Paraneoplastic Leukocytosis and Thrombocytosis as Prognostic Biomarkers in Non-small Cell Lung Cancer  

作　　者：Prajwal BODDU Dana VILLLINES Mebea AKLILU 

机构地区：[1]Department of Internal Medicine, Advocate Illinois Masonic Medical Center [2]Department of Clinical Research, Advocate Illinois Masonic Hospital [3]Hematology/Oncology, Advocate Creticos Cancer Center

出　　处：《中国肺癌杂志》2016年第11期725-730,共6页Chinese Journal of Lung Cancer

摘　　要：Background and Objectives: Search for inexpensive laboratory markers have identified associations between blood counts and lung cancer outcomes. In this study, we evaluated the prognostic value of paraneoplastic leukocytosis(p-Leukocytosis) and paraneoplastic thrombocytosis(p-Thrombocytosis) in patients with non-small cell lung cancer(NSCLC). We also studied their relation to the expression of commonly detected molecular markers. Methods: We conducted a retrospective chart review on 571 consecutive NSCLC patients over a 10 year period. Blood counts were recorded at the time of cancer diagnosis. Kaplan-Meier survival curves were used to compare overall survival(OS) between patients with and without p-Leukocytosis(or) p-Thrombocytosis(p-Leuko/Thrombocytosis). Cox regression was used to determine if leukocytosis/thrombocytosis was a predictor of OS in NSCLC.Results: Patients with p-Leukocytosis and p-Thrombocytosis had a significantly poorer survival compared patients with normal blood counts(P<0.001). In a multivariate survival analysis, both continued to correlate even when adjusted for histology, gender, stage and chemotherapy(P<0.01, 0.03 respectively). Stage I and II NSCLC with p-Leuko/Thrombocytosis did not perform poorly compared to stage I/II NSCLC patients without paraneoplasia. Patients with the combined leukothrombocytosis syndrome did not have worse outcomes compared to those with either paraneoplastic syndrome alone. Conclusions: p-Leuko/Thrombocytosis is an accessible laboratory parameter of prognostic value in NSCLC. Evidence of p-Leuko/Thrombocytosis portends poor survival. The role of various cytokines in tumor pathobiology provides a rationale for identifying cytokine factors responsible for the paraneoplasia and administering anti-cytokine therapies alongside traditional chemotherapy in an attempt to improve survival outcomes in these subset of patients.Background and Objectives： Search for inexpensive laboratory markers have identified associations between blood counts and lung cancer outcomes. In this study, we evaluated the prognostic value of paraneoplastic leukocytosis（p-Leukocytosis） and paraneoplastic thrombocytosis（p-Thrombocytosis） in patients with non-small cell lung cancer（NSCLC）. We also studied their relation to the expression of commonly detected molecular markers. Methods： We conducted a retrospective chart review on 571 consecutive NSCLC patients over a 10 year period. Blood counts were recorded at the time of cancer diagnosis. Kaplan-Meier survival curves were used to compare overall survival（OS） between patients with and without p-Leukocytosis（or） p-Thrombocytosis（p-Leuko/Thrombocytosis）. Cox regression was used to determine if leukocytosis/thrombocytosis was a predictor of OS in NSCLC.Results： Patients with p-Leukocytosis and p-Thrombocytosis had a significantly poorer survival compared patients with normal blood counts（P〈0.001）. In a multivariate survival analysis, both continued to correlate even when adjusted for histology, gender, stage and chemotherapy（P〈0.01, 0.03 respectively）. Stage I and II NSCLC with p-Leuko/Thrombocytosis did not perform poorly compared to stage I/II NSCLC patients without paraneoplasia. Patients with the combined leukothrombocytosis syndrome did not have worse outcomes compared to those with either paraneoplastic syndrome alone. Conclusions： p-Leuko/Thrombocytosis is an accessible laboratory parameter of prognostic value in NSCLC. Evidence of p-Leuko/Thrombocytosis portends poor survival. The role of various cytokines in tumor pathobiology provides a rationale for identifying cytokine factors responsible for the paraneoplasia and administering anti-cytokine therapies alongside traditional chemotherapy in an attempt to improve survival outcomes in these subset of patients.

关 键 词：PARANEOPLASTIC Leukothrombocytosis Paraneoplastic leukocytosis Paraneoplastic thrombocytosis Lung neoplasms Prognosis CYTOKINE Epidermal growth factor receptor 

分 类 号：R734.2[医药卫生—肿瘤]