Page 87 - GTM-3-4

Global Translational Medicine Blood parameters for SCLC and AC relapse prognosis

correspondence between their concentration in the blood selecting these indicators was to compare their prognostic
and the tumor response in NSCLC is only 40 – 70%. 26 value with known marker, including CYFRA 21-1, SCC
To increase the diagnostic and prognostic efficiency antigen, and tissue polypeptide antigen (TPA).
of these markers, there have been attempts to create 2. Materials and methods
multianalytical panels incorporating these and other
indicators of tumor tissue metabolism. However, to 2.1. Study population
27
date, there is still no informative single biomarker or To substantiate the risk groups for tumor recurrence
combination of biomarkers that can help in predicting in patients with operable Stage III (T1-4N0-2) SCLC,
the recurrence of LC after diagnosis and before treatment a retrospective study was initially undertaken using
initiation. This is believed due to the lack of a standardized information from the Belarusian Cancer Registry database.
study designs, patient stratification criteria, and the low The study included 416 patients with newly diagnosed
diagnostic sensitivity and/or specificity of the markers. 27 SCLC (Table 1) and 451 patients with Stage III (T1-4N0-2)
As histological subtypes of NSCLC, AC and SCLC AC (Table 2), between January 1, 2015, and December 31,
differ in etiology and course. Thus, SCLC develops 2021. The period of relapse development after treatment
28
significantly more often in smoking patients, while AC is was analyzed based on the results of 1-year observation,
more associated with obesity. Compared to AC, SCLC is due to the majority of NSCLC relapses develop within the
more prevalent in men, whereas AC is more frequently first year following treatment. 33
seen in women. The investigation of laboratory parameters was carried
Both subtypes are characterized by symptoms, out in a “study group” of 73 patients with newly diagnosed
including hemoptysis, dyspnea, chest pain, cough, and SCLC (Table 1) and 77 patients with Stage III (T1-4N0-2)
general weakness. Changes in the level of some laboratory AC (Table 2), who were admitted to the thoracic oncology
parameters in the blood of patients, such as CRP, department of the N.N. Alexandrov Republican Scientific
fibrinogen, and haptoglobin, also show similar patterns in and Practical Center for OMR between January 1, 2022,
both subtypes. In both cases, the disease often proceeds and December 31, 2023. Inclusion criteria included a
29
without any clinical manifestations for extended periods, newly diagnosed stage IIIA or IIIB SCLC, while exclusion
leading to a late diagnosis (stage III or IV) in 45% of criteria were the presence of metachronous or secondary
patients with AC and SCLC. 30 cancer, and patient refusal to participate in the study. No

Compared with SCLC, AC is slightly more often patient dropped out during the first year of observation.
detected in patients with early-stage disease (I or II). In Patients with T1N2M0, T2N2M0, T3N1M0, and T3N2M0
31
patients with Stage I SCLC, the 5-year survival rate is 47%, underwent surgical tumor resection (surgical volume - R0)
while for AC, this figure is almost twice as high (79%). For followed by 4 courses of adjuvant polychemotherapy,
28
Stage II AC and SCLC, the prognosis of the disease worsens consisting of a combination of vinorelbine (V) at 25 –

2
2
significantly. During this period, the 5-year survival rate for 30 mg/m and cisplatin (C) at 80 mg/m . Meanwhile, in
patients with SCLC (32%) is also significantly lower than patients with T4N0M0, T4N1M0, and T4N2M0, two
for those with AC (50%). In patients with Stage IV SCLC courses of neoadjuvant chemotherapy, consisting of a
and AC, this figure drops to only 2% and 6%, respectively. 28 combination of V+C were administered, followed by
surgical tumor resection and two additional courses of
In SCLC, serum levels of CYFRA 21-1 and CEA have adjuvant polychemotherapy of V+C.
been reported to associate with overall and relapse-free
survival. However, these studies were also conducted only 2.2. Ethical approval and consent
12
in patients with early-stage disease (I–II). Patients with Stage All patients provided written informed consent. The study
III were examined only in a mixed group with early stages. was performed according to the ethical regulations in
32
Information on the role of blood laboratory parameters in Belarus and approved by the Ethics Committee at Belarusian
predicting relapse-free survival in patients with Stage III State Medical University, protocol №2 from April 10, 2021.
SCLC, as well as with Stage III AC, was lacking.
2.3. Sample collection and analysis
Therefore, the aim of this study was to investigate the
potential use of pre-operative levels several indicators, Blood samples were collected from patients of the “study
which characterize the cellular composition and group” before treatment (39 patients with SCLC and
metabolism in the blood of patients with Stage III AC and 40 patients with AC). Blood cell concentrations were
SCLC, to predict their relapse-free survival and make a determined on a Sysmex XE-5000 hematology analyzer
decision on the therapeutic strategy. A key condition for (Sysmex Group, Japan). Albumin and CRP levels

Volume 3 Issue 4 (2024) 3 doi: 10.36922/gtm.4865