title: High N-terminal pro-B-type natriuretic peptide: a biomarker of lung cancer?
abstract: BACKGROUND
  The level of N-terminal pro-B-type natriuretic peptide (NT-proBNP) is affected by many known factors. Our study aimed to evaluate whether other factors, in particular lung cancer, could be responsible for an increase in NT-proBNP levels in a population with no known risk factors for elevated NT-proBNP.
  
  
  METHODS
  This study was based on the RIABO (Recueil de l'Ischémie au Bloc Opératoire) database, a single-center registry that prospectively records in elective noncardiac surgery. Patients aged > 75 years and those presenting with 1 or more known risk factors for high NT-proBNP were excluded. Patients were divided into 2 groups according to preoperative NT-proBNP levels: (≥ 125 pg/mL or < 125 pg/mL).
  
  
  RESULTS
  Between October 2005 and February 2007, 439 patients were eligible for inclusion. Among 35 patients with lung cancer, 26 (74%) had elevated NT-proBNP (≥ 125 pg/mL), versus 9 (26%) with NT-proBNP < 125 pg/mL (P < .0001). By multivariate analysis, the presence of lung cancer was an independent risk factor for a level of NT-proBNP ≥ 125 pg/mL (odds ratio, 7; 95% CI, 2.9-17; P < .0001). We also observed an independent relationship between NT-proBNP ≥ 125 pg/mL and age, female sex, smoking status, and C-reactive protein levels.
  
  
  CONCLUSIONS
  In our study, patients with lung cancer were 7 times more likely to have elevated NT-proBNP (≥ 125 pg/mL). The presence of lung cancer should therefore be taken into account when interpreting NT-proBNP levels. Further studies are warranted to explore the diagnostic value of this marker in lung cancer and to identify the cause of the elevation.
authors.affiliation: Département d'Anesthésie Réanimation, Bocage University Hospital, Dijon, France. naujollet@yahoo.fr
authors.forename: Nathalie
authors.initials: N
authors.lastname: Aujollet
authors.forename: Marjorie
authors.initials: M
authors.lastname: Meyer
authors.forename: Romain
authors.initials: R
authors.lastname: Cailliod
authors.forename: Fanny
authors.initials: F
authors.lastname: Combier
authors.forename: Yann
authors.initials: Y
authors.lastname: Coignet
authors.forename: Sebastien
authors.initials: S
authors.lastname: Campard
authors.forename: Olivier
authors.initials: O
authors.lastname: Facy
authors.forename: Alain
authors.initials: A
authors.lastname: Bernard
authors.forename: Claude
authors.initials: C
authors.lastname: Girard
mesh_terms: D000368:Aged; D015415:Biomarkers / Q000378:metabolism*; D002097:C-Reactive Protein / Q000378:metabolism; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000378:metabolism*; D008297:Male; D008875:Middle Aged; D020097:Natriuretic Peptide, Brain / Q000378:metabolism*; D010446:Peptide Fragments / Q000378:metabolism*; D012372:ROC Curve; D012044:Regression Analysis; D012307:Risk Factors
chemical_list: D015415:Biomarkers; D010446:Peptide Fragments; C109794:pro-brain natriuretic peptide (1-76); D020097:Natriuretic Peptide, Brain; D002097:C-Reactive Protein