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ORIGINAL ARTICLE
Year : 2020  |  Volume : 16  |  Issue : 4  |  Page : 839-842

Hospital-based study on demographic, hematological, and biochemical profile of lung cancer patients


1 Department of Physiology, King George's Medical University, Lucknow, Uttar Pradesh, India
2 Department of Respiratory Medicine, King George's Medical University, Lucknow, Uttar Pradesh, India

Date of Submission26-Mar-2018
Date of Decision06-May-2018
Date of Acceptance27-Jul-2018
Date of Web Publication12-Oct-2018

Correspondence Address:
Sandeep Bhattacharya
Department of Physiology, King George's Medical University, Lucknow, Uttar Pradesh
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/jcrt.JCRT_185_18

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 > Abstract 


Background: Lung cancer is considered as the most commonly diagnosed cancer. It is the leading cause of cancer-related mortality. Smoking and environmental pollutants act as important risk factors in majority of lung cancer cases (80%–90%).
Material and Methods: This is a hospital-based study carried on in lung cancer patients of North India. Demographic profile of lung cancer patients was recorded. Hematological and biochemical profiles of lung cancer patients and healthy controls were compared.
Results: Highest proportion of lung cancer was found in the age group of 46–60 years. Lung cancer was seen in highest number in male gender (76.63%) and also in those patients belonging to the rural category (84.58%). In this study, only 3.98% lung cancer patients having the past history of cancer and 5.47% showing the family history of cancer. Significant differences were found in weight and body mass index (BMI) of lung cancer patients when compared to healthy control (P < 0.0001). Hemoglobin (Hb) was found lower in lung cancer patients as compared with healthy controls. Significant difference was also observed in Hb levels of these two groups (P < 0.000). The serum protein level was lower in lung cancer patients than healthy controls. A significant difference was also observed in the protein levels of these two groups (P < 0.0001). Serum alkaline phosphatase (ALP) levels were higher in lung cancer patients in comparison to healthy controls. A significant difference was also observed in serum ALP levels in lung cancer patients as compared with healthy controls (P < 0.0001).
Conclusions: Significant difference between BMI, Hb, serum albumin, and total protein was found in this study. These biomarkers may be helpful in the diagnosis of lung cancer at early stage and also in the follow-up assessment of the effects of treatment.

Keywords: Biomarkers, diagnosis, lung cancer, smoking


How to cite this article:
Gaur P, Bhattacharya S, Kant S, S. Kushwaha R A, Garg R, Pandey S, Dubey A. Hospital-based study on demographic, hematological, and biochemical profile of lung cancer patients. J Can Res Ther 2020;16:839-42

How to cite this URL:
Gaur P, Bhattacharya S, Kant S, S. Kushwaha R A, Garg R, Pandey S, Dubey A. Hospital-based study on demographic, hematological, and biochemical profile of lung cancer patients. J Can Res Ther [serial online] 2020 [cited 2020 Sep 26];16:839-42. Available from: http://www.cancerjournal.net/text.asp?2020/16/4/839/247187




 > Introduction Top


Lung cancer is considered as the most commonly diagnosed cancer and is constitutes the leading cause of cancer-related mortality.[1] The majority of lung cancer cases (80%–90%) are due to smoking. Tobacco smoke and other environmental pollutants have been recognized as risk factors for >80%–90% of cancer incidence in men,[2] alcohol intake is one of the most important risk factors for lung cancer. It has been considered that the consumption of beer, spirits, and regular use of alcohol were associated with increased risk of lung cancer.[3] It has been found from the several studies that fatigue is the most commonly reported symptom of cancer and cancer therapy [4],[5],[6] and it is well known that anemia is one of the main factors causing fatigue in cancer patients.[7] Fatigue is the most frequently reported symptoms in cancer and cancer treatment.[8],[9] The measurement of biochemical markers such as serum enzymes is gradually increasing in general practice for early diagnosis and monitoring a variety of malignant diseases, as in the process of transformation of normal cells into malignant cells often leads to abnormal serum enzyme synthesis, even before changes in tumor morphology.[10] The enzymes have also been useful in following the effects of treatment of cancer. Hence, the enzyme studies have recently received widespread attention. The clinical importance of serum enzyme such as alkaline phosphatase (ALP) in malignancies has been reported by various studies.[11] It has been reported from the previous study that the high serum ALP levels was found in 68.78% of cases and majority of cases (75.63%) belonged to Stage III and IV.[12] It has been reported that the serum ALP level was found to be low in the early stage of the disease as the metastatic sites were less in number, but serum ALP is elevated during the last month of life, suggesting tumor metastases.[13],[14],[15] This is a hospital-based study on demographic profiles of lung cancer patients. This study was an effort to discover the serum biomarker for lung cancer and evaluating their utility in the diagnosis of lung cancer and also find the association between these biomarkers with the disease.


 > Materials and Methods Top


This study was conducted at the Department of Respiratory Medicine, King George's Medical University, Lucknow, India. Data of the sociodemographic history, family history, smoking history, type and number smoked, duration of smoking, exposure to ETS or biomass fuel, past history of symptoms, and histological subtypes of cancer were collected through the questionnaire. A total of 201 histopathologically confirmed lung cancer patients were enrolled in this study after excluding those having other disorders such as chronic obstructive pulmonary disease, asthma, tuberculosis, interstitial lung disease, and 100 healthy controls without having the past history of any chronic or acute disease for the last 1 months were also enrolled to compare the hematological and biochemical parameters.

Statistical analysis

The data were analyzed by Graph Pad Prism version 5 (Graph Pad software Inc.; La, Jolla, CA, USA). The data were presented in mean, standard deviation, and percentage. Student's t-test is performed to compare between two groups for categorical variables. P < 0.05 is considered statistically significant.


 > Results Top


Highest proportions of patients were in the age group 46–60 years (52.74%) followed by second highest age group 61–75 (24.88%). There were 9 (4.48%) patients in the age group ≤30 and only 4 (1.99%) patients were in the age >75 years [Table 1].
Table 1: Demographic profile of lung cancer patients (n=201)

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Out of 201 patients, 150 (74.63%) were male and 51 (25.37%) were female. The male: female (M:F) ratio was 3:1 in lung cancer patients. The study comprises 159 (79.10%) Hindus and 42 (20.90%) Muslims [Table 1]. One hundred and seventy (84.58%) of the patients belong to the rural area, while 31 (15.42%) were from the urban [Table 1]. Most of the patients 143 (71.14%) were illiterate and 49 (24.38%) were educated up to intermediate. Only small proportion of 9 (4.48%) was educated above to intermediate [Table 1]. Out of 201 patients, 8 (3.98%) having the past history of cancer [Table 2] and 11 (5.47) having the family history of cancer [Table 2]. Majority of the patients having the symptoms of cough, which was found in 167 (83.08) of the patients [Table 3]. One hundred and sixteen (57.71%) of the patients having nonvegetarian pattern of diet [Figure 1].
Table 2: History of cancer (n=201)

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Table 3: Clinical symptoms of lung cancer patients (n=201)

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Figure 1: Socioeconomic status of lung cancer patients

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Eighty-three (41.29%) of the patients was current smokers, 64 (31.84%) was ex-smokers, and 47 (23.38%) was nonsmokers [Figure 2]. Other type of addiction was tobacco, found in (33.33%) of the patients and alcohol seen in (34.33%) [Figure 3].
Figure 2: Smoking habits of lung cancer patients

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Figure 3: Types of addiction

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Most common histological subtype was adenocarcinoma comprised 114 (57%) and squamous cell carcinoma in 72 (36%) of the populations [Table 4].
Table 4: Histological subtypes (201)

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The mean age of lung cancer patients (54.11 ± 11.49) and healthy controls were (53.02 ± 11.39). The M: F ratio was 3:1 in lung cancer cases and healthy controls. There was significant difference found in weight and body mass index (BMI) of lung cancer patients when compared to healthy control (P < 0.0001) [Table 5].
Table 5: Demographic profile of lung cancer patients and healthy controls

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Significant difference was found in hemoglobin (Hb) levels of two groups (<0.0001). Hb was found lower in lung cancer patients as compared with healthy controls [Table 6].
Table 6: Hematological and biochemical profiles of lung cancer patients and healthy controls

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The serum albumin level was lower in lung cancer patients as compared with healthy control. There was significant difference found between these two groups (<0.0001) [Table 6].

The serum protein level was lower in lung cancer patients when compared with healthy controls. There was a significant difference found in the protein levels of these two groups (P < 0.0001) [Table 6].

Serum ALP levels were higher in lung cancer patients as compares with healthy controls. There was significant difference between the ALP levels found (<0.0001) [Table 6].


 > Discussion Top


The mean age of lung cancer patients was (54.11 ± 11.49) and healthy controls was (53.02 ± 11.39). The M: F ratio was 3:1 in lung cancer cases and healthy controls. 84.58% of the patients belong to the rural area while 15.42% was from the urban. The BMI of lung cancer patients was lower when compared with the healthy controls. The mean difference between these two groups was statistically significant (P < 0.0001). It has been reported from the previous study that increased risk of lung cancer for lower BMI in male patients was found. Furthermore, an inverse association between BMI and the incidence of lung cancer has been reported in several case–control and cohort studies.[16] In another study, it has been reported that the BMI was significantly and inversely associated with the lung cancer in both men and women and also showed that a lower BMI was related to a higher mortality in advanced non-small cell lung cancer.[17] An elevated risk of lung cancer associated with lower levels of BMI has been reported in case–control and cohort studies. It has been reported from various studies. The interpretation of the association between low BMI and lung cancer is complicated by the fact that weight loss may be a sign of the disease.[18],[19],[20] In this study, Hb levels were lower than that of healthy control. This difference was statistically significant (P < 0.0001). Anemia incidence varies with cancer types, stages, and patient characteristics, it has been estimated that over 40% of all cancer patients are anemic at diagnosis and additional 40% increased after chemotherapy or radiation therapy treatments.[21] Malnutrition in cancer patients are significant problems due to a variety of mechanisms involving in the tumor, the host response to the tumor, and anticancer therapies.[22] Malnutrition has been associated with a number of clinical consequences, including deteriorated quality of life, decreased response to treatment, increased risk of chemotherapy-induced toxicity, and a reduction in cancer survival.[23] Serum albumin has also been described as an independent prognostic factor of survival in various cancers such as lung cancer.[24] Low serum albumin has also been shown to be an independent indicator for prognosis in cancer patients with unknown primaries.[25] Serum protein levels were significantly lower in lung cancer when compared to control group (P < 0.0001), these finding was supported by previous study.[26] In this study, the serum ALP level was higher than the healthy control. Statistically significant difference was found between these two groups (P < 0.0001). These findings are consistent with the previous study.[26],[27] In a previous study conducted with Stage I patients of both preoperative and postoperative, hypoalbuminemia was shown to be an independent poor prognostic factor for tumor recurrence.[28] In a study conducted with advanced stage NSCLC patients, low albumin level was shown to be related with Grade III/IV toxicity developing in the course of paclitaxel–carboplatin treatment.[29]


 > Conclusions Top


Significant differences were found in weight and BMI of lung cancer patients when compared to healthy control. Hb was found lower in lung cancer patients as compared with healthy controls. The serum protein level and Hb were lower in lung cancer patients than healthy controls, while serum ALP level was higher in lung cancer patients in comparison to healthy controls. Significant difference was also observed in Hb, protein, and ALP levels of these two groups.

Dietary lifestyle plays an important role in the development of lung cancer. It has been found from the various studies that there is a direct relationship between unhealthy diet and lifestyle with the increased risk of tumor development and cancer. Hence, a good nutritional status based on a balanced diet constitutes one of the main preventive factors for tumors.

Acknowledgment

We are greatly thankful to the Department of Respiratory Medicine for carrying out the study and appreciate patients and healthy volunteers who participated in the study.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
 > References Top

1.
Ferlay J, Shin HR, Bray F, Forman D, Mathers C, Parkin DM, et al. Estimates of worldwide burden of cancer in 2008: GLOBOCAN 2008. Int J Cancer 2010;127:2893-917.  Back to cited text no. 1
    
2.
Khuder SA. Effect of cigarette smoking on major histological types of lung cancer: A meta-analysis. Lung Cancer 2001;31:139-48.  Back to cited text no. 2
    
3.
Fan L, Cai L. Meta-analysis on the relationship between alcohol consumption and lung cancer risk. Wei Sheng Yan Jiu 2009;38:85-9.  Back to cited text no. 3
    
4.
Okuyama T, Akechi T, Kugaya A, Okamura H, Imoto S, Nakano T, et al. Factors correlated with fatigue in disease-free breast cancer patients: Application of the cancer fatigue scale. Support Care Cancer 2000;8:215-22.  Back to cited text no. 4
    
5.
Stone P, Hardy J, Broadley K, Tookman AJ, Kurowska A, A'Hern R, et al. Fatigue in advanced cancer: A prospective controlled cross-sectional study. Br J Cancer 1999;79:1479-86.  Back to cited text no. 5
    
6.
Yellen SB, Cella DF, Webster K, Blendowski C, Kaplan E. Measuring fatigue and other anemia-related symptoms with the functional assessment of cancer therapy (FACT) measurement system. J Pain Symptom Manage 1997;13:63-74.  Back to cited text no. 6
    
7.
Portenoy RK, Itri LM. Cancer-related fatigue: Guidelines for evaluation and management. Oncologist 1999;4:1-10.  Back to cited text no. 7
    
8.
Vogelzang NJ, Breitbart W, Cella D, Curt GA, Groopman JE, Horning SJ, et al. Patient, caregiver, and oncologist perceptions of cancer-related fatigue: Results of a tripart assessment survey. The fatigue coalition. Semin Hematol 1997;34:4-12.  Back to cited text no. 8
    
9.
Winningham ML, Nail LM, Burke MB, Brophy L, Cimprich B, Jones LS, et al. Fatigue and the cancer experience: The state of the knowledge. Oncol Nurs Forum 1994;21:23-36.  Back to cited text no. 9
    
10.
Cascante M, Centelles JJ, Veech RL. Role of thiamin (Vitamin B1) and transketolase in tumor cell proliferation. Nutr Cancer 2000;36:150-154.  Back to cited text no. 10
    
11.
Rao YN, Singh GP, Chakravorty M, Khanna NW. Serum lactate dehydrogenase, leucine amino peptidase and alkaline phosphatase in the diagnosis of cancer. Ind J Cancer 1978;15:39-44.  Back to cited text no. 11
    
12.
Maestu I, Pastor M, Gómez-Codina J, Aparicio J, Oltra A, Herranz C, et al. Pretreatment prognostic factors for survival in small-cell lung cancer: A new prognostic index and validation of three known prognostic indices on 341 patients. Ann Oncol 1997;8:547-53.  Back to cited text no. 12
    
13.
Kawahara M, Fukuoka M, Saijo N, Nishiwaki Y, Ikegami H, Tamura T, et al. Prognostic factors and prognostic staging system for small cell lung cancer. Jpn J Clin Oncol 1997;27:158-65.  Back to cited text no. 13
    
14.
Jacot W, Quantin X, Boher JM, Andre F, Moreau L, Gainet M, et al. Brain metastases at the time of presentation of non-small cell lung cancer: A multi-centric AERIO analysis of prognostic factors. Br J Cancer 2001;84:903-9.  Back to cited text no. 14
    
15.
Gault MH, Cohen MW, Kahana LM, Leelin FT, Meakins JF, Aronovitch M. Serum enzymes in patients with carcinoma of lung: Lactic-acid dehydrogenase, phosphohexose isomerase, alkaline phosphatase and glutamic oxaloacetic transaminase. Can Med Assoc J 1967;96:87-94.  Back to cited text no. 15
    
16.
Kagohashi K, Satoh H, Kurishima K, Ishikawa H, Ohtsuka M. Body mass index and lung cancer risk in never smokers. Radiol Oncol 2006;40:239-44.  Back to cited text no. 16
    
17.
Hsu CL, Chen KY, Shih JY, Ho CC, Yang CH, Yu CJ, et al. Advanced non-small cell lung cancer in patients aged 45 years or younger: Outcomes and prognostic factors. BMC Cancer 2012;12:241.  Back to cited text no. 17
    
18.
Kabat GC, Wynder EL. Body mass index and lung cancer risk. Am J Epidemiol 1992;135:769-74.  Back to cited text no. 18
    
19.
Chyou PH, Nomura AM, Stemmermann GN. A prospective study of weight, body mass index and other anthropometric measurements in relation to site-specific cancers. Int J Cancer 1994;57:313-7.  Back to cited text no. 19
    
20.
Albanes D, Jones DY, Schatzkin A, Micozzi MS, Taylor PR. Adult stature and risk of cancer. Cancer Res 1988;48:1658-62.  Back to cited text no. 20
    
21.
Wan S, Lai Y, Myers RE, Li B, Palazzo JP, Burkart AL, et al. Post-diagnosis hemoglobin change associates with overall survival of multiple malignancies-results from a 14-year hospital-based cohort of lung, breast, colorectal, and liver cancers. BMC Cancer 2013;13:340.  Back to cited text no. 21
    
22.
von Meyenfeldt M. Cancer-associated malnutrition: An introduction. Eur J Oncol Nurs 2005;9 Suppl 2:S35-8.  Back to cited text no. 22
    
23.
Dewys WD, Begg C, Lavin PT, Band PR, Bennett JM, Bertino JR, et al. Prognostic effect of weight loss prior to chemotherapy in cancer patients. Eastern cooperative oncology group. Am J Med 1980;69:491-7.  Back to cited text no. 23
    
24.
Lam PT, Leung MW, Tse CY. Identifying prognostic factors for survival in advanced cancer patients: A prospective study. Hong Kong Med J 2007;13:453-9.  Back to cited text no. 24
    
25.
Seve P, Ray-Coquard I, Trillet-Lenoir V, Sawyer M, Hanson J, Broussolle C, et al. Low serum albumin levels and liver metastasis are powerful prognostic markers for survival in patients with carcinomas of unknown primary site. Cancer 2006;107:2698-705.  Back to cited text no. 25
    
26.
Samanta S, Sharma A, Das B, Mallick AK, Kumar A. Significance of total protein, albumin, globulin, serum effusion albumin gradient and LDH in the differential diagnosis of pleural effusion secondary to tuberculosis and cancer. J Clin Diagn Res 2016;10:BC14-8.  Back to cited text no. 26
    
27.
Koch N, Ibetombi Devi Th, Jaichand L, Gupta BK. Enzymes: Lactate dehydrogenase and alkaline phosphatase in lung cancer patients before and after treatment. Int J Adv Res 2016;4:1057-65.  Back to cited text no. 27
    
28.
Jin Y, Zhao L, Peng F. Prognostic impact of serum albumin levels on the recurrence of stage I non-small cell lung cancer. Clinics (Sao Paulo) 2013;68:686-93.  Back to cited text no. 28
    
29.
Arrieta O, Michel Ortega RM, Villanueva-Rodríguez G, Serna-Thomé MG, Flores-Estrada D, Diaz-Romero C, et al. Association of nutritional status and serum albumin levels with development of toxicity in patients with advanced non-small cell lung cancer treated with paclitaxel-cisplatin chemotherapy: A prospective study. BMC Cancer 2010;10:50.  Back to cited text no. 29
    


    Figures

  [Figure 1], [Figure 2], [Figure 3]
 
 
    Tables

  [Table 1], [Table 2], [Table 3], [Table 4], [Table 5], [Table 6]



 

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