| [Background]The morbidity and mortality of lung cancer is in the first place among all the malignant tumor. According to the histological classification, it can be divided into: small cell lung cancer and non-small cell lung cancer. Small cell lung cancer accounts for about12%to15%of the total number of lung cancer, with its special biological behaviour, short doubling time, high malignant degree, early metastasis to lymph nodes and distant organs. Small cell lung cancer has poor prognosis, related factors including age, sex, stage, lactate dehydrogenase, glutamic-pyruvic transaminase, neuron-specific enolase, etc. At present, the level of serum sodium may be associated with poor prognosis of small cell lung cancer. If we can predict the prognosis accurately before treatment and set individual treatment strategies, we will improve the effect of treatment.[Objectives]Based on the clinical manifestation, diagnosis and treatment of the small cell lung cancer patients with hyponatremia, diagnose early and timely and treat the disease effectively. On the prognosis analysis of these patients, investigate whether hyponatremia is the independent poor prognosis factor for small cell lung cancer.[Methods]Retrospect the156cases of patients with small cell lung cancer in January2009to December2010in the Radiotherapy of Tumor Hospital of Shandong Province, according to the level of serum sodium, who were divided into hyponatremia group and control group. The similarities and differences between the two groups were compared in the clinical characteristics and treatments. Telephone follow-up of its survival, for the statistical analysis by SPSS version19.0software package, the single factor choosing Kaplan Meier-survival analysis method, the relationship between serum sodium levels associated with clinical factors analysis choosing the X2test method, Multi-factor survival analysis using COX proportional hazards regression model, P<0.05for statistical significance.[Results]In the156cases of small cell lung cancer patients, there are23cases with hyponatremia, accounting for14.7%. The median survival time in156cases of SCLC patients was15months. The median survival time of hyponatremia group was11months, and the median survival time of control group was16months, the P value was0.046, with statistical significance. Hyponatremia group’s survival rates in one year, two years, three years were47.8%,17.4%, and0%respectively; the control group’s were66.9%,24.1%, and6%respectively. The Objective response rate after treatment in the hyponatremia group is56.5%, and the Objective response rate in the normal serum sodium group after treatment is78.2%, according to chi-square test, P value is0.037, the difference is statistically significant. Gender, age, stage, personal history, the level of serum NSE, tumor site, metastasis, treatment effect of factors such as the level of serum sodium in patients with small cell lung cancer and there was no correlation(P>0.05). There was a correlation between the level of serum sodium and KPS score, P value is0.029. Analysis of the relationship between the gender, age, KPS score, staging, smoking history, NSE levels,the serum sodium level and the survival are as follows:male, age greater than60, KPS score less than80points, extensive period, smoking, NSE levels higher than normal, serum sodium levels lower than normal are the risk factors influencing the prognosis of survival, in addition to the gender, the rest all have statistical significance.[Conclusions]In small cell lung cancer patients, when the serum sodium level before treatment is below normal, it indicates independent factors of poor prognosis of small cell lung cancer patients. Besides, male, age greater than60, KPS score less than80points, extensive period, smoking, NSE levels higher than normal also indicate poor prognosis. If it appears repeatedly hyponatremia, or hyponatremia occurs after the end of the first-line therapy, attention should be paid to the possibility of tumor recurrence or metastasis. |
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