Akciğer kanseri tanısı alan hastaların başlangıç serum sodyum ve globülin oranının prognoz tahminindeki yeri
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Tarih
2021
Yazarlar
Dergi Başlığı
Dergi ISSN
Cilt Başlığı
Yayıncı
Kırıkkale Üniversitesi
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Amaç: Akciğer kanseri mortalite ve morbidite oranı yüksek bir hastalık olması nedeniyle, prognozunun belirlenmesi çok önemli bir yere sahiptir. Literatürdeki çalışmalar elektrolit bozukluğu ve inflamasyonun akciğer kanserinde kötü prognoz ile ilişkili olabileceğini göstermiştir ancak yine de bu konuda daha fazla çalışma yapılması gerekmektedir. Bu çalışmada akciğer kanseri tanısı olan hastaların tanı anında bakılan sodyum ve globülin oranının prognoz tahminindeki yerinin araştırılması planlandı. Gereç ve Yöntem: Çalışma Kırıkkale Üniversitesi (KKÜ) Tıp Fakültesi Hastanesi İç Hastalıkları Anabilim Dalı ve Tıbbi Onkoloji Bilim Dalı'nda 1 Ocak 2015 ile 1 Ocak 2021 tarihleri arasında akciğer kanseri tanısı ile takipli 165 hastanın hasta dosyalarından ve hastane kayıtlarından retrospektif olarak yürütüldü. Tanı anında ulaşılabilir sodyum, albümin ve total protein değerleri olan hastalar çalışmaya dahil edildi. Çalışmaya dâhil edilen hastaların hemogram parametreleri, kreatinin ve tahmini glomerüler filtrasyon hızına (eGFR), alanin aminotransferaz (ALT) düzeyi, albümin düzeyi, total protein düzeyi ve globülin düzeyi, C-reaktif protein (CRP) düzeyi, CEA ve tiroid stimülan hormon (TSH) düzeyleri; ayrıca sodyum/globülin oranı (SGO), CRP/albümin oranı (CAO) değerlendirildi. Bulgular: Hastaların %87,3'ü erkek, %12,7'si kadın cinsiyettir. Hastaların ortalama başvuru yaşı 62,5 ± 9,1 dir. Adenokanser 76 hastayla kanserlerin %46,1'ini, skuamöz hücreli karsinom 69 hastayla %41,8'ini, küçük hücreli karsinom 20 hastayla %12,1'ini oluşturmaktadır. Hastaların 11 (%6,7)'i evre 1, 25 (%15,2)'i evre 2, 58 (%35,2)'i evre 3 ve 71 (%43)'i evre 4 hastalardan oluşmaktadır. Hastaların 111 (%67,3)'i ölmüştür. Ortalama takip süresi 16,6 aydır. Çalışmamızda yapılan çok değişkenli regresyon analizlerinde mortalite ile sodyum/globülin oranı (SGO) ve progresyonsuz sağkalım ile sodyum/globülin oranı (SGO) ilişkisiz bulundu. Sodyum/globülin oranı (SGO) ile CRP/albümin oranı (CAO) arasında zayıf düzeyde negatif korelasyon saptandı. Çok değişkenli regresyon analizinde mortaliteye hastalığın evresi, diyabet ve CRP düzeyi, progresyonsuz sağkalıma ise hastalığın evresi etki eden bağımsız değişkenler olarak bulundu (p<0,001). Sonuç: Akciğer kanseri tanılı hastalarda bağımsız prognostik faktörler; mortalite için hastalığın evresi, diyabet ve CRP düzeyi, progresyonsuz sağkalım için evre olarak bulundu. Sodyum/globülin oranı (SGO) ile CRP/albümin oranı (CAO) arasındaki zayıf ilişki göz önüne alındığında, SGO ileride kanser hastalarında prognozu belirlemede biyobelirteç olarak kullanılabilir. SGO ile akciğer kanseri arasındaki ilişki hakkında daha fazla bilgi sahibi olabilmek için ileride daha fazla çalışmaya ihtiyaç vardır. Anahtar Kelimeler: Akciğer kanseri, sodyum, globülin, genel sağkalım, mortalite
Objective: Since lung cancer is a disease with a high mortality and morbidity rate, determining its prognosis has a very important place. Studies in the literature have shown that electrolyte disturbance and inflammation may be associated with poor prognosis in lung cancer, however, further studies are needed on this subject. In this study, it was planned to investigate the place of sodium and globulin ratio measured at the time of diagnosis in the prognosis prediction of patients with lung cancer diagnosis. Materials and Methods: The study was carried out retrospectively from the patient files and hospital records of 165 patients who were followed up with the diagnosis of lung cancer between January 1, 2015 and January 1, 2021 in Kırıkkale University (KKU) Faculty of Medicine, Department of Internal Medicine and Medical Oncology Department. Patients with achievable sodium, albumin and total protein values at the time of diagnosis were included in the study. Hemogram parameters of the patients included in the study, creatinine and estimated glomerular filtration rate (eGFR), alanine aminotransferase (ALT) level, albumin level, total protein level and globulin level, C-reactive protein (CRP) level, CEA and TSH levels; In addition, the sodium/globulin ratio (SGR) and the CRP/albumin ratio (CAR) were evaluated. Results: 87.3% of the patients were male and 12.7% were female. The mean age at presentation was 62.5 ± 9.1 years. Adenocancer accounts for 46.1% of cancers with 76 patients, squamous cell carcinoma for 41.8% with 69 patients, and small cell carcinoma for 12.1% with 20 patients. 11 (6.7%) of the patients were stage 1, 25 (15.2%) stage 2, 58 (35.2%) stage 3 and 71 (43%) stage 4 patients. 111 (67.3%) of the patients died. Average follow-up time is 16.6 months. In the regression analyzes performed in our study, mortality and sodium/globulin ratio (SGR) and progression-free survival and sodium/globulin ratio (SGR) were found to be unrelated. There was a weak negative correlation between sodium/globulin ratio (SGR) and CRP/albumin ratio (CAR). In the multivariate regression analysis, the stage of the disease, diabetes and CRP level were found to be the independent variables affecting mortality, and the stage of the disease affecting progression-free survival. (p<0.001). Conclusion: Independent prognostic factors in patients with lung cancer; stage of disease for mortality, diabetes and CRP level were found as stage for progression-free survival. Considering the weak relationship between sodium/globulin ratio (SGR) and CRP/albumin ratio (CAR), SGR can be used as a future biomarker to predict prognosis in cancer patients. Further studies are needed to learn more about the relationship between SGR and lung cancer. Keywords: Lung cancer, sodium, globulin, overall survival, mortality
Objective: Since lung cancer is a disease with a high mortality and morbidity rate, determining its prognosis has a very important place. Studies in the literature have shown that electrolyte disturbance and inflammation may be associated with poor prognosis in lung cancer, however, further studies are needed on this subject. In this study, it was planned to investigate the place of sodium and globulin ratio measured at the time of diagnosis in the prognosis prediction of patients with lung cancer diagnosis. Materials and Methods: The study was carried out retrospectively from the patient files and hospital records of 165 patients who were followed up with the diagnosis of lung cancer between January 1, 2015 and January 1, 2021 in Kırıkkale University (KKU) Faculty of Medicine, Department of Internal Medicine and Medical Oncology Department. Patients with achievable sodium, albumin and total protein values at the time of diagnosis were included in the study. Hemogram parameters of the patients included in the study, creatinine and estimated glomerular filtration rate (eGFR), alanine aminotransferase (ALT) level, albumin level, total protein level and globulin level, C-reactive protein (CRP) level, CEA and TSH levels; In addition, the sodium/globulin ratio (SGR) and the CRP/albumin ratio (CAR) were evaluated. Results: 87.3% of the patients were male and 12.7% were female. The mean age at presentation was 62.5 ± 9.1 years. Adenocancer accounts for 46.1% of cancers with 76 patients, squamous cell carcinoma for 41.8% with 69 patients, and small cell carcinoma for 12.1% with 20 patients. 11 (6.7%) of the patients were stage 1, 25 (15.2%) stage 2, 58 (35.2%) stage 3 and 71 (43%) stage 4 patients. 111 (67.3%) of the patients died. Average follow-up time is 16.6 months. In the regression analyzes performed in our study, mortality and sodium/globulin ratio (SGR) and progression-free survival and sodium/globulin ratio (SGR) were found to be unrelated. There was a weak negative correlation between sodium/globulin ratio (SGR) and CRP/albumin ratio (CAR). In the multivariate regression analysis, the stage of the disease, diabetes and CRP level were found to be the independent variables affecting mortality, and the stage of the disease affecting progression-free survival. (p<0.001). Conclusion: Independent prognostic factors in patients with lung cancer; stage of disease for mortality, diabetes and CRP level were found as stage for progression-free survival. Considering the weak relationship between sodium/globulin ratio (SGR) and CRP/albumin ratio (CAR), SGR can be used as a future biomarker to predict prognosis in cancer patients. Further studies are needed to learn more about the relationship between SGR and lung cancer. Keywords: Lung cancer, sodium, globulin, overall survival, mortality
Açıklama
Tıp Fakültesi, İç Hastalıkları Ana Bilim Dalı
Anahtar Kelimeler
Onkoloji, Oncology
