Correlation Analysis Of Serum Albumin Level With Body Immune Status And Prognosis Of Patients With Non-small Cell Lung Cancer

Background and objective: Serum albumin(ALB)as most commonly biomarker for nutritional status is often closely associated with the prognosis of patients with non-small cell lung carcinoma(NSCLC).Whether the cause is related to the effects on host immune status,especially for distribution of immune cells,remains unknown.The purpose of this study was to determine whether the effect of albumin on the prognosis of NSCLC is related to the immune status of the body by analyzing the factors that affect the prognosis of NSCLC and the correlation between immune status and albumin.Methods: The clinical data of 211 patients with NSCLC diagnosed in the First Hospital of Jilin University between February 2009 and March 2017 were retrospectively analyzed.All the enrolled patients were pathologically diagnosed with NSCLC.Records in patients with clinical features include age,sex,smoking,with or without hydrothorax,ALB,CRP,TG,CHO,HDL,LDL and Glu test indicators before treatment,therapeutic options(surgery,chemotherapy,radiation,and MAR);Patients were followed up and progression free survival(PFS)and OS were recorded monthly.SPSS 17.0 software was used for statistical calculation,ROC curve analysis was used to determine the cut-off value of continuous variable,and Kaplan-Meier method was used to conduct single-factor survival analysis and draw the survival curve to determine the factors influencing the prognosis.Multivariate analysis was performed by COX regression,and independent prognostic factors affecting PFS or OS were determined.P<0.05 was considered statistically significant.Research results: 1.The ROC curve was drawn from the serum ALB index of the patient before treatment,The critical point for predicting the prognosis of NSCLC patients was taken as ALB=41.75 g/ L.2.In total 211 enrolled NSCLC patients,ALB became an independent prognostic factor through multivariate Cox regression analysis(P=0.037).The median OS in patients with low ALB(n=155)vs.high ALB(n=56)were 28.2 vs.42.2 months(P=0.0142),respectively.3.Among patients with non-metastasis NSCLC(stage I-III),there was a higher incidence rates of distant metastasis in low ALB group than that in high ALB group(41.3% and 22.2%;P=0.043),in addition to a strong association with higher risk of death(P<0.01)and disease progression(P<0.0001).4.High ALB was closely correlated with more PBL cholesterol(r=0.4189,P<0.0001),triglyceride(r=0.2302,P=0.0008)and low-density lipoprotein(r=0.3543,P< 0.0001)? CD8~+ cytotoxic T cells(P=0.007)and around the tumor(P=0.047)but not infiltrated in tumor.5.High ALB also associated with more diversity of TCR repertoire(P=0.023).Conclusions: 1.Decreased serum ALB level is an independent risk factor for death in patients with NSCLC.2.Increased serum ALB level reduced the risk of distant metastases and improved the survival in NSCLC patients.3.Serum ALB concentration is related to the distribution of CD8 + T cells and TCR diversity.