Clinical Characteristics And Strategies On The Treatment In107Lung Cancer Complicating Syndrome Of Inappropriate Antidiuretic Hormone Secretion

Objective: Discuss and summarize the clinical characteristics and strategies on thetreatment in107lung cancer complicating syndrome of inappropriate antidiuretichormone secretion(SIADH), in order to provide reference for clinical diagnosis of thepatients with lung cancer complicating SIADH.Method: A retrospective analysis of107cases of lung Cancercomplicating SIADH in the first affiliated hospital of Dalian MedicalUniversity from January2009to December2012were grouped according tothe blood sodium level. Patients enrolled met the diagnostic criteria for SIADH(sodium content of the serum declining; sodium content of the urinary increasing; theosmolality of plasma colloid declining; urine osmolality greater than plasmaosmolality; primary disease or medication history; plasma AVP levels inappropriatelyincreasing; no significant edema, kidney and adrenal function normally. excludingcirrhotic ascites, chronic heart failure, kidney disease with hyponatremia), thediagnostic criteria for lung cancer (long-term smokers above40years of age, obviousclinical manifestations, the examination for chest X-ray and CT, and selectingbronchoscopy, sputum cytology, biopsy and other methods to obtain pathologicaldiagnosis of lung cancer according to the patient’s condition and tumor location) andsyndrome of inappropriate secretion of antidiuretic hormone for its first clinicalmanifestation that the primary disease is lung cancer. It had to be excluded in theEnrolled patients that was associated with other serious primary lung disease; youngerthan18years old or more than80years of age; pregnancy and breast-feeding womenonset disease; serious primary disease for heart, cerebrovascular, liver, kidney and bloodsystem;mental illness; and din’t comply the inclusion criteria or incompleteinformation patients. Using SPSS13.0processed the datas. Normal distribution for mean standard deviation (±S) was said; Skewness distribution datawith the median (four percentile) M (X25%, X75%) was said.Compared between measurement data: Two independent samples metthe normality and homogeneity of variance using the t test and do not satisfied withWilcoxon rank sum test;count data were compared using the X2test. Therewere significant differences when P<0.05.We finished their medical records, compared the difference of their age structure, sex ratio, histopathologic classification, clinical treatment and theinfluence of survival. According to the patient’s serum sodium levels, wedivided them into2groups and analyzed its characteristics.Result:1.107patients with the average age of64years being treated of lungcancer were finally diagnosed as lung cancer with SIADH. The incidence is high amongmale in the relatively low sodium group.2. A total of84cases which are determined thehistologic type, there were43cases are the SCLC patients, accounting for51.2%. Andthe proportion of SCLC in the relatively low sodium group is little high.3.There was nosignificant overall differences in effects between the two groups.Conclusion:1.SCLC was more likely to happen in fall in men;2.In the histologicaltype of lung cancer, the highest incidence of SIADH was small cell lungcancer(SCLC).When the lung cancer patients showed when hyponatremia, SCLCshould be considered firstly.3.SIADH had no specific clinical features and wasdiscriminated among hyponatremia induced a variety of diseases and certain drug. Thediagnosis mainly depended on laboratory tests to avoid misdiagnosis or delayeddiagnosis.4.The clinical symptoms of SCLC with SIADH would disappeare because oftumor resection or chemotherapy treatment.5.Whether there are statistically significantbetween the two groups on the treatment effects need further research and validation.