Prognostic value of fasting glucose concentration in patients with newly diagnosed lung cancer_West China Medical Journal

Authors：

WANG Weiwen , DAI Sisi , LI Lei ,  LI Weimin

Department of Respiratory and Critical Care Medicine, West China Hospital / West China School of Medicine, Sichuan University, Chengdu, Sichuan 610041, P. R. China;

Corresponding author：

LI Weimin, Email: weimin003@163.com

Keywords：

Lung cancer; Fasting blood glucose concentration; Prognosis

DOI：

10.7507/1002-0179.201901128

Video：

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Objective To explore the prognostic value of fasting blood glucose concentration in patients with newly diagnosed lung cancer.Methods The clinical data of 956 patients with lung cancer who were first diagnosed at West China Hospital of Sichuan University between January 2008 and December 2011 were retrospectively analyzed. The patients were followed up for more than 5 years. Using the fasting blood glucose concentration of 6.1 mmol/L as the cut-off value, the patients were divided into the hyperglycemia group and the control group. Kaplan-Meier method was used for survival analysis, and log-rank test was used to analyze the survival of different groups. Univariate and multivariate Cox proportional hazard models were used to evaluate the prognostic variables.Results There were 166 patients in the hyperglycemia group with a 5-year overall survival rate of 23.5%, and 790 patients in the control group with a 5-year survival rate of 30.8%, and the difference between the two groups was statistically significant (P=0.008). Univariate Cox proportional hazard analysis found that blood glucose concentration, gender, age, smoking history, staging, and whether surgery were factors that affected the 5-year survival rate of patients (P<0.05); multivariate Cox proportional hazard analysis showed that blood glucose concentration [hazard ratio (HR)=1.235, 95% confidence interval (CI) (1.013, 1.504), P=0.036], age [HR=1.305, 95%CI (1.110, 1.534), P=0.001], smoking history [HR=1.210, 95%CI (1.033, 1.418), P=0.018], staging [HR=1.546, 95%CI (1.172, 2.040), P=0.002], and whether surgical treatment [HR=0.330, 95%CI (0.257, 0.424), P<0.001] were independent factors which influenced 5-year survival rate. Blood glucose concentration, age, smoking history, and staging were independent risk factors.Conclusion Fasting blood glucose concentration is able to be a prognostic factor for patients with newly diagnosed lung cancer.

Citation： WANG Weiwen, DAI Sisi, LI Lei, LI Weimin. Prognostic value of fasting glucose concentration in patients with newly diagnosed lung cancer. West China Medical Journal, 2019, 34(4): 375-378. doi: 10.7507/1002-0179.201901128 Copy

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14.	Ding CZ, Guo XF, Wang GL, et al. High glucose contributes to the proliferation and migration of non-small cell lung cancer cells via GAS5-TRIB3 axis. Biosci Rep, 2018, 38(2): BSR20171014.
15.	于露, 梁良. 高血糖对肺癌患者肺功能的影响. 现代医药卫生, 2018, 34(11): 1699-1700.
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1. Bray F, Ferlay J, Soerjomataram I, et al. Global cancer statistics 2018: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin, 2018, 68(6): 394-424.
2. Allemani C, Matsuda T, Di Carlo V, et al. Global surveillance of trends in cancer survival 2000-14(CONCORD-3): analysis of individual records for 37513025 patients diagnosed with one of 18 cancers from 322 population-based registries in 71 countries. Lancet, 2018, 391(1125): 1023-1075.
3. Chen W, Zheng R, Baade PD, et al. Cancer statistics in China, 2015. CA Cancer J Clin, 2016, 66(2): 115-132.
4. Luo JH, Chen YJ, Chang LJ. Fasting blood glucose level and prognosis in non-small cell lung cancer (NSCLC) patients. Lung Cancer, 2012, 76(2): 242-247.
5. Farrokhi F, Smiley D, Umpierrez GE. Glycemic control in non-diabetic critically ill patients. Best Pract Res Clin Endocrinol Metab, 2011, 25(5): 813-824.
6. Gao Y, Gao F, Ma JL, et al. Analysis of the characteristics and prognosis of advanced non-small-cell lung cancer in older patients. Patient Prefer Adherence, 2015, 9: 1189-1194.
7. Detterbeck FC, Boffa DJ, Kim AW. The eighth edition lung cancer stage classification. Chest, 2017, 151(1): 193-203.
8. Travis WD, Brambilla E, Burke AP, et al. WHO Classification of tumours of the lung, pleura, thymus and heart. 4th ed. Lyon: International Agency for Research on Cancer, 2015: 9-96.
9. Alberti KG, Zimmet PZ. Definition, diagnosis and classification of diabetes mellitus and its complications. Part 1: diagnosis and classification of diabetes mellitus provisional report of a WHO consultation. Diabet Med, 1998, 15(7): 539-553.
10. Parés-Badell O, Banqué M, Macià F, et al. Impact of comorbidity on survival by tumour location: breast, colorectal and lung cancer (2000-2014). Cancer Epidemiol, 2017(49): 66-74.
11. Storey S, Von Ah D, Hammer MJ. Measurement of hyperglycemia and impact on health outcomes in people with cancer: challenges and opportunities. Oncol Nurs Forum, 2017, 44(4): E141-E151.
12. Vander Heiden MG, Cantley LC, Thompson CB. Understanding the Warburg effect: the metabolic requirements of cell proliferation. Science, 2009, 324(5930): 1029-1033.
13. Han L, Ma Q, Li J, et al. High glucose promotes pancreatic cancer cell proliferation via the induction of EGF expression and transactivation of EGFR. PLoS One, 2011, 6(11): e27074.
14. Ding CZ, Guo XF, Wang GL, et al. High glucose contributes to the proliferation and migration of non-small cell lung cancer cells via GAS5-TRIB3 axis. Biosci Rep, 2018, 38(2): BSR20171014.
15. 于露, 梁良. 高血糖对肺癌患者肺功能的影响. 现代医药卫生, 2018, 34(11): 1699-1700.
16. van de Poll-Franse DV, Houterman S, Janssen-Heijnen ML, et al. Less aggressive treatment and worse overall survival in cancer patients with diabetes: a large population based analysis. Int J Cancer, 2007, 120(9): 1986-1992.

West China Medical Journal

Prognostic value of fasting glucose concentration in patients with newly diagnosed lung cancer

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