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.