Similarly, p53 is a key gene in the control of DNA amplification and proliferation of aneuploid cells,40 whereas cyclin A can be overexpressed as result of cell cycle deregulation leading to aneuploidy.41 Inflammation has previously been shown to associate with AFI false positivity.14 Since inflammatory pathways can drive genetic and epigenetic changes during carcinogenesis in BO,42 it is possible that the AFI signal, inflammation and biomarkers are all closely related. Here, CCNA2 is linked to bronchiolitis obliterans syndrome.