Evaluation of the relationship between serum ghrelin levels and cancer cachexia in patients with locally advanced nonsmall-cell lung cancer treated with chemoradiotherapy
Pelin Uysal1, Cigdem Usul Afsar2, Volkan Sozer3, Berrin Inanc4, Fulya Agaoglu1, Zeynep Gural1, Nevin Yaman Fazlıoglu5, Caglar Cuhadaroglu6, Hafize Uzun7
1 Department of Chest Diseases, Faculty of Medicine, Atakent Hospital, Mehmet Ali Aydınlar University, Tekirdag, Turkey
2 Department of Medical Oncology, Faculty of Medicine, Bakırkoy Hospital, Mehmet Ali Aydınlar University, Tekirdag, Turkey
3 Department of Biochemistry, Yildiz Technical University, Tekirdag, Turkey
4 Department of Radiation Oncology, İstanbul Education and Research Hospital, Tekirdag, Turkey
5 Department of Chest Diseases, Faculty of Medicine, Tekirdag Namık Kemal University, Tekirdag, Turkey
6 Department of Chest Diseases, Faculty of Medicine, Altunizade Hospital, Mehmet Ali Aydınlar University, Tekirdag, Turkey
7 Department of Biochemistry, Cerrahpasa Faculty of Medicine, Istanbul University-Cerrahpasa, Istanbul, Turkey
Department of Biochemistry, Cerrahpasa Faculty of Medicine, Istanbul University-Cerrahpasa, 34303 Cerrahpasa, Istanbul
Source of Support: None, Conflict of Interest: None
Background: Ghrelin plays a role in mechanisms related to cancer progression – including cell proliferation, invasion and migration, and resistance to apoptosis in the cell lines from several cancers. We investigated the role of ghrelin levels in cancer cachexia-anorexia in patients with locally advanced nonsmall-cell lung cancer (NSCLC) treated with chemoradiotherapy (CRT).
Materials and Methods: This study involved 84 NSCLC patients who had received concomitant CRT. Blood ghrelin levels were compared before and 3 months after CRT. Meanwhile, changes in body weight of the patients were also investigated with changes in ghrelin levels before and after CRT.
Results: Ghrelin levels were significantly decreased in line with changes in patients' weights in patients receiving CRT (P < 0.001). Serum albumin levels and inflammatory-nutritional index were significantly decreased after radiotherapy (RT) (3.01 ± 0.40 g/dL, 0.38 ± 0.20) when compared with its baseline levels (3.40 ± 0.55 g/dL,P < 0.001; 0.86 ± 0.71,P < 0.001, respectively). Serum C-reactive protein levels were significantly increased after CRT (7.49 ± 6.53 mg/L) when compared with its baseline levels (9.54 ± 3.80 mg/L,P = 0.038). After RT, ghrelin levels in patients were positively correlated with body mass index (r = 0.830,P < 0.001) and albumin (r = 0.758,P < 0.001).
Conclusion: Ghrelin may play a role in the pathogenesis of weight loss in NSCLC patients. Ghrelin seems to be implicated in cancer-related weight loss. Ghrelin, cancer, and RT all together have a role in tumor-related anorexia-cachexia in patients with NSCLC. Results of this study need further evaluation as regards to its potential role as an adjuvant diagnostic or prognostic marker.