Oxygenation gain factor: a novel parameter characterizing the association between hemoglobin level and the...

Tumor hypoxia has been linked to acquired treatment resistance, tumor progression, and poor prognosis. Because anemia is a major causative factor for the development of hypoxia, the association between blood hemoglobin concentration (cHb) and breast cancer oxygenation was examined in this study. In addition, a novel parameter characterizing the relationship between oxygenation status and rising cHb is introduced: the oxygenation gain factor (OGF). In breast cancer patients, median cHb over the range 8.5-14.7 g/dl correlated positively with the median pO(2) (3-15 mm Hg), yielding an average OGF of 2 mm Hg.dl/g. In contrast, in normal tissues (normal breast, subcutis, and skeletal muscle) the median pO(2) values were substantially higher (52 mm Hg, 51 mm Hg, and 37 mm Hg, respectively) and remained constant irrespective of the hemoglobin level over the range from 10 to 16 g/dl (OGF = 0 in grade I anemia and nonanemic patients). Moderately lower median pO(2) values in subcutis and skeletal muscle were only observed in grade II anemia (8 g/dl < cHb < or =10 g/dl), although this would appear to be of no biological relevance. Conversely, in breast cancers, even mild anemia (grade I anemia) is a major causative factor for the development of hypoxia or anoxia.