A decreased postoperative basophil percentage is an independent risk factor for prognosis in patients with lung
Bingyuan Zhou1, Jutong He1, Shixue Zhang1
1Department of Thoracic Surgery, Zhongnan Hospital of Wuhan University, Wuhan, China.
Background:
Lung cancer remains a leading cause of cancer-related mortality worldwide, and effective prognostic biomarkers are still lacking. Granulocytes, particularly basophils, have been implicated in tumor progression, but the prognostic value of their dynamic perioperative changes remains unclear. The main objective of this single-center retrospective cohort study was to evaluate the potential prognostic value of perioperative changes in the peripheral blood basophil percentage (PBB%) in patients with lung cancer and to build a multifactorial prognostic model.
Methods:
A total of 468 patients who met the inclusion criteria were included and divided into two groups: the lower group included patients whose PBB% after surgery was lower than that before surgery, and the higher group included patients whose postoperative PBB% was higher than that before surgery. We compared the overall survival (OS) of the two groups using Kaplan-Meier analysis. Comorbidities, American Society of Anesthesiologists (ASA) physical status score, chronic obstructive pulmonary disease (COPD), forced expiratory volume in 1 second/forced vital capacity (FEV1/FVC), and diffusing capacity of the lungs for carbon monoxide percentage predicted (DLCO%) were collected. Univariate and multivariate Cox regression were performed.
Results:
Patients in the lower group had a significantly better prognosis (P<0.05). In most of the subgroups, we found the same results (P<0.05), except for the left lobe, squamous cell carcinoma, in which there was no significant difference in OS between the lower and higher groups (P>0.05). Cox regression analysis identified three independent risk factors for OS in lung cancer patients: the trend of PBB% change, metastasis (M) stage, and postoperative complications.
Conclusions:
Lung cancer patients with a decreased postoperative PBB% have a better prognosis, especially patients with right lobe adenocarcinoma and stage I disease. This factor, when combined with M staging and postoperative complications, can be used to construct a multifactorial prognostic model for lung cancer.