Prognosis and lung-cancer - the contribution of plasma-proteins

In this prospective study we aimed at assessing the potential prognostic significance of the serum protein content. We studied 388 consecutive patients, newly diagnosed for lung cancer during the last 6 years, by measuring the serum concentration of immunoglobulins (IgG, IgA, IgM), transferrin (T), haptoglobin (HP), alpha-1-acid glycoprotein (AGP), alpha-1-antitrypsin (AT) and alpha-2-macroglobulin (MG). In all patients, the values of other 9 clinical variables (age, sex, weight loss, ECOG performance status, stage- of disease, TNM factors and histology) were also available. Univariate analysis showed that patients with transferrin above 218 mg/dl had a median survival of 9 months, as compared to the 7 months for the remaining subjects (p<0.01). Patients with AT above 281 mg/dl had a significantly shorter survival than patients with low AT (11 months vs 6 months, p<0.01). High AP and AGP were also significantly associated with a poor prognosis (p<0.01 and 0.05 respectively). A multivariate analysis of survival (the Cox's proportional hazards regression analysis), selected, in decreasing order of significance, the following variables: (i) stage of disease; (ii) ECOG performance status; (iii) sex; (iv) alpha-1-acid glycoprotein; (v) weight loss; (vi) histology. We conclude that serum proteins (particularly AGP, T and AT) do have some prognostic significance in lung cancer.