Abstract
BackgroundSerum cholinesterase (ChE) was found to be involved in cancer initiation and progression. However, the survival association between serum ChE and non-small cell lung cancer (NSCLC) has not been extensively discussed. In the present study, we aim to elevate the role of ChE in overall survival (OS) of NSCLC patients.MethodsA total of 961 histologically confirmed NSCLC patients diagnosed between 2013 and 2018 in a provincial cancer hospital in southwestern China were retrospectively selected. Relevant information, such as histological type, clinical stage, chemotherapy, smoking status, body mass index (BMI), important serum indicators (albumin, neutrophil-to-lymphocyte ratio, ChE), date of death of the patients was extracted from the computerized hospital information system. Univariate and multivariate Cox proportional hazards models were used to determine the association between baseline serum ChE measured at the diagnosis and the OS of NSCLC patients.ResultsThe median of baseline ChE (7700 units/liter) was used as a cut-off to dichotomize NSCLC patients. After controlling for possible confounding factors, serum ChE at diagnosis was significantly associated with OS of NSCLC: patients with higher level of ChE were observed a better prognosis (hazard ratio, HR: 0.77, 95% CI: 0.67–0.93, p = 0.006). Subgroup analysis revealed significant ChE-OS association for NSCLC patients: with lower systemic inflammation level (baseline NLR < 2.95, HR: 0.71, 95% CI: 0.56–0.89, p = 0.003), of adenocarcinoma (HR: 0.66, 95% CI: 0.54–0.80, p < 0.001), in advanced stage (HR: 0.77, 95% CI: 0.66–0.92, p < 0.01), and received chemotherapy (HR: 0.75, 95% CI: 0.59–0.96, p < 0.02).ConclusionBaseline ChE may have independent prognostic value for NSCLC patients. Longitudinal studies should be performed to corroborate this finding.
Highlights
Serum cholinesterase (ChE) was found to be involved in cancer initiation and progression
General characteristics of the study subjects were described in Table 1: the mean diagnosis age was 61.15 years; the majority of the patients were males (64.60%); more than half of the patients reported smoking history (60.00%); adenocarcinoma and squamous cell carcinoma combined accounted for 95.6% of all the patients
By taking group 1 as the reference group, after adjusted for potential covariates identified in the previous univariate models, we found that the adjusted hazard ratio (HR) for group 2 to group 4 were 0.63, 0.64 and 0.55, respectively (Fig. 2)
Summary
Serum cholinesterase (ChE) was found to be involved in cancer initiation and progression. The survival association between serum ChE and non-small cell lung cancer (NSCLC) has not been extensively discussed. The 5-year cumulative survival rate for all types of lung cancer is around 20%, and only 5% for distant-stage disease [2,3,4,5]. Under this circumstance, exploring potential prognostic factors is imperative for lung cancer patients, for non-small-cell lung cancer (NSCLC), a predominant histological type that accounts for over 80% of lung cancer patients, and generally observed better prognosis than small-cell lung cancer (SCLC) [6, 7]. For NSCLC patients, heterogeneity in prognosis was associated with a variety of factors, such as tumor size, clinical stage of the disease, presence of pulmonary or constitutional symptoms, continued smoking, etc. [7, 8]
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
