH4, BD Pharmingen, CA, USA). Flow cytometric analysis was conducted using a CytoFLEX V5-B5-R3 Instrument (Beckman Coulter, CA, USA) equipped with 405 nm, 488 nm and 638 nm lasers running with CytExpert software v2. Data analysis was performed using FlowJo v10 (LLC Software, SD, USA).
In patients with pulmonary lesions suspicious for lung cancer, transbronchial biopsies or endobronchial ultrasound-guided transbronchial needle aspiration were performed in the same procedure to obtain histological diagnosis in the majority of patients.