Integrated analysis of clinical, bioelectrical and functional variables in newly diagnosed lung cancer adult patients: Pilot study

doi:10.21203/rs.3.rs-1619753/v1

Background

Many variables have been studied in cancer patients. Nevertheless, an study that analyzes simultaneously physical, functional and biological variables in they from clinical, physical and statistical points of views is not reported in the literature. The aim of this study is to propose an integrated analysis of clinical, bioelectrical and functional variables in newly diagnosed lung cancer adult patients for the integral evaluation and possible prognostic of them.

Methods

This Pilot study was retrospective and cross-sectional and 23 patients aged 53–82 years participated in it. The electrical resistance and capacitive electrical reactance were measured with the Bodystat Quadscan^® 4000 analyzer. The electrical impedance modulus and the phase angle were calculated. The serum concentrations of epidermal growth factor, CYFRA21-1 and CA 72 − 4 were quantified. Correlations/associations among variables and the principal component analysis were suggested.

Results

The majority of patients had tumor markers, electrical resistance and the phase angle in their respective normal ranges. The capacitive electrical resistance was below its normal range. Minimum, low and moderate grades of linear correlation/association prevailed among studied variables. The principal components I and II were interpreted as prognosis and body energetic reserve of the patient, respectively.

Conclusions

It is concluded that the clinical, bioelectrical and functional variables allow the integral analysis and possible prognosis of newly diagnosed lung cancer adult patients. The decrease of the capacitive electrical reactance is the most influence to the loss of the body energetic reserve that leads to alterations of the overall health, tiredness and decrease of weight and body mass index of these patients.

Bioelectrical impedance analysis

Newly diagnosed lung cancer adult patients

Spearman's Rho correlation coefficient

Association coefficient of eta

Principal component analysis

Table 1 Characteristic variables in each newly diagnosed lung cancer adult patient

C	Variables
	Biologic of patients					Biologic of the lung cancer						Bioelectrics
	A	G	H	P_o	DP	d-ECOG-fs	LCHV	LCS	sEGF (pg/mL)	sCYFRA 21-1 (ng/mL)	sCA72-4 (U/mL)	R (W)	R/H (W/m)	Xc (W)	Xc/H (W/m)	q (^o)
1	57	M	1.74	76	2.7	1	SCLC	IV	293.78	1.03	2.00	403.0	231.61	48.9	28.10	6.7
2	73	M	1.63	70	11.1	2	EC	IIA	578.49	0.60	4.65	402.0	246.62	42.9	26.31	6.1
3	82	F	1.47	58	23.4	3	ADC	IV	789.15	3.68	8.20	610.0	414.96	44.3	30.13	4.2
4	69	M	1.59	57	-3.4	2	ADC	IV	1234.67	2.10	4.30	465.0	292.45	43.0	27.04	5.3
5	69	M	1.68	50	-26.5	3	ADC	IV	1009.34	6.20	5.98	478.0	284.52	21.7	12.91	3.6
6	58	M	1.63	61	-3.2	2	ADC	IIA	1238.24	0.98	3.56	523.0	320.85	56.6	34.72	6.2
7	71	M	1.70	73	4.3	1	ADC	IIA	187.45	2.37	4.99	404.0	237.64	51.4	30.23	6.6
8	53	M	1.68	56	-17.6	3	ADC	IV	970.06	11.76	28.34	561.0	333.92	65.9	39.22	6.7
9	71	F	1.67	78	16,4	2	ADC	IV	246.34	8.54	12.33	556.0	332.93	59.2	35.44	6.1
10	58	M	1.77	89	15,6	2	ADC	IIA	238.20	1.08	4.21	693.0	391.52	50.6	28.58	5.3
11	75	F	1.61	80	31.1	3	ADC	IV	303.67	6.45	8.43	571.0	354.65	49.4	30.68	6.7
12	79	M	1.79	87	10.1	2	nSCLC	IIIB	294.09	9.72	17.11	566.0	316.20	48.4	27.03	6.2
13	77	M	1.61	52	-14.8	3	EC	IV	667.32	5.49	7.81	514.0	318.01	44.3	27.51	6.3
14	74	M	1.63	58	-7.9	3	ADC	IIIB	1498.54	0.34	2.33	521.0	319.63	43.2	26.50	6.3
15	69	F	1.57	51	-10.5	3	CLC	IV	499.03	1.08	4.23	513.0	326.75	44.8	28.35	6.2
16	56	M	1.61	59	-3.3	1	ADC	IV	563.07	0.99	2.08	557.0	345.96	51.8	32.17	6.3
17	68	M	1.72	81	12.5	2	EC	IV	608.11	0.48	2.77	558.0	321.66	50.7	29.47	6.1
18	53	F	1.51	54	5.9	2	EC	IV	1201.18	5.60	5.16	611.0	399.42	45.4	29.67	5.3
19	77	F	1.54	42	-22.2	3	EC	IIIB	593.05	2.01	2.08	558.0	362.33	47.3	30.71	6.1
20	59	F	1.58	49	-15.5	3	ADC	IIIB	412.66	11.92	23.99	640.0	405.06	60.3	38.16	5.9
21	56	F	1.51	58	13.7	3	ADC	IV	1432.23	7.34	8.92	527.0	349.00	57.4	38.01	5.8
22	77	F	1.53	64	20.8	3	ADC	IV	289.09	0.87	2.34	572.0	373.85	50.9	33.36	6.2
23	58	M	1.69	83	20.3	3	EC	IV	674.08	0.69	3.09	568.0	336.09	52.3	30.94	6.4

C (code of the patient), A (age, in years), G (gender), M (male gender), F (female gender), H (height, in m), P_o (patient body weight, in kg), DP (relative change in unintentional body weight of each NDLCAPs, in %), d-ECOG-fs (degree of ECOG functional scale), ECOG (Eastern Cooperative Oncology Group), LCHV (lung cancer histological variety), LCS (lung cancer stage), SCLC (small cell lung cancer), nSCLC (non-small cell lung cancer), ADC (adenocarcinoma), EC (epidermoide carcinoma), CLC (carcinoma of large cells) and sEGF (serum Epidermal Growth Factor). sCYFRA 21-1 (serum CYFRA 21-1) and sCA72-4 (serum CA72-4) were tumor biomarkers. Code 1 (NPB), Code 2 (OMR), Code 3 (NHB), Code 4 (RSF), Code 5 (LGT), Code 6 (HMR), Code 7 (MBZ), Code 8 (ODR), Code 9 (OGC), Code 10 (JIRB), Code 11 (EGM), Code 12 (EPI), Code 13 (ITR), Code 14 (JRL), Code 15 (VTT), Code 16 (JCRO), Code 17 (RMP), Code 18 (ECP), Code 19 (EGC), Code 20 (NLB), Code 21 (OSP), Code 22 (CPI) and Code 23 (RGF).

Table 2 Mean ± standard error of the mean of sEGF, CYFRA21-1, and CA 72-4 tumor marker values for apparently healthy subjects and newly diagnosed lung cancer adult patient

Age groups (years)	Gender	N	Tumor biomarkers
Age groups (years)	Gender	N	sEGF (pg/mL)	sCYFRA 21-1 (ng/mL)	sCA 72-4 (U/mL)
46-60	M	6	653.91 ± 162.69 (998.40 ± 71.18; N₁ = 18)	2.76 ± 1.81	7.21 ± 4.25
	F	3	1 015.36 ± 309.01 (1 025.00 ± 47.63; N₁ = 19)	8.29 ± 2.54	12.69 ± 5.76
	M + F	9	779.39 ± 147,21 (1 012.00 ± 41.85; N₁ = 37)	4.60 ± 1,58	9.04 ± 1,11
61-80	M	8	759.75 ± 160.40 (899.00 ± 65.08; N₁ = 14)	3.41 ± 1.20	6.24 ± 1.67
	F	6	453.39 ± 86.89 (901.60 ± 80.86; N1 = 16)	3.77 ± 1.28	6.27 ± 1.66
	M + F	14	628.45 ± 104.63 (900.30 ± 51.86; N₁ = 30)	3.57± 0.84	6.25 ± 1.14
46-80	M	14	718.25 ± 110.66 (954.90 ± 49.18; N₁ = 32)	3.13 ± 0.99	6.66 ± 2.33
	F	9	640.71 ± 140.92 (968.80 ± 45.64; N₁ = 35)	5.28 ± 1.24	8.41 ± 2.25
	M + F	23	687.21 ± 85.31 (962.20 ± 33.22; N₁ = 67)	3.97± 0.79	7.34 ± 1.45

M (male gender), F (female gender), N (total number of newly diagnosed lung cancer adult patients), N₁ (total number of apparently healthy adult subjects), sEGF (serum Epidermal Growth Factor), sCYFRA 21-1 (serum CYFRA 21-1) and sCA72-4 (serum CA72-4). Averages ± standard errors of the mean of sEGF for apparently healthy adult subjects, by age group and gender, (between bracket) were reported in.¹⁴ Normal ranges of sCYFRA 21-1 (0,1 - 3,30 ng/mL) and sCA72-4 (0,1 - 6,90 U/mL) were reported in.²

Table 3 Mean ± standard deviation (standard error of the mean) of R/H, Xc/H and q (newly diagnosed lung cancer adult patients) and (R/H)_r, (Xc/H)_r and q_r (apparently healthy subjects), by age group and gender

Age groups

(years)

Adult subjects

Gender

Apparently healthy

(N_T1 = 2 964)

Newly diagnosed lung cancer patients

(N_T = 23)

N₁

(R/H)_r

(W/m)

(Xc/H)_r

(W/m)

q_r

(^o)

N

R/H

(W/m)

Xc/H

(W/m)

q

(^o)

17-59

M

1 263

292.3±45.8

(1.3)

33,8±3,6

(0.1)

6.6±0.5

(0.0)^*

6

323.2±33.5

(13.7)

32.1±4.6

(1.9)

6.3±0.5

(0.2)

F

1 399

398.0±46.8

(1.3)

42.0±5.2

(0.1)

6.0±0.5

(0.0)^*

3

313.8±36.3

(21.0)

35.3±5.1

(2.9)

5.7±0.3

(0.2)

60-80

M

174

318.2±42.2

(3.2)

32.0±4.1

(0.3)

5.8±0.6

(0.0)^**

8

392.6±32.3

(11.4)

29.6±4.8

(1.7)

5.8±0.9

(0.3)

F

128

404.4±59.6

(5.3)

38.0±5.4

(0.5)

5.4±0.5

(0.0)^**

6

391.3±30.3

(12.4)

31.5±5.2

(2.1)

5.9±0.8

(0.3)

*0.01.

**0.04.

H (height of the subject), N_T1 (total number of apparently healthy adult subjects), N₁ (number of apparently healthy adult subjects by age group and gender), N_T (total number of newly diagnosed lung cancer adult patients), and N (number of of newly diagnosed lung cancer adult patients by age group and gender). (R/H)_r, (Xc/H)_r and q_r were the body electrical resistance divided by H, body capacitive electrical reactance divided by H and phase angle of apparently healthy adult subjects, respectively (courtesy of MSc. Alcibiades Lara Lafargue (coordinator of the investigation) and authorized by the Centro Nacional de Electromagnetismo Aplicado, Universidad de Oriente (institution responsible of the investigation and conservation of original data for 15 years))¹⁵. R/H, Xc/H and q were these respective bioelectrical variables estimated in newly diagnosed lung cancer adult patients.

Table 4 Spearman's rho correlation r (probability p) for each pair of variables analyzed

X1

X2

X3

X4

X5

X6

X7

X8

X9

X10

X11

X12

X13

X14

X15

X2

0.195

(0.372)

X3

0.032

(0.884)

-0.323

(0.133)

X4

-0.147

(0.504)

-0.741

(0.000)

0.630

(0.001)

X5

-0.028

(0.898)

0.470

(0.024)

0.113

(0.608)

-0.219

(0.316)

X6

-0.458

(0.028)

0.154

(0.482)

0.242

(0.266)

0.114

(0.605)

0.383

(0.071)

X7

-0.053

(0.809)

-0.216

(0.321)

0.251

(0.249)

0.312

(0.147)

-0.210

(0.337)

0.319

(0.137)

X8

0.293

(0.175)

0.439

(0.036)

-0.471

(0.023)

-0.474

(0.022)

0.294

(0.173)

-0.070

(0.751)

-0.070

(0.750)

X9

-0.163

(0.459)

0.254

(0.242)

-0.137

(0.532)

-0.284

(0.189)

0.058

(0.791)

0.007

(0.975)

0.069

(0.753)

0.256

(0.238)

X10

0.092

(0.676)

0.205

(0.347)

0.075

(0.733)

-0.087

(0.694)

0.057

(0.798)

0.140

(0.525)

-0.209

(0.338)

0.202

(0.355)

0.107

(0.628)

X11

0.052

(0.815)

0.094

(0.669)

0.891

(0.000)

0.192

(0.381)

0.025

(0.909)

0.098

(0.656)

0.133

(0.545)

-0.187

(0.393)

-0.045

(0.839)

0.258

(0.234)

X12

-0.061

(0.782)

0.685

(0.000)

-0.148

(0.499)

-0.562

(0.005)

0.894

(0.000)

0.338

(0.115)

-0.304

(0.159)

0.415

(0.049)

0.144

(0.513)

0.111

(0.613)

0.018

(0.934)

X13

-0.344

(0.108)

0.443

(0.034)

-0.044

(0.844)

-0.287

(0.185)

0.477

(0.021)

0.898

(0.000)

0.184

(0.400)

0.158

(0.471)

0.114

(0.605)

0.205

(0.347)

-0.027

(0.904)

0.573

(0.004)

X14

-0.007

(0.973)

0.779

(0.000)

-0.281

(0.194)

-0.709

(0.000)

0.802

(0.000)

0.265

(0.221)

-0.310

(0.150)

0.459

(0.028)

0.199

(0.363)

0.100

(0.651)

-0.013

(0.952)

0.972

(0.000)

0.551

(0.006)

X15

-0.232

(0.286)

0.604

(0.002)

-0.268

(0.216)

-0.581

(0.004)

0.441

(0.035)

0.716

(0.000)

0.056

(0.799)

0.304

(0.159)

0.214

(0.328)

0.223

(0.307)

-0.105

(0.632)

0.636

(0.001)

0.932

(0.000)

0.671

(0.000)

X1: age, X2: gender, X3: weight, X4: height, X5: electrical resistance, X6: capacitive reactance, X7: phase angle, X8: ECOG (Eastern Cooperative Oncology Group), X9: stage, X10: tumor histological variety, X11: body mass index (BMI), X12: R/T, X13: Xc/T, X14: R/T², X15: Xc/T².

Table 5 Eta correlation coefficients

Categorical variables	Quantitative variables
Categorical variables	X1	X3	X4	X5	X6	X7	X11	X12	X13	X14	X15
X2	0.174	0.318	0.706	0.401	0.175	0.094	0.048	0.618	0.390	0.723	0.540
X8	0.278	0.490	0.483	0.454	0.097	0.306	0.330	0.508	0.083	0.525	0.188
X9	0.293	0.448	0.414	0.277	0.112	0.129	0.432	0.328	0.047	0.371	0.122
X10	0.358	0.243	0.287	0.408	0.115	0.297	0.242	0.438	0.139	0.418	0.186

X1: age, X2: gender, X3: weight, X4: height, X5: electrical resistance, X6: capacitive reactance, X7: phase angle, X8: ECOG (Eastern Cooperative Oncology Group), X9: stage, X10: tumor histological variety, X11: body mass index (BMI), X12: R/T, X13: Xc/T, X14: R/T², X15: Xc/T².

Table 6 Eigenvalues and eigenvectors of the correlation matrix of 11 independent variables considering R and Xc

Eigenvalues	3.2383	2.0543	1.6718	1.0872	1.0376	0.7220	0.5819	0.2807	0.2091	0.1160	0.0010
Proportion	0.294	0.187	0.152	0.099	0.094	0.066	0.053	0.026	0.019	0.011	0.000
Accumulated	0.294	0.481	0.633	0.732	0.826	0.892	0.945	0.970	0.989	1.000	1.000
Eigenvectors
Variables	PC1	PC2	PC3	PC4	PC5	PC6	PC7	PC8	PC9	PC10	PC11
Age	0.147	0.054	0.510	-0.532	0.178	0.106	0.357	0.438	-0.211	0.160	-0.005
Gender	0.368	-0.363	-0.074	-0.249	-0.003	-0.382	0.032	0.086	0.710	0.074	-0.019
Weight	-0.432	-0.291	0.329	-0.014	-0.176	0.006	0.027	-0.120	0.134	0.058	0.744
Height	-0.457	0.077	0.156	0.239	-0.082	0.391	0.151	0.250	0.520	0.179	-0.394
R	0.161	-0.461	-0.008	0.475	-0.147	-0.028	0.544	0.248	-0.188	-0.346	-0.028
Xc	-0.152	-0.480	-0.426	0.005	0.251	0.089	-0.109	0.239	-0.247	0.604	0.011
q	-0.280	-0.202	-0.368	-0.479	0.241	0.339	0.088	-0.039	0.079	-0.572	-0.013
ECOG	0.413	-0.164	0.092	0.016	0.051	0.583	0.212	-0.590	0.070	0.232	0.009
TS	0.208	-0.092	-0.108	-0.205	-0.766	0.341	-0.323	0.283	-0.074	-0.028	0.017
HV	0.195	-0.252	0.382	0.246	0.401	0.222	-0.606	0.214	0.047	-0.258	0.011
BMI	-0.264	-0.439	0.345	-0.196	-0.192	-0.246	-0.130	-0.360	-0.217	-0.014	-0.538

R, Xc, q, ECOG, TS, HV, and BMI were the body electrical resistance, body electrical capacitive reactance, body phase angle, Eastern Cooperative Oncology Group, tumor stage, histological variety of the tumor, and body mass index, respectively. PC_i (i = 1, …, 11) meant type of principal component.

Table 7 Eigenvalues and eigenvectors of the correlation matrix of 11 independent variables considering R/H and Xc/H

Eigenvalues	3.4889	2.0063	1.6994	1.0391	0.9626	0.7251	0.4934	0.2431	0.2338	0.1074	0.0011
Proportion	0.317	0.182	0.154	0.094	0.088	0.066	0.045	0.022	0.021	0.010	0.000
Accumulated	0.317	0.500	0.654	0.749	0.836	0.902	0.947	0.969	0.990	1.000	1.000
Eigenvectors
Variables	PC1	PC2	PC3	PC4	PC5	PC6	PC7	PC8	PC9	PC10	PC11
Age	0.092	0.126	0.506	-0.030	-0.666	-0.137	-0.128	0.448	0.109	0.166	0.004
Gender	0.411	-0.283	0.035	0.065	-0.153	-0.318	0.107	-0.178	-0.757	0.076	0.018
Weight	-0.380	-0.359	0.335	0.153	0.099	0.014	-0.124	-0.068	-0.083	0.063	-0.741
H	-0.461	0.023	0.100	0.027	0.169	0.341	-0.289	0.292	-0.508	0.209	0.401
R/H	0.372	-0.290	0.041	0.039	0.359	-0.148	-0.543	0.415	0.094	-0.384	0.031
Xc/H	0.115	-0.551	-0.347	-0.238	-0.016	0.111	0.100	0.272	0.199	0.608	-0.011
q	-0.202	-0.362	-0.331	-0.105	-0.554	0.302	-0.064	-0.017	-0.074	-0.547	0.013
ECOG	0.396	0.020	0.176	-0.009	-0.101	0.558	-0.452	-0.488	0.072	0.205	-0.008
TS	0.203	-0.032	-0.051	0.818	-0.017	0.355	0.309	0.250	0.028	-0.015	-0.017
HV	0.194	-0.105	0.449	-0.437	0.220	0.405	0.506	0.158	-0.077	-0.244	-0.010
BMI	-0.194	-0.494	0.391	0.203	0.016	-0.193	0.091	-0.325	0.292	-0.027	0.536

H, R/H, Xc/H, q, ECOG, TS, HV, and BMI were the height of patient, body electrical resistance divided by H, body electrical capacitive reactance divided by H, body phase angle, Eastern Cooperative Oncology Group, tumor stage, histological variety of the tumor, and body mass index, respectively. PCi (i = 1, …, 11) meant type of principal component.

Table 8 Eigenvalues and eigenvectors of the correlation matrix of 11 independent variables considering R/H² and Xc/H²

Eigenvalues	3.8485	1.8737	1.6729	1.0287	0.9047	0.7318	0.4143	0.2510	0.1822	0.0910	0.0011
Proportion	0.350	0.170	0.152	0.094	0.082	0.067	0.038	0.023	0.017	0.008	0.000
Accumulated	0.350	0.520	0.672	0.766	0.848	0.915	0.952	0.975	0.992	1.000	1.000
Eigenvectors
Variables	PC1	PC2	PC3	PC4	PC5	PC6	PC7	PC8	PC9	PC10	PC11
Age	0.071	0.036	0.527	0.022	0.695	-0.243	0.084	-0.160	0.342	-0.156	-0.004
Gender	0.405	-0.275	0.022	-0.050	0.090	-0.242	0.063	0.818	-0.106	-0.070	-0.018
Weight	-0.357	-0.441	0.241	-0.139	-0.113	0.006	-0.181	0.059	0.047	-0.056	0.739
H	-0.456	0.006	0.078	-0.044	-0.096	0.296	-0.246	0.381	0.522	-0.207	-0.408
R/H²	0.427	-0.194	0.003	-0.035	-0.243	-0.191	-0.415	-0.171	0.518	0.461	-0.038
Xc/H²	0.261	-0.441	-0.378	0.236	-0.016	0.112	0.115	-0.249	0.240	-0.627	0.012
q	-0.160	-0.352	-0.392	0.127	0.566	0.337	0.025	0.057	0.001	0.493	-0.013
ECOG	0.357	0.057	0.235	-0.041	0.161	0.550	-0.589	-0.033	-0.327	-0.174	0.008
TS	0.188	-0.017	-0.043	-0.846	0.012	0.302	0.354	-0.067	0.159	0.003	0.017
HV	0.170	-0.122	0.475	0.394	-0.272	0.456	0.487	0.044	0.094	0.215	0.010
BMI	-0.166	-0.595	0.280	-0.173	-0.090	-0.174	-0.022	-0.232	-0.362	0.026	-0.534

H, R/H², Xc/H², q, ECOG, TS, HV, and BMI were the height of patient, body electrical resistance divided by H², body electrical capacitive reactance divided by H², body phase angle, Eastern Cooperative Oncology Group, tumor stage, histological variety of the tumor, and body mass index, respectively. PCi (i = 1, …, 11) meant type of principal component.

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Integrated analysis of clinical, bioelectrical and functional variables in newly diagnosed lung cancer adult patients: Pilot study

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