Predictive value of a series of inflammatory markers in COPD for lung cancer diagnosis: a case-control study

• Published in: Respiratory research 2019-08, Vol.20 (1), p.198-198, Article 198
• Main Authors: Mouronte-Roibás, Cecilia, Leiro-Fernández, Virginia, Ruano-Raviña, Alberto, Ramos-Hernández, Cristina, Casado-Rey, Pedro, Botana-Rial, Maribel, García-Rodríguez, Esmeralda, Fernández-Villar, Alberto
• Format: Article
• Language: English
• Subjects: A1AT; Age composition; Aged; Bilirubin; Biological markers; Biomarkers; Biomarkers - blood; Blood; Blood platelets; Blood tests; C-reactive protein; Cancer diagnosis; Cancer research; Case studies; Case-Control Studies; Cholesterol; Chronic obstructive lung disease; Chronic obstructive pulmonary disease; Comorbidity; Complications and side effects; Control methods; COPD; Disease control; Female; Fibrin; Fibrinogen; Genetic aspects; Humans; Identification and classification; Immunoglobulin E; Inflammation; Inflammation Mediators - blood; Interleukin 6; Interleukin 8; Leukocytes; Leukocytes (neutrophilic); Lung cancer; Lung diseases; Lung Neoplasms - complications; Lung Neoplasms - diagnosis; Lung Neoplasms - physiopathology; Lymphocytes; Male; Medical research; Middle Aged; Neutrophils; Obstructive lung disease; Occupational exposure; Occupational health; Occupational safety and health; Peripheral blood; Platelets; Predictive Value of Tests; Pulmonary Disease, Chronic Obstructive - blood; Pulmonary Disease, Chronic Obstructive - diagnosis; Pulmonary Disease, Chronic Obstructive - physiopathology; Respiratory function; Risk factors; Risk management; Smoking; Spirometry - methods; Tumor necrosis factor; Tumor necrosis factor-α
• ISSN: 1465-993X; 1465-9921; 1465-993X; 1465-9921
• DOI: 10.1186/s12931-019-1155-2

There is a relationship between Chronic Obstructive Pulmonary Disease (COPD) and the development of lung cancer (LC). The aim of this study is to analyse several blood markers and compare their concentrations in patients with only COPD and LC + COPD. Case-control study with cases presenting combined LC and COPD and two control groups (patients presenting only COPD and patients presenting only LC). We also included LC patients with descriptive purposes. In both groups, peripheral blood analyses of TNF-α, IL-6, IL-8, total leukocyte, lymphocyte and neutrophil counts, neutrophil-to-lymphocyte ratio, total platelet count, mean platelet volume, platelet-to-lymphocyte ratio, alpha 1-antitripsin (A1AT), IgE, C-reactive protein, fibrinogen, cholesterol and bilirubin were performed. We developed univariate and multivariate analyses of these markers, as well as a risk score variable, and we evaluated its performance through ROC curves. We included 280 patients, 109 cases (LC + COPD), 83 controls (COPD) and 88 LC without COPD. No differences were observed in the distribution by sex, age, BMI, smoking, occupational exposure, lung function, GOLD stage or comorbidity. Patients with LC + COPD had significantly higher levels of neutrophils [OR 1.00 (95%CI 1.00-1.00), p = 0.03] and A1AT [OR 1.02 (95%CI 1.01-1.03), p = 0.003] and lower cholesterol levels [OR 0.98 (95%CI 0.97-0.99), p = 0.009] than COPD controls. We developed a risk score variable combining neutrophils, A1AT and cholesterol, achieving a sensitivity of 80%, a negative predictive value of 90.7% and an area under the curve of 0.78 (95%CI 0.71-0.86). COPD patients who also have LC have higher levels of neutrophils and A1AT and lower of cholesterol. These parameters could be potentially predicting biomarkers of LC in COPD patients.