Retinol and retinol-binding protein in lung cancer screening.
Human epidemiology studies demonstrate an inverse correlation between serum levels of vitamin A and the incidence of lung cancer. While such studies suggest that vitamin A may have a role in cancer prevention, the intent of this study was to investigate the use of vitamin A status parameters as markers for detection of occult lung cancer. In the first of two phases of this study, we established criteria for a prospective screening study. Serum levels of retinol-binding protein (RBP), zinc, retinol, and beta-carotene in lung cancer patients were compared to levels in controls. For the second phase, a prospective screening study, 100 ambulatory male cigarette smokers over the age of 45 were enrolled. Subjects were excluded if they had a known diagnosis of cancer, recent weight loss, or serum albumin less than 3.5 g/dl. Subjects with RBP less than 4.2 mg/dl and retinol less than 42 micrograms/dl were classified as high-risk; those remaining were classified as controls. A chest X-ray (CXR) was obtained on all 17 high-risk subjects and on 26 of the 83 controls. CXR was read and follow-up was performed by physicians without knowledge of this study. Lung cancer was detected in 24% (4/17) of the high-risk subset, and 4% (1/26) of the controls. These data suggest that retinol and RBP may be useful in lung cancer screening for selecting a high-risk population that warrants further examination.
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Department of Medicine, Harry S. Truman Memorial Veterans Hospital, Columbia, MO 65201.
McDonald
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D014408:Biomarkers, Tumor / Q000097:blood*; D002338:Carotenoids / Q000097:blood; D006801:Humans; D015994:Incidence; D008175:Lung Neoplasms / Q000097:blood / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000517:prevention & control*; D008297:Male; D008403:Mass Screening; D008875:Middle Aged; D011237:Predictive Value of Tests; D011446:Prospective Studies; D011859:Radiography; D012177:Retinol-Binding Proteins / Q000032:analysis*; D012307:Risk Factors; D012907:Smoking; D014801:Vitamin A / Q000097:blood*; D015032:Zinc / Q000097:blood
D014408:Biomarkers, Tumor; D012177:Retinol-Binding Proteins; D014801:Vitamin A; D002338:Carotenoids; D015032:Zinc