The value of soluble selectin levels in the management of lung cancer patients

Increased expression of selectins has been found on endothelial cells of venules and capillaries in the tumor stroma of human neoplasms. E-selectin is also thought to participate in angiogenesis, based on the observation that its levels correlate with angiogenesis in hemangiomas. This suggests that the elevated levels of sE-selectin found in advanced stages of some human cancer may reflect adhesion processes of circulating tumor cells and/or neovascularization. Thus, this study was aimed to analyze the behavior of plasma soluble (s)E-selectin and sP-selectin levels in 154 patients with either benign (38) or malignant (116) lung diseases and 59 healthy donors. The association with CEA levels and clinicopathological variables was also analyzed. The results obtained showed that sP- (F=4.3, p<0.02), sE-selectin (F=6.0, p<0.005) and CEA (F=11.9, p<0.001) levels were higher in patients with lung cancer. CEA levels correlated with sP- (r=0.25, p<0.01), but not sE-selectin levels, in the overall population. Increased levels of sP-selectin, sE-selectin and CEA were significantly associated with advanced squamous lung cancer (p<0.05), but not adenocarcinoma. To further analyze the relationship among these variables, a multiple regression analysis including age, sex, CEA, sP- and sE-selectin levels was also carried out. The final model obtained by stepwise regression analysis revealed that elevated CEA [beta=0.41, p<0.001], sE-selectin [beta 0.34, p<0.01], sPselectin [beta=0.24, p<0.05] levels, and male gender [beta=0.26, p<0.03] were independently related to the stage of squamous lung cancer, whereas only elevated sE-selectin levels were independently related to the presence of distant metastasis [beta=0.35, p<0.01) in the same histotype. These results suggest that measurement of plasma soluble selectins might represent an useful laboratory parameter in the management of patients with squamous lung cancer.