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LUNG CANCER: Raghu S. Loganathan, Diane E. Stover, Weiji Shi, and Ennapadam Venkatraman Prevalence of COPD in Women Compared to Men Around the Time of Diagnosis of Primary Lung Cancer Chest 2006; 129: 1305-1312 [Abstract] [Full text] [PDF]

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Chronic obstructive pulmonary disease may adversely affect prognosis in lung cancer

Murat Dincer, Kadri Altundag   (16 May 2006)

Chronic obstructive pulmonary disease may adversely affect prognosis in lung cancer 16 May 2006
Murat Dincer, MD Hacettepe University Institute of Oncology, Kadri Altundag Send letter to journal: Re: Chronic obstructive pulmonary disease may adversely affect prognosis in lung cancer muratdincer{at}mynet.com Murat Dincer, et al.	To The Editor, We read with great interest the study by Loganathan et al [1]. In their study they found that prevalence of chronic obstructive pulmonary disease (COPD) in women is lower compared to men around the time of diagnosis of primary lung cancer. Some studies showed that women with lung cancer have a more favorable prognosis than in men, an effect probably more significant in stage I patients [2] [3]. COPD is known to be an inflammatory condition and neutrophil elastase has long been considered a significant mediator of the disease [4]. Tumor invasion, metastasis, and angiogenesis involve the disruption of anatomical barriers formed by basement membranes and the penetration of cells into normal adjacent tissues. These invasive processes require the concerted action of a number of proteolytic enzymes, including matrix metalloproteinases (MMPs). MMP-2 (gelatinase A), is secreted as an inactive zymogen (proMMP-2) and activated by proteolytic cleavage. It has been reported that polymorphonuclear neutrophil-derived elastase activate proMMP-2 [5] Moreover severity of COPD was found to be correlated a reduction in histone deacetylase activity (HDAC) in lung tissue and alveolar macrophages. A key enzymatic function of HDAC is the inhibition or modulation of production of proinflammatory cytokines and MMPs by macrophages [6]. Taken all together existence of COPD around the time of diagnosis of primary lung cancer may increase invasiveness and metastatic capacity of cancer cells through the mechanisms of increased elastase activity and reduced HDAC levels. Less favorable prognosis of lung cancer in men compared to women may be partly explained by these mechanisms. References 1. Loganathan RS, Stover DE, Shi W, Venkatraman E: Prevalence of COPD in Women Compared to Men Around the Time of Diagnosis of Primary Lung Cancer. Chest 2006, 129(5):1305-1312. 2. Chatkin JM, Abreu CM, Fritscher CC, Wagner MB, Pinto JA: Is there a gender difference in non-small cell lung cancer survival? Gend Med 2004, 1(1):41-47. 3. Visbal AL, Williams BA, Nichols FC, 3rd, Marks RS, Jett JR, Aubry MC, Edell ES, Wampfler JA, Molina JR, Yang P: Gender differences in non-small- cell lung cancer survival: an analysis of 4,618 patients diagnosed between 1997 and 2002. Ann Thorac Surg 2004, 78(1):209-215; discussion 215. 4. Sevenoaks MJ, Stockley RA: Chronic Obstructive Pulmonary Disease, inflammation and co-morbidity - a common inflammatory phenotype? Respir Res 2006, 7(1):70. 5. Shamamian P, Schwartz JD, Pocock BJ, Monea S, Whiting D, Marcus SG, Mignatti P: Activation of progelatinase A (MMP-2) by neutrophil elastase, cathepsin G, and proteinase-3: a role for inflammatory cells in tumor invasion and angiogenesis. J Cell Physiol 2001, 189(2):197-206. 6. Schottenfeld D, Beebe-Dimmer J: Chronic inflammation: a common and important factor in the pathogenesis of neoplasia. CA Cancer J Clin 2006, 56(2):69-83.