| OBJECTIVE:The aim of this study was to investigate the relationship between clinical features,efficacy and prognosis in patients with small cell lung cancer(SCLC)with hyponatremia,and to provide evidence for early diagnosis,clinical treatment and prognosis evaluation of SCLC patients.METHODSA retrospective collection of 100 cases of SCLC patients with hyponatremia admitted to the First Affiliated Hospital of Dalian Medical University from January 2002 to May 1818,and a total of 96 patients with normal blood sodium were compared.All SCLC were diagnosed by histology and cytological pathology.Patient's gender,age,smoking status,newly diagnosed ECOG,newly diagnosed gastrin-releasing peptide precursor(proGRP),newly diagnosed neuron-specific enolase(NSE),and serum lactate dehydrogenase(LDH)were reviewed by medical records and telephone.initial diagnosis of T stage,initial diagnosis of N stage,initial diagnosis of distant metastasis,initial diagnosis of distant metastasis,initial diagnosis of chest / pericardial effusion,initial stage(limited period LD,extensive stage ED),first-line chemotherapy cycle,first line Clinical characteristics of treatment mode,second-line treatment,minimum blood sodium level,blood sodium recovery,nervous system symptoms,body weight,etc.,record the patient's treatment efficacy including objective response rate(ORR),disease control rate(disease)Control rate(DCR),follow-up patients with progression-free survival(PFS)and overall survival(OS).Statistical analysis was performed using SPSS 22.0 software.The chisquare test compared the clinical features of patients with hyponatremia and normal serum sodium SCLC.The Kaplan Meier method was used to evaluate PFS and OS,and factors with significant differences were applied to Cox regression multivariate analysis.P < 0.05 was a significant difference criterion.RESULTS(1)Patients with hyponatremia are more likely to have low initial NSE,high LDH,bone metastases and chest/pericardial effusion,late N stage,late stage of disease,and weight loss.The proportion of chemotherapy is higher,the number of cycles receiving first-line chemotherapy is lower,the proportion of patients receiving second-line chemotherapy is less,and the first-line treatment relapses earlier.Hyponatremia and normal blood sodium patients in terms of gender,age,smoking history,initial diagnosis of ECOG score,proGRP,T staging,initial diagnosis of distant metastasis,brain metastasis,liver metastasis,adrenal metastasis and first-line treatment adverse reactions Statistical differences.(2)ORR(P=0.041)and DCR(P=0.004)in patients with hyponatremia and normal blood sodium,with statistical difference,indicating that patients with hyponatremia are inferior to normal blood in terms of ORR and DCR.Sodium.(3)The median PFS of 196 patients with SCLC was 8.3 months(2.1-31.5 months).The median PFS was 6.3 months and 10.4 months(P=0.006)in the hyponatremia group and the normal sodium group,respectively,with statistical differences.It shows that the PFS of patients with hyponatremia is significantly worse than that of normal blood sodium.(4)The MST of 196 patients with SCLC was 14.5 months(3.4-51.8 months).The MST of the hyponatremia group and the normal blood sodium group were 12.3 months and 16.6 months(P=0.002),the 1-year survival rate was 43.52% and 77.78%,respectively,and the 2-year survival rate was 12.44% and 27.93%.There are statistical differences.It is indicated that the OS of hyponatremia is significantly worse than that of normal blood sodium.(5)N stage at the initial diagnosis,number of distant metastases,presence or absence of bone metastasis,stage of disease,number of first-line chemotherapy cycles,first-line treatment efficacy,minimum blood sodium level,recovery of hyponatremia after treatment,whether with nerves Systemic symptoms were significantly associated with PFS in patients with hyponatremia SCLC.Among them,the initial N-stage,first-line chemotherapy,whether with neurological symptoms,and the lowest serum sodium value were independent factors influencing PFS in patients with hyponatremia.And gender,age,smoking history,newly diagnosed ECOG score,proGRP,NSE,newly diagnosed LDH,disease stage,brain metastasis,newly diagnosed liver metastasis,adrenal metastasis,chest/pericardial effusion,first-line treatment mode,weight loss within 1 month>5 %,first-line adverse reactions.(6)N stage at the initial diagnosis,number of distant metastases,presence or absence of bone metastasis,liver metastasis,adrenal metastasis,disease stage,ECOG score,firstline treatment mode,first-line chemotherapy cycle,first-line treatment efficacy,recurrence classification,minimum blood Sodium values,whether hyponatremia was restored after treatment,and whether neurological symptoms were associated with OS in patients with hyponatremia SCLC were significantly associated.Among them,the initial N-stage,first-line treatment mode,first-line chemotherapy efficacy,minimum blood sodium value,recurrence typing and neurological symptoms were independent factors influencing OS in patients with hyponatremia SCLC.Gender,age,smoking history,newly diagnosed proGRP,NSE,LDH,T stage,newly diagnosed brain metastases,chest/pericardial effusion,whether second-line chemotherapy,1 month weight loss is >5%,whether first-line treatment adverse reactions are not related to OS.Conclusion(1)Patients with SCLC who are at high initial level of NSE,elevated LDH,presence of bone metastases and pleural/pericardial effusion,late N stage,late stage of disease,and decreased weight are more likely to develop hyponatremia;patients with hyponatremia The proportion of patients receiving chemotherapy alone was higher,the number of cycles receiving first-line chemotherapy was lower,the proportion of patients receiving second-line chemotherapy was less,and the first-line treatment was relapsed earlier.(2)Patients with hyponatremia SCLC were inferior to normal blood sodium in terms of ORR and DCR.(3)Patients with hyponatremia were significantly worse than normal sodium in both PFS and OS.(4)N stage at the initial diagnosis,number of distant metastasis,presence of bone metastasis,disease stage,first-line chemotherapy cycle,first-line treatment efficacy,minimum blood sodium value,recovery after hyponatremia after treatment,whether with nerves Systemic symptoms were significantly associated with PFS in patients with hyponatremia SCLC.Among them,the initial N-stage,first-line chemotherapy,whether with neurological symptoms,and the lowest serum sodium value were independent factors influencing PFS in patients with hyponatremia.(5)N stage at the initial diagnosis,number of distant metastases,presence or absence of bone metastasis,liver metastasis,adrenal metastasis,disease stage,ECOG score,firstline treatment mode,first-line chemotherapy cycle,first-line treatment efficacy,recurrence classification,minimum blood Sodium values,whether hyponatremia was restored after treatment,and whether neurological symptoms were associated with OS in patients with hyponatremia SCLC were significantly associated.Among them,the initial N-stage,first-line treatment mode,first-line chemotherapy efficacy,minimum blood sodium value,recurrence typing and neurological symptoms were independent factors influencing OS in patients with hyponatremia SCLC. |
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