Author(s)

Mohan Li ¹, Weilin Liu ²

Affiliation(s)

¹ Department of Internal Medicine, Peking Union Medical College Hospital, Beijing, China
² Department of Gastroenterology, The Third Xiangya Hospital, Central South University, Changsha, China

Corresponding Author

Weilin Liu

ABSTRACT

The correlation between serum bilirubin level and multiple respiratory system diseases including lung cancer has been reported. We aimed to explore the relationship between serum bilirubin level and the prevalence of lung cancer among smokers in China. Therefore, a retrospective case-control study and enrolled 266 lung cancer patients and 266 matched controls from The Third Xiangya Hospital of Central South University from February 2011 to May 2017 was designed. Data including diagnosis, serum bilirubin levels and smoking history were collected, which consistently showed significant differential in cases and controls. We found lower total and indirect bilirubin level is correlated with smoking but they can be recuperating after cessation. The average bilirubin level in lung cancer patients was lower than matched controls, while lower indirect bilirubin level within normal range is the risk factor of lung cancer in smokers (OR = 2.710). Of note, smokers whose serum indirect bilirubin lower than 7.88 μmol / L has a higher risk of lung cancer in Chinese adults. In conclusions, serum indirect bilirubin level would be a screening predictor to identify higher risk smokers of lung cancer.

KEYWORDS

Bilirubin level; Lung cancer; Smoking; Early cancer screening; Bio-marker

CITE THIS PAPER

Mohan Li, Weilin Liu, Relationship between Serum Bilirubin Level and the Prevalence of Lung Cancer in Smokers. Transactions on Cancer (2024) Vol. 5: 28-33. DOI: http://dx.doi.org/10.23977/tranc.2024.050104.

REFERENCES

[1] FITZMAURICE, C., ABATE, D., ABBASI, N., ABBASTABAR, H., ABD-ALLAH, F., ABDEL-RAHMAN, O., ABDELALIM, A., ABDOLI, A., ABDOLLAHPOUR, I., ABDULLE, A. S. M., ABEBE, N. D., ABRAHA, H. N., ABU-RADDAD, L. J., ABUALHASAN, A., ADEDEJI, I. A., ADVANI, S. M., AFARIDEH, M., AFSHARI, M., AGHAALI, M., … MURRAY, C. J. L. (2019). Global, Regional, and National Cancer Incidence, Mortality, Years of Life Lost, Years Lived With Disability, and Disability-Adjusted Life-Years for 29 Cancer Groups, 1990 to 2017: A Systematic Analysis for the Global Burden of Disease Study. JAMA oncology, 5(12), 1749–1768.
[2] ZHENG R, ZENG H, ZHANG S, et al. National estimates of cancer prevalence in China, 2011 [J]. Cancer Lett, 2016, 370(1): 33–38.
[3] BODOR J N, BOUMBER Y, BORGHAEI H. Biomarkers for immune checkpoint inhibition in non-small cell lung cancer (NSCLC) [J]. Cancer, 2020, 126(2): 260-270.
[4] RAHIMI JAMNANI F. The state of the art in the development of a panel of biomarkers for the early detection of lung cancer [J]. J Thorac Dis, 2018, 10(2): 625-627.
[5] CHEN W, ZHENG R, ZENG H, et al. The incidence and mortality of major cancers in China, 2012 [J]. Chin J Cancer, 2016, 35(1): 73.
[6] FERLAY J, SOERJOMATARAM I, DIKSHIT R, et al. Cancer incidence and mortality worldwide: sources, methods and major patterns in GLOBOCAN 2012 [J]. Int J Cancer, 2015, 136(5): E359-386.
[7] MUSCARI A, COLLINI A, FABBRI E, et al. Changes of liver enzymes and bilirubin during ischemic stroke: mechanisms and possible significance [J]. BMC Neurol, 2014, 14: 122.
[8] ZHONG P, WU D, YE X, et al. Association of circulating total bilirubin level with ischemic stroke: a systemic review and meta-analysis of observational evidence [J]. Ann Transl Med, 2019, 7(14): 335.
[9] COLTELL O, ASENSIO E M, SORLI J V, et al. Genome-Wide Association Study (GWAS) on Bilirubin Concentrations in Subjects with Metabolic Syndrome: Sex-Specific GWAS Analysis and Gene-Diet Interactions in a Mediterranean Population [J]. Nutrients, 2019, 11(1).
[10] DO SAMEIRO-FARIA M, KOHLOVA M, RIBEIRO S, et al. Potential cardiovascular risk protection of bilirubin in end-stage renal disease patients under hemodialysis [J]. Biomed Res Int, 2014, 2014: 175286.
[11] WANG L, BAUTISTA L E. Serum bilirubin and the risk of hypertension [J]. Int J Epidemiol, 2015, 44(1): 142-152.
[12] GUNDAMARAJU R, VEMURI R, CHONG W C, et al. Bilirubin Attenuates ER Stress-Mediated Inflammation, Escalates Apoptosis and Reduces Proliferation in the LS174T Colonic Epithelial Cell Line [J]. Int J Med Sci, 2019, 16(1): 135-144.
[13] KUHN T, SOOKTHAI D, GRAF M E, et al. Albumin, bilirubin, uric acid and cancer risk: results from a prospective population-based study [J]. Br J Cancer, 2017, 117(10): 1572-1579.
[14] LIM J E, KIMM H, JEE S H. Combined effects of smoking and bilirubin levels on the risk of lung cancer in Korea: the severance cohort study [J]. PLoS One, 2014, 9(8): e103972.
[15] BACH P B, MIRKIN J N, OLIVER T K, et al. Benefits and harms of CT screening for lung cancer: a systematic review [J]. JAMA, 2012, 307(22): 2418-2429.
[16] KOVALCHIK S A, TAMMEMAGI M, BERG C D, et al. Targeting of low-dose CT screening according to the risk of lung-cancer death [J]. N Engl J Med, 2013, 369(3): 245-254.
[17] WEI J, ZHAO H, FAN G, et al. Bilirubin treatment suppresses pulmonary inflammation in a rat model of smoke-induced emphysema [J]. Biochem Biophys Res Commun, 2015, 465(2): 180-187.
[18] SONG Q, WANG B, WANG S, et al. Lower serum levels of bilirubin in the newly diagnosed lung cancer patients: A case-control study in China [J]. J Cancer Res Ther, 2015, 11 Suppl 2: C168-C172.
[19] HORSFALL L J, RAIT G, WALTERS K, et al. Serum bilirubin and risk of respiratory disease and death [J]. JAMA, 2011, 305(7): 691-697.
[20] FROST-PINEDA K, MUHAMMAD-KAH R, RIMMER L, et al. Predictors, indicators, and validated measures of dependence in menthol smokers [J]. J Addict Dis, 2014, 33(2): 94-113.
[21] O'MALLEY S S, WU R, MAYNE S T, et al. Smoking cessation is followed by increases in serum bilirubin, an endogenous antioxidant associated with lower risk of lung cancer and cardiovascular disease [J]. Nicotine Tob Res, 2014, 16(8): 1145-1149.
[22] WEN C P, ZHANG F, LIANG D, et al. The ability of bilirubin in identifying smokers with higher risk of lung cancer: a large cohort study in conjunction with global metabolomic profiling [J]. Clin Cancer Res, 2015, 21(1): 193-200.

Sponsors, Associates, and Links

---

• MEDS Clinical Medicine
  
  
• Journal of Neurobiology and Genetics
  
  
• Medical Imaging and Nuclear Medicine
  
  
• Bacterial Genetics and Ecology
  
  
• Journal of Biophysics and Ecology
  
  
• Journal of Animal Science and Veterinary
  
  
• Academic Journal of Biochemistry and Molecular Biology
  
  
• Transactions on Cell and Developmental Biology
  
  
• Rehabilitation Engineering & Assistive Technology
  
  
• Orthopaedics and Sports Medicine
  
  
• Hematology and Stem Cell
  
  
• Journal of Intelligent Informatics and Biomedical Engineering
  
  
• MEDS Basic Medicine
  
  
• MEDS Stomatology
  
  
• MEDS Public Health and Preventive Medicine
  
  
• MEDS Chinese Medicine
  
  
• Journal of Enzyme Engineering
  
  
• Advances in Industrial Pharmacy and Pharmaceutical Sciences
  
  
• Bacteriology and Microbiology
  
  
• Advances in Physiology and Pathophysiology
  
  
• Journal of Vision and Ophthalmology
  
  
• Frontiers of Obstetrics and Gynecology
  
  
• Digestive Disease and Diabetes
  
  
• Advances in Immunology and Vaccines
  
  
• Nanomedicine and Drug Delivery
  
  
• Cardiology and Vascular System
  
  
• Pediatrics and Child Health
  
  
• Journal of Reproductive Medicine and Contraception
  
  
• Journal of Respiratory and Lung Disease
  
  
• Journal of Bioinformatics and Biomedicine