D2.432 - Blood morphology in health & cancer: comparative, preliminary study on 783 patients

Although the phenomenon of paraneoplastic hypereosinophilia is widely known to allergists and immunologists, little is commonly known about general blood morphology characteristics both in malignancies vs. healthy patients, as well as when comparing different cancer populations. This is an initial comparative study aiming to introduce this issue, in order to be able to conduct future research taking into account the distribution of data from this simple, cheap and available test.

The 8th edition of TNM classification according to the American Joint Committee on Cancer (AJCC) is not consistent for pancreatic ductal adenocarcinoma (PDAC, n=153) and breast cancer (BC, n=231). In connection with that fact, for the purposes of this study, we defined “early” and “advanced” diseases in both cancer cohorts: PDAC as stadia I-IIA vs. IIB-IV and in BC cohort: early as N0 vs. advanced as N≥1. The control group consisted of n=399 subjects hospitalized in Orthopedic Department hospitalized for planned plastic surgery of cruciate ligaments.

We have compared the blood morphology test results between control and study groups: the differences between levels were statistically significant as follows: basophils – lower than in control in PDAC cohort (p=0,000) but higher in BC cohort (p=000); eosinophils, monocytes – lower than in control in BC cohort (both with p=0,000); lymphocytes – lower than in control both in PDAC cohort (p=0,000) and BC cohort (p=0,000); neutrophils – higher than in control in both PDAC (p=0,012) and BC (p=0,016). Comparing early and advance disease within one histopathological cohort (PDAC, lobular BC), linear analysis of white blood cells levels provided no statistically significant results; the groups were also similar in terms of clinical parameters like sex, age, cancer grade 

The blood morphology results of healthy control and cancer patients are divergent. Low levels of eosinophils, lymphoctes, neutrophils can be the universal features of cancer patients, as well as differences in basophil levels probably constitute a sign of different immune mechanism activated between different cancer cohorts.