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Year : 2014  |  Volume : 10  |  Issue : 4  |  Page : 1019-1023

Changes of serum albumin level and systemic inflammatory response in inoperable non-small cell lung cancer patients after chemotherapy

1 Department of Thoracic Surgery, Tianjin Key Laboratory of Artificial cells, Tianjin Third Central Hospital, Tianjin, China
2 Department of Pathophysiology, School of Basic Medical Sciences, Tianjin Medical University, Tianjin, China

Correspondence Address:
Xiaomei Yao
Department of Pathophysiology, School of Basic Medical Sciences, Tianjin Medical University, Tianjin
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Source of Support: This study is supported by the Tianjin Science and Technology Council Grant of China (No. 09JCYBJC11700), the Tianjin Educational and Scientific Grant (No. 20050107), and the Natural Science Foundation of China (NSFC, No. 81273009), Conflict of Interest: None

DOI: 10.4103/0973-1482.137953

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Aim: Hypoalbuminemia and systemic inflammatory response (SIR) parameters are a key role in the prognosis of cancer patients. We aim to investigate the changes of serum albumin level and SIR after chemotherapy, in patients with inoperable non-small cell lung cancer (NSCLC). The hypothesis is that improved serum albumin level may be beneficial to the SIR parameters and will reduce chemotherapy-induced toxicity. Patients and Methods: Forty-nine stage III b or stage IV inoperable NSCLC patients were divided into two groups, depending on whether albumin administration was given before chemotherapy. The Karnofsky performance score (KPS), nutritional status including body mass index (BMI), and serum albumin level were evaluated. SIR was evaluated by investigating the changes of the C-reactive protein (CRP), calculating the neutrophil lymphocyte ratio (NLR), and the platelet lymphocyte ratio (PLR), before and after chemotherapy. The chemotherapy-induced toxicity was also evaluated. Results: In the group of patients without albumin administration before chemotherapy, the serum albumin level was significantly decreased (P < 0.05) and the CRP level was significantly increased than before (P < 0.05). Significant correlations were noted between hypoalbuminemia and CRP increase (r = 0.533 P < 0.05), between hypoalbuminemia and NLR ≥5 (r = 0.574 P < 0.01) after chemotherapy. Patients with hypoalbuminemia developed more severe chemotherapy-induced toxicity symptoms. In the group of patients with albumin administration before chemotherapy, there was no significant difference in serum albumin level before and after chemotherapy (P > 0.05), even though the patients may have been malnourished or diagnosed with pleural effusions. There were no significant changes in the SIR parameters. Conclusion: Early assessment of the serum albumin level in patients with inoperable NSCLC and their improvement in the serum albumin level may suggest that there are beneficial effects after chemotherapy.

Abstract in Chinese

不能手术的非小细胞肺癌患者化疗后血清白蛋白水平与全身炎症反应的变化 摘要 目的:低白蛋白血症和全身炎症反应(SIR)参数在癌症患者预后上起关键作用。我们的目标是探讨不能手术的中晚期非小细胞肺癌(NSCLC)化疗后血清白蛋白水平和全身炎症反应的变化。假设是,提高血清白蛋白水平可能有利于全身炎症反应参数并且将减少化疗引起的毒性。 患者和方法:49例ⅢB期或IV期不能手术的非小细胞肺癌患者,根据化疗前是否给予白蛋白分为两组。Karnofsky评分(KPS),营养状况,包括身体质量指数(BMI)、血清白蛋白水平进行评价。化疗前后,全身炎症反应通过对C反应蛋白(CRP)的变化,计算中性粒细胞淋巴细胞比值(NLR)和血小板淋巴细胞比例(PLR)进行评估。对化疗诱导的毒性也进行了评价。 结果:无化疗前白蛋白组病例,血清白蛋白水平显著下降(P<0.05),CRP水平明显升高(P<0.05)。化疗后,低白蛋白血症和CRP的增加之间有显着的相关性(r=0.533,P<0.05),低蛋白血症和NLR≥5之间也有显著相关性(R = 0.574, P<0.01)。低蛋白血症患者化疗引起的毒性症状更严重。在化疗前注射白蛋白组的患者,化疗前后血清白蛋白水平无显著差异(P>0.05),即使患者可能有营养不良或有胸腔积液。在全身炎症反应参数没有显著的变化。 结论:对不能手术的非小细胞肺癌,血清白蛋白水平的早期评估及血清白蛋白水平的改善可能提示化疗后有益的结果。 关键词:白蛋白,化疗,非小细胞肺癌,全身性炎症反应

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