Respiratory Research (Aug 2019)

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

  • Cecilia Mouronte-Roibás,
  • Virginia Leiro-Fernández,
  • Alberto Ruano-Raviña,
  • Cristina Ramos-Hernández,
  • Pedro Casado-Rey,
  • Maribel Botana-Rial,
  • Esmeralda García-Rodríguez,
  • Alberto Fernández-Villar

DOI
https://doi.org/10.1186/s12931-019-1155-2
Journal volume & issue
Vol. 20, no. 1
pp. 1 – 10

Abstract

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Abstract Background 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. Methods 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. Results 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). Conclusions 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.

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