Hemoglobin levels as a component of the paraneoplastic syndrome in lung cancer

Recently, some studies indicate that paraneoplastic syndrome may be the first sign of lung cancer and may serve in early detection of cancer. Namely, during the last ten years, an increasing importance is given to hematological paraneoplastic syndrome of lung cancer. The aim of this study was to evaluate whether hemoglobin levels have paraneoplastic nature in patients diagnosed with lung cancer prior to any form of therapy, and to examine its relationships with platelet count. The study included 239 patients with lung cancer who were hospitalized at the Clinic for Pulmonary Diseases, Clinical Center of Sarajevo, during the period from January 2005 to December 2008, and a control group of 60 healthy persons. The study did not include lung cancer patients with evident hemoptysis and patients who were under chemotherapy and/or were undergoing surgery. The results of our study have shown that the average hemoglobin for each histopathological type of lung cancer was significantly lower than the average hemoglobin in control group, except for large cell carcinoma. Lung cancers are classified according to the TNM classification. There were no significant differences in average hemoglobin between different stage of non small cell lung carcinoma as well as in average hemoglobin between limited and extended stage of small cell lung carcinoma. Our results also showed that there was a significant negative correlation between platelet count and hemoglobin levels. On the basis of our results we concluded that low hemoglobin in patients with lung cancer, with no evident hemoptysis, may have the character of paraneoplastic syndrome.