Background
Methods
Study population
Lung cancer group
Lung cancer without COPD | Lung cancer with COPD | COPD | p-value | |
---|---|---|---|---|
Number of patients (%) | 92 (44.4%) | 115 (55.6%) | 42 | |
Age on randomization, y | ||||
median | 67.5 | 65.8 | 70 | p = 0.175 |
< 59 | 23 (25%) | 21 (18.3%) | 6 (14.3%) | |
60–69 | 35 (38%) | 58 (50.4%) | 14 (33.3%) | |
70+ | 34 (37%) | 36 (31.3%) | 22 (52.4%) | |
Sex | ||||
Female | 41 (45%) | 52 (45%) | 23 (55%) | p = 0.237 |
Male | 51 (55%) | 63 (55%) | 19 (45%) | |
COPD 2017 classification | ||||
II Moderate (FEV1 50–80%) | 99 (86.1%) | 16 (38%) | p < 0.001 | |
III Severe (FEV1 30–50%) | 15 (13%) | 18 (43%) | ||
IV Very severe (FEV1 < 30%) | 1 (0.9%) | 8 (19%) | ||
Steroids | ||||
Oral | No info | No info | 4 (9.5%) | |
Inhalation | No info | No info | 27 (64.3%) | |
No steroids | 11(26.2%) | |||
Smoking status | ||||
Never | 9 (9.8%) | 1 (0.9%) | 3 (7%) | p = 0.016 |
Former | 57 (62%) | 65 (56.5%) | 29 (69%) | |
Current | 26 (28.2%) | 49 (42.6%) | 10 (24%) | |
Pack-years smoked among former/current smokers | 83 | 114 | 39 | p = 0.008 |
< 30 | 47 (57%) | 44 (39%) | 11 (29%) | |
30–39 | 16 (20%) | 28 (25%) | 10 (26%) | |
40–49 | 4 (5%) | 20 (18%) | 11 (29%) | |
50+ | 15 (18%) | 22 (19%) | 6 (16%) | |
No information | 1 | 1 | ||
Never smokers | 9 | 1 | 3 | |
Lung cancer histology | ||||
Squamous cell carcinoma | 35 (38%) | 69 (60%) | p = 0.001 | |
Adenocarcinoma | 57 (62%) | 46 (40%) | ||
Lung cancer stage | ||||
I | 46 (50%) | 72 (62.6%) | p = 0.105 | |
II | 28 (30%) | 25 (21.7%) | ||
III | 16 (17%) | 17 (14.8%) | ||
IV | 2 (3%) | 1 (0.9%) | ||
5-year survival | 54 (59%) | 68 (59%) |
COPD group
Spirometry
Blood sample processing
Serum analyses
Markers for | Protein short name | Protein full name |
---|---|---|
Vascular inflammation | OPG | Osteoprotegrin |
PTX3 | Pentraxin 3 | |
Axl | Tyrosine-protein kinase receptor | |
CXCL16 | C-X-C motif chemokine ligand 16 | |
vWF | Von Willebrand factor | |
ePCR | Endothelial cell protein C receptor | |
Activated monocytes/ | Alcam (CD166) | Activated leukocyte cell adhesion molecule |
macrophage markers | PARC | p53-associated parkin-like cytoplasmic protein |
sCD163 | Cluster of differentiation 163 | |
CD14 | Cluster of differentiation 14 | |
Gal3BP | Galectin-3-binding protein | |
Extracellular matrix | CD147 | Cluster of differentiation 147 |
remodeling (ECM) and fibrosis | (Basigin. EMMPRIN) | |
Endostatin | ||
GDF15 | Growth differentiation factor-15 | |
Cats | Cathepsin S (Chloramphenicol acetyl transferase) | |
General inflammation | sTNFR1 | Tumour necrosis factor receptor 1 |
CRP | C-reactive protein | |
Notch | DLL1 | Delta-like protein 1 |
Statistical analyses
Results
Characteristics of lung cancer patients and COPD patients
Serum protein levels in lung cancer patients and COPD patients
MANCOVA | MANCOVA | ANOVA | |||||
---|---|---|---|---|---|---|---|
Protein | COPD (n = 42) vs LC (n = 207) | BC-sign | COPD / LConly / LCcopd | BC-sign | COPD vs LCcopd | COPD vs LConly | LCcopd vs LConly |
OPG | p < 0.001 | Sign. | p < 0.001 | Sign. | p < 0.001 | p < 0.001 | ns |
PTX3 | p = 0.001 | Sign. | p = 0.002 | Sign. | p = 0.04 | p = 0.001 | ns |
Axl | p < 0.001 | Sign. | p < 0.001 | Sign. | p < 0.001 | p = 0.002 | ns |
CXCL16 | p = 0.019 | ns | p = 0.005 | ns | ns | p = 0.002 | p = 0.023 |
Alcam (CD166) | p < 0.001 | Sign. | p < 0.001 | Sign. | p < 0.001 | p < 0.001 | ns |
sCD163 | p = 0.001 | Sign. | p = 0.001 | Sign. | ns | p = 0.01 | ns |
CD147 | p < 0.001 | Sign. | p < 0.001 | Sign. | p < 0.001 | p < 0.001 | ns |
Endostatin | ns | ns | p = 0.005 | ns | ns | ns | p = 0.033 |
Cats | p = 0.002 | Sign. | p = 0.004 | ns | p = 0.029 | p = 0.004 | ns |
CRP | ns | ns | p = 0.004 | ns | p = 0.018 | ns | p = 0.001 |
DLL1 | p < 0.001 | Sign. | p < 0.001 | Sign. | p < 0.001 | p < 0.001 | ns |
Prognostic significance
PFS | OS | PFS histology | OS histology | |||||||
---|---|---|---|---|---|---|---|---|---|---|
Protein | LC tot | LC | LCCOPD | LC tot | LC | LCCOPD | SQCC | AC | SQCC | AC |
OPG | ns | ns | p = 0.01 HR = 0.17 [0.04–0.70] | ns | ns | p = 0.03 HR = 0.14 [0.03–0.8] | p = 0.02 HR = 0.19 [0.05–0.75] | ns | p = 0.03 HR = 0.16 [0.03–0.81] | ns |
PTX3 | ns | ns | p = 0.01 HR = 1.70 [1.11–2.61] | ns | ns | ns | ns | ns | ns | ns |
vWF | ns | ns | ns | ns | ns | ns | p = 0.05 HR = 3.14 [1.01–9.78] | ns | p = 0.01 HR = 7.68 [1.69–34.77] | ns |
ePCR | ns | ns | ns | ns | p = 0.01 HR = 0.29 [0.11–0.77] | ns | ns | ns | ns | ns |
PARC | p = 0.01 HR = 1.93 [1.16–3.22] | ns | ns | ns | ns | ns | ns | ns | ns | ns |
Cats | ns | ns | ns | ns | ns | ns | ns | ns | ns | p = 0.01 HR = 39.44 [2.27–684.2] |
sTNFR1 | p = 0.03 HR = 0.57 [0.35–0.94] | ns | p = 0.03 HR = 0.49 [0.25–0.93] | p = 0.01 HR = 0.45 [0.25–0.83] | p = 0.04 HR = 0.3 [0.09–0.95] | p = 0.01 HR = 0.33 [0.15–0.73] | ns | p = 0.01 HR = 0.37 [0.18–0.78] | p = 0.02 HR = 0.31 [0.11–0.85] | p = 0.001 HR = 0.24 [0.10–0.58] |
CRP | ns | ns | ns | p = 0.002 HR = 1.41 [1.13–1.75] | p = 0.01 HR = 1.73 [1.14–2.63] | p = 0.17 HR = 1.59 [1.09–2.33] | ns | p = 0.03 HR = 1.39 [1.04–1.85] | p = 0.02 HR = 1.61 [1.08–2.40] | p = 0.01 HR = 1.6 [1.11–2.34] |