Alpha1-antitrypsin deficiency carriers, serum alpha 1-antitrypsin concentration, and non-small cell lung cancer survival

Yan Li, Michael Joseph Krowka, Yingwei Qi, Jerry A. Katzmann, Yong Song, Yafei Li, Sumithra J Mandrekar, Ping Yang

Research output: Contribution to journalArticle

15 Citations (Scopus)

Abstract

Although the association between alpha 1-antitrypsin deficiency (α1ATD) carriers and lung cancer risk has been found, the effects of α1ATD carriers and serum alpha 1-antitrypsin (α1AT) concentration on non-small cell lung cancer (NSCLC) survival remained unclear. Methods: Patients were selected from the Epidemiology and Genetics of Lung Cancer Study at Mayo Clinic with the criteria of (1) primary NSCLC diagnosis and (2) available α1ATD carrier status tested by isoelectric focusing serum α1AT concentration by immunonephelometry. The effects of carrier status and serum α 1AT concentration on survival were evaluated by Cox proportional hazards models with (1) a landmark approach, where overall survival was defined from the time of blood draw to death from any cause and (2) included only patients with blood draw time before initial treatment. Results: One thousand three hundred twenty-one patients were included in this study, with 179 α1ATD carriers and 1142 noncarriers. No differences in overall survival by α1ATD carrier status were found (adjusted hazard ratio [AHR]: 0.98; 95% confidence interval [CI]: 0.82-1.18). Nevertheless, serum α1AT concentration was significantly associated with survival among all patients in the landmark model (AHR per 50 mg/dl increments: 1.15; 95% CI: 1.10-1.20) and among patients whose blood was drawn for serum α1AT level assessment before any treatment (AHR per 50 mg/dl increments: 1.44; 95% CI: 1.21-1.71). Conclusions: Being an α 1ATD carrier had no significant effect on NSCLC survival. The increased serum α1AT concentration was a poor prognosis marker for NSCLC, regardless of carrier status.

Original languageEnglish (US)
Pages (from-to)291-295
Number of pages5
JournalJournal of Thoracic Oncology
Volume6
Issue number2
DOIs
StatePublished - Feb 2011

Fingerprint

alpha 1-Antitrypsin
Non-Small Cell Lung Carcinoma
Survival
Serum
Confidence Intervals
Proportional Hazards Models
Lung Neoplasms
alpha 1-Antitrypsin Deficiency
Molecular Epidemiology
Isoelectric Focusing
Cause of Death
Therapeutics

Keywords

  • Alpha 1-antitrypsin
  • Alpha 1-antitrypsin deficiency
  • Non-small cell lung cancer
  • Survival

ASJC Scopus subject areas

  • Oncology
  • Pulmonary and Respiratory Medicine

Cite this

Alpha1-antitrypsin deficiency carriers, serum alpha 1-antitrypsin concentration, and non-small cell lung cancer survival. / Li, Yan; Krowka, Michael Joseph; Qi, Yingwei; Katzmann, Jerry A.; Song, Yong; Li, Yafei; Mandrekar, Sumithra J; Yang, Ping.

In: Journal of Thoracic Oncology, Vol. 6, No. 2, 02.2011, p. 291-295.

Research output: Contribution to journalArticle

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abstract = "Although the association between alpha 1-antitrypsin deficiency (α1ATD) carriers and lung cancer risk has been found, the effects of α1ATD carriers and serum alpha 1-antitrypsin (α1AT) concentration on non-small cell lung cancer (NSCLC) survival remained unclear. Methods: Patients were selected from the Epidemiology and Genetics of Lung Cancer Study at Mayo Clinic with the criteria of (1) primary NSCLC diagnosis and (2) available α1ATD carrier status tested by isoelectric focusing serum α1AT concentration by immunonephelometry. The effects of carrier status and serum α 1AT concentration on survival were evaluated by Cox proportional hazards models with (1) a landmark approach, where overall survival was defined from the time of blood draw to death from any cause and (2) included only patients with blood draw time before initial treatment. Results: One thousand three hundred twenty-one patients were included in this study, with 179 α1ATD carriers and 1142 noncarriers. No differences in overall survival by α1ATD carrier status were found (adjusted hazard ratio [AHR]: 0.98; 95{\%} confidence interval [CI]: 0.82-1.18). Nevertheless, serum α1AT concentration was significantly associated with survival among all patients in the landmark model (AHR per 50 mg/dl increments: 1.15; 95{\%} CI: 1.10-1.20) and among patients whose blood was drawn for serum α1AT level assessment before any treatment (AHR per 50 mg/dl increments: 1.44; 95{\%} CI: 1.21-1.71). Conclusions: Being an α 1ATD carrier had no significant effect on NSCLC survival. The increased serum α1AT concentration was a poor prognosis marker for NSCLC, regardless of carrier status.",
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