[The assessment of acute phase proteins as prognostic factors in patients surgically treated for non-small cell lung cancer]

Abstract

Introduction: The aim of the study was to assess quantitative changes of the acute phase protein (APP) serum level in patients with non-small cell lung cancer (NSCLC) who underwent a radical resection. We analysed the correlation between quantitative APP changes and: the survival rate, the histological type of the cancer, TNM stage and grading.

Material and methods: We analysed a group of 46 patients surgically treated for NSCLC from 2003 to 2004. The average age of patients was 61 (45 to 77 years). The most frequent histological types of cancer were: squamous cell lung cancer (24 patients) and adenocarcinoma (17 patients). The majority of them were in stage II B (15 patients) and III A (14 patients). We analysed serum levels of: C-reactive protein (CRP), alpha1-acid glycoprotein (AGP), alpha1-antichymotrypsin (ACT), alpha1-antitrypsin (AT), alpha2-macroglobulin (M), ceruloplasmin (Cp), haptoglobin (Hp), and transferrin (Tf) by means of rocket immunoelectrophoresis by Laurell.

Results: The level of AT was significantly higher in patients with adenocarcinoma, as compared to other histological types of cancer. In the case of patients with squamous cell lung cancer, significantly higher M and Cp. We did not find any correlation between the APP level and grading. The levels of five APP: CRP, AGP, ACT, M and Cp were significantly higher in the group of patients with T3 or T4 category, while N1 or N2 status had significantly higher concentrations of AT, CRP and Hp. The multivariate analysis confirmed the influence of the following factors on long-term survival: N stage, histological type of cancer and preoperative serum levels of AGP and Hp.

Conclusions: The serum concentration of some APP may correlate with the more aggressive clinical behavior of lung cancer. The patients with N1 or N2 stage of adenocarcinoma have significantly higher serum level of AT and the preoperative concentration of AGP and Hp correlates with the overall survival. These proteins could serve as prognostic factors in the risk assessment of the cancer recurrence after the surgical management.