Abstract
Background: Malignant Pleural Mesothelioma (MPM) is a very rare and aggressive form of cancer. Recently it was found that pretreatment Serum Albumin (SA), the main circulating protein in blood is a significant prognostic factor for MPM patients. The objective of this present article is to show the relationship between pretreatment Serum albumin (SA) levels with the risk of MPM. Methods: Generalized additive model (GAM), an advanced regression analysis method has been introduced here to find this mathematical relationship between the response variable (SA) and the cofactors. Results: The main determinates of SA are identified - asbestos exposure, hemoglobin, disease diagnosis status (patients having MPM) are the factors having significant association with SA, whereas duration of asbestos exposure, duration of disease symptoms, total protein (TP), Pleural lactic dehydrogenise (PLD), pleural protein (PP), pleural glucose (PG) and C-reactive protein (CRP) are the significant continuous variables for SA. The non-parametric estimation part of this model shows Lactate dehydrogenase (LDH) and Glucose level are the significant smoothing terms. Additionally it is also found that, second and third order interactions between cofactors are highly significant for SA. Conclusions: The findings of this present work can conclude that - serum albumin may play the role of a very significant prognostic factor for MPM disease and it has been established here through mathematical modeling. Few of the findings are already been exist in MPM research literature whereas some of the findings are completely new in the literature.
Highlights
Malignant pleural mesotheliomas (MPM) are very aggressive tumors, which is a disease originating from pleura, pericardium, peritoneum or tunica vaginalis and it is since the early 1960s recognized to be strongly related to asbestos exposure [1], it may be related to previous simian virus 40 (SV40) infection, radiation and quite possible for genetic predisposition [2, 3]
The Serum Albumin (SA) is positive valued, non- normally distributed, heterogeneous continuous variable. This response variable has been modeled through gamma distributed log linked generalized additive models
The best Generalized additive model (GAM) model is identified through the Generalized Cross Validation (GCV) value (Table 2) along with the model checking criteria (Figure 1 and 2)
Summary
Malignant pleural mesotheliomas (MPM) are very aggressive tumors, which is a disease originating from pleura, pericardium, peritoneum or tunica vaginalis and it is since the early 1960s recognized to be strongly related to asbestos exposure [1], it may be related to previous simian virus 40 (SV40) infection, radiation and quite possible for genetic predisposition [2, 3]. The incidence of malignant pleural mesothelioma (MPM) is extremely high in some Turkish villages where there is a low-level environmental exposure to erionite, is a naturally occurring fibrous mineral that belongs to a group of minerals called zeolites. MPM is a fatal cancer of increasing incidence associated with asbestos exposure [12]. Malignant Pleural Mesothelioma (MPM) is a very rare and aggressive form of cancer. It was found that pretreatment Serum Albumin (SA), the main circulating protein in blood is a significant prognostic factor for MPM patients. The objective of this present article is to show the relationship between pretreatment Serum albumin (SA) levels with the risk of MPM
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