Poor efficacy of the phosphorylated high-molecular-weight neurofilament heavy subunit serum level, a biomarker of axonal damage, as a marker of chemotherapy-induced peripheral neuropathy.
The phosphorylated form of the high-molecular-weight neurofilament heavy subunit (pNF-H) is a major structural protein in axons. The pNF-H level is elevated in the serum of certain patients with central nervous disorders, including chemotherapy-induced cognitive impairment. The present study was conducted to elucidate the potential role of pNF-H as a marker of chemotherapy-induced peripheral neuropathy (CIPN). A total of 71 patients with early breast cancer in various stages of treatment (following 1, 3 or 7 cycles of chemotherapy, or a previous history of breast cancer chemotherapy) were assessed with a self-administered PainDETECT questionnaire [pain location, pain intensity on an 11-point numeric rating scale (NRS), and various pain qualities] and a single serum pNF-H measurement. Patients were divided into two groups based on the presence or absence of bilateral symmetric pain in the distal portions of the extremities [CIPN(+) or CIPN(-)]. The χ2and Mann-Whitney tests were used for statistical analyses. Among the participants, only 8 patients complained of CIPN. Their pain intensity was 3.5±1.9 (mean ± standard deviation) compared with 1.5±1.8 in the CIPN(-) group (P<0.01). The NRS of numbness in the CIPN(+) group was significantly higher (2.4±1.4) than that of the CIPN(-) group (1.0±1.0). Increased pNF-H levels were observed in 37.5% of the CIPN(+) patients and in 23.8% of CIPN(-) patients (P=0.40). In conclusion, CIPN is observed in the most distal portions of the peripheral nerves that are composed of dendrites but not axons. Although serum pNF-H is a biomarker of axonal damage, it is not useful as a marker of CIPN.
Department of Pain and Palliative Medicine, The University of Tokyo Hospital, Tokyo 113-0033, Japan.
Masahiko
M
Sumitani
Department of Rehabilitation for the Movement Functions, Research Institute, National Rehabilitation Center for Persons with Disabilities, Tokorozawa, Saitama 359-8555, Japan.
Toru
T
Ogata
The Oncology and Breast Centers, St. Luke's International Hospital, Tokyo 104-8560, Japan.
Akina
A
Natori
Department of Pain and Palliative Medicine, The University of Tokyo Hospital, Tokyo 113-0033, Japan.
Jun
J
Hozumi
Department of Critical Care Medicine, Tsukuba University Hospital, Tsukuba, Ibaraki 305-8576, Japan.
Nobutake
N
Shimojo
The Oncology and Breast Centers, St. Luke's International Hospital, Tokyo 104-8560, Japan.
Kumiko
K
Kida
The Oncology and Breast Centers, St. Luke's International Hospital, Tokyo 104-8560, Japan.
Hideko
H
Yamauchi
The Oncology and Breast Centers, St. Luke's International Hospital, Tokyo 104-8560, Japan.
Teruo
T
Yamauchi
biomarker; chemotherapy; peripheral neuropathy; phosphorylated high-molecular-weight neurofilament heavy subunit