Journal of Clinical Pathology 2007;60:705-708
ORIGINAL ARTICLE
The relationship between an inflammation-based prognostic score (Glasgow Prognostic Score) and changes in serum biochemical variables in patients with advanced lung and gastrointestinal cancer
1 St Columba’s Hospice, Edinburgh, UK
2 Department of Respiratory Medicine, Stobhill Hospital, Glasgow, UK
3 SUERC, East Kilbride, Glasgow
4 University Department of Surgery, Royal Infirmary, Glasgow
Correspondence to:
Correspondence to:
D J F Brown
St Columba’s Hospice, 15 Boswall Road, Edinburgh EH5 3RW, UK; dbrown{at}stcolumbashospice.org.uk
Background: The Glasgow Prognostic Score (GPS), an inflammation-based prognostic score formed from standard thresholds of C reactive protein (CRP) and albumin, has prognostic value in patients with advanced cancer. Little is known about the general biochemical disturbance associated with the systemic inflammatory response in cancer.
Aim: To examine the relationship between the GPS and blood biochemistry in patients with advanced lung and gastrointestinal cancer.
Methods: The GPS (albumin <35 g/l = 1 and CRP >10 mg/l = 1 combined to form a prognostic score of 0 (normal) and 1 or 2 (abnormal)) and a variety of biochemical variables were examined in patients (n = 50) with advanced lung or gastrointestinal cancer and in a healthy control group (n = 13).
Results: The GPS was normal in all the controls, but abnormal in 78% of the cancer group. Serum levels of sodium, chloride, creatine kinase, zinc and vitamin D were lower in the cancer group (all p<0.01), whereas levels of calcium, copper (both p<0.05), alkaline phosphatase, 
-glutamyl transferase (both p<0.001) and lactate dehydrogenase (p<0.10) were raised. In the patient group, with increasing GPS, there was a median reduction in Karnofsky Performance Status (25%), haemoglobin (22%), sodium (3%), zinc (15%) and survival (93%, all p<0.05) and a median increase in white cell count (129%), alkaline phosphatase (217%), -glutamyl transferase (371%) and lactate dehydrogenase (130%, all p<0.05). CRP levels were strongly and similarly correlated with alkaline phosphatase and -glutamyl transferase, accounting for more than 25% of the variation in their activities.
Conclusion: Several correlations were seen between biochemical variables and increasing GPS. In particular, chronic activation of the systemic inflammatory response in cancer was associated with increase in -glutamyl transferase and alkaline phosphatase activity in patients with advanced lung and gastrointestinal cancer.
Abbreviations: CRP, C reactive protein; GPS, Glasgow Prognostic Score; KPS, Karnofsky Performance Status
CiteULike 
Complore 
Connotea 
Del.icio.us 
Digg 
Reddit 
Technorati What's this?
- Full Text
- Full Text (PDF)
-
All Versions of this Article:
jcp.2005.033217v1
60/6/705 most recent - Submit a response
- Alert me when this article is cited
- Alert me when eLetters are posted
- Alert me if a correction is posted
Services
- Email this link to a friend
- Similar articles in this journal
- Similar articles in PubMed
- Add article to my folders
- Download to citation manager
- Request Permissions
Citing Articles
Google Scholar
PubMed
Topic Collections
Bookmark with
Register for free content
The full back archive is now available for all BMJ Journals. Institutional subscribers may access the entire archive as part of their subscription. Personal subscribers will also have access to all content when logged in. Non-subscribers who register have free access to all articles published before 2006 right back to volume 1 issue 1. Register here to access the free archive of all BMJ Journals.
Don't forget to sign up for content alerts so you keep up to date with all the articles as they are published.
