Akciğer kanseri tanılı hastaların tanı anında bakılan lipid düzeyleri ve oranlarının prognoz tahminindeki yerinin değerlendirilmesi
[ X ]
Tarih
2021
Yazarlar
Dergi Başlığı
Dergi ISSN
Cilt Başlığı
Yayıncı
Kırıkkale Üniversitesi
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Amaç: Kansere bağlı ölümlerin başlıca nedenlerinden biri olan akciğer kanserinde, prognozun belirlenmesi kritik öneme sahiptir. Ortaya çıkan kanıtlar, lipid metabolizması bozukluğunu akciğer hastalıkları ile ilişkilendirmiştir ancak kan lipid profili ile akciğer kanseri riski arasındaki ilişki tartışmalı ve sonuçsuzdur. Bu çalışma ile akciğer kanseri tanılı hastaların tanı anındaki lipid düzeyleri ve oranlarının prognoz tahminine olan ilişkisi araştırılması planlanmıştır. Gereç ve Yöntem: Kırıkkale Üniversitesi Tıp Fakültesi Onkoloji Kliniğine 2013 ile 2020 tarihleri arasında başvurmuş akciğer kanseri tanısı alan 92 hastanın sosyodemografik ve hastalığa bağlı klinik özellikleri hastane veritabanı sistemi ve hasta dosyaları taranarak retrospektif olarak gözden geçirildi. Tanı anında ulaşılabilir lipid parametrelerine sahip olan hastalar değerlendirildi. Çalışmaya dahil edilen hastaların hemogram parametreleri, kreatinin ve tahmini glomerüler filtrasyon hızına(eGFR), alanin aminotransferaz(ALT) düzeyi, albümin düzeyi, C-reaktif protein(CRP) düzeyi, ayrıca total kolesterol/HDL oranı, non-HDL/HDL oranı, LDL/HDL oranı, trigliserit/HDL oranlarına bakılmıştır. Bulgular: Hastaların %90,2'si erkek, %9,8'i kadındır. Ortalama başvuru yaşı 64,2±9,1 idi. Akciğer kanserlerinin dağılımı ise küçük hücreli akciğer kanseri (KHAK) 6 (%6,5), küçük hücreli dışı akciğer kanseri (KHDAK) 86 (%93,5) kişidir. Hastaların 22(%23,9)'si sınırlı evre, 70 (%76,1)'i yaygın evrededir. Hastaların ortalama takip süresi 12 aydır. Takip sırasında hastaların 63'ü (%68,5) ölmüştür. Yapılan tek değişkenli regresyon analizinde mortalite ile non-HDL/HDL oranı ilişkili olarak bulunmuştur (p<0,001). Çok değişkenli regresyon analizinde ise hastalığın evresi, albümin düzeyi ve total kolesterol düzeyi akciğer kanserli hastaların mortalitesine etki eden bağımsız değişkenler olarak bulunmuştur (p<0,001). Sınırlı evre ve ileri evre hastalık arasında sağkalım açısından anlamlı fark bulunmuştur (Log Rank testi p<0,001). Sonuç: Akciğer kanseri hastalarında mortalite için bağımsız prognostik faktörler; hastalığın evresi, albümin düzeyi, total kolesterol düzeyidir. Hastaların sağkalımına etki eden faktör ise ileri evre hastalık olarak bulunmuştur. Total kolesterol(TK) düzeyi prognostik öneme sahip olabilir. Tanı anındaki TK düzeyleri prognoz tayininde yön gösterici olabilir. Lipid metabolizması ve akciğer kanseri etiyolojisi ilişkisini aydınlatmak, lipid düzeyleri ve oranlarının prognoz tahminindeki yerini belirlemek için daha fazla deneysel çalışmaya ihtiyaç vardır. Anahtar Kelimeler: dislipidemi, akciğer kanseri, genel sağkalım, mortalite
Objective: Determining the prognosis in lung cancer, which is one of the main causes of cancer-related deaths, is of critical importance. Emerging evidence has linked lipid metabolism disorder with lung diseases, but the relationship between blood lipid profile and lung cancer risk is controversial and inconclusive. With this study, it was planned to investigate the relationship of lipid levels and ratios at the time of diagnosis to the prognosis prediction of patients with lung cancer. Materials and Methods: Sociodemographic and disease-related clinical characteristics of 92 patients diagnosed with lung cancer, who applied to Kırıkkale University Faculty of Medicine Oncology Clinic between 2013 and 2020, were reviewed retrospectively by scanning the hospital database system and patient files. Patients with available lipid parameters at the time of diagnosis were evaluated. Hemogram parameters of the patients included in the study, creatinine and estimated glomerular filtration rate (eGFR), alanine aminotransferase (ALT) level, albumin level, C-reactive protein (CRP) level, as well as total cholesterol/HDL ratio, non-HDL/HDL ratio, LDL/HDL ratio, triglyceride/HDL ratios were examined. Results: 90.2% of the patients were male and 9.8% were female. The mean age at presentation was 64.2±9.1. The distribution of lung cancers is 6 (6.5%) for small cell lung cancer (SCLC) and 86 (93.5%) for non-small cell lung cancer (NSCLC). 22 (23.9%) of the patients were in the limited stage, 70 (76.1%) were in the extensive stage. The mean follow-up period of the patients is 12 months. During the follow-up, 63 (68.5%) of the patients died. In the univariate regression analysis, mortality and non-HDL/HDL ratio were found to be correlated (p<0.001). In multivariate regression analysis, disease stage, albumin level and total cholesterol level were found to be independent variables affecting the mortality of patients with lung cancer (p<0.001). There was a significant difference in survival between limited and advanced disease (Log Rank test p<0.001). Conclusion: Independent prognostic factors for mortality in lung cancer patients are disease stage, albumin level, total cholesterol level. The factor affecting the survival of the patients was found to be advanced-stage disease. Total cholesterol (TC) level may have prognostic importance. TC levels at the time of diagnosis can be a guide in determining the prognosis. More experimental studies are needed to elucidate the relationship between lipid metabolism and lung cancer etiology and to determine the role of lipid levels and ratios in prognosis prediction. Keywords: dyslipidemia, lung cancer, overall survival, mortality
Objective: Determining the prognosis in lung cancer, which is one of the main causes of cancer-related deaths, is of critical importance. Emerging evidence has linked lipid metabolism disorder with lung diseases, but the relationship between blood lipid profile and lung cancer risk is controversial and inconclusive. With this study, it was planned to investigate the relationship of lipid levels and ratios at the time of diagnosis to the prognosis prediction of patients with lung cancer. Materials and Methods: Sociodemographic and disease-related clinical characteristics of 92 patients diagnosed with lung cancer, who applied to Kırıkkale University Faculty of Medicine Oncology Clinic between 2013 and 2020, were reviewed retrospectively by scanning the hospital database system and patient files. Patients with available lipid parameters at the time of diagnosis were evaluated. Hemogram parameters of the patients included in the study, creatinine and estimated glomerular filtration rate (eGFR), alanine aminotransferase (ALT) level, albumin level, C-reactive protein (CRP) level, as well as total cholesterol/HDL ratio, non-HDL/HDL ratio, LDL/HDL ratio, triglyceride/HDL ratios were examined. Results: 90.2% of the patients were male and 9.8% were female. The mean age at presentation was 64.2±9.1. The distribution of lung cancers is 6 (6.5%) for small cell lung cancer (SCLC) and 86 (93.5%) for non-small cell lung cancer (NSCLC). 22 (23.9%) of the patients were in the limited stage, 70 (76.1%) were in the extensive stage. The mean follow-up period of the patients is 12 months. During the follow-up, 63 (68.5%) of the patients died. In the univariate regression analysis, mortality and non-HDL/HDL ratio were found to be correlated (p<0.001). In multivariate regression analysis, disease stage, albumin level and total cholesterol level were found to be independent variables affecting the mortality of patients with lung cancer (p<0.001). There was a significant difference in survival between limited and advanced disease (Log Rank test p<0.001). Conclusion: Independent prognostic factors for mortality in lung cancer patients are disease stage, albumin level, total cholesterol level. The factor affecting the survival of the patients was found to be advanced-stage disease. Total cholesterol (TC) level may have prognostic importance. TC levels at the time of diagnosis can be a guide in determining the prognosis. More experimental studies are needed to elucidate the relationship between lipid metabolism and lung cancer etiology and to determine the role of lipid levels and ratios in prognosis prediction. Keywords: dyslipidemia, lung cancer, overall survival, mortality
Açıklama
Tıp Fakültesi, İç Hastalıkları Ana Bilim Dalı
Anahtar Kelimeler
İç Hastalıkları, Internal diseases
