Abstract
Objective: The clinical association between alpha-1 antitrypsin (AAT) blood concentration and phenotypes with non-small cell lung cancer (NSCLC) is not clear, as well as the role of AAT in lung carcinogenesis. We investigated AAT serum levels and phenotypes in NSCLC patients to evaluate its potential biological and clinical significance.
Methods: serum samples from 148 NSCLC patients (stages I-IV) were analyzed for AAT blood concentration by nephelometry, AAT phenotype by isoelectrofocusing and genotype by DNA sequencing. Reference group consisted of 154 PiMM COPD patients.
Results: 6/148 (4%) NSCLC patients carried deficient AAT allele (3 MS, 1 MZ, 1 FM, 1 MX) with mean AAT blood concentration of 169.17 mg/dl. In the group of PiMM NSCLC patients mean AAT serum concentration (206.33 mg/dl) was significantly higher than in the PiMM COPD group (171.39 mg/dl; p<0.0000). AAT concentration was significantly higher in squamous cell carcinoma (205.42 mg/dl) than adenocarcinoma (182.76 mg/dl; p<0.029) patients, and in advanced (IIIb-IV, 241.36 mg/dl) versus early stage disease (I-IIIa, 194.62 mg/dl, p<0.0000).
Conclusions: Our results might reflect an active AAT role in lung carcinogenesis as well as its local production by tumor cells. The positive association of AAT serum levels with stage and histology might be clinically valuable, if confirmed in a larger study. Our study is to be continued, patient groups extended and NSCLC tissue specimens analyzed for AAT expression by immunohistochemistry method.
- © 2014 ERS