Clinical Prognostic Analysis Of Small Cell Lung Cancer With Hyponatremia

Background:Small cell lung cancer(SCLC)is a neuroendocrine tumor,accounting for 15%-20%of the total number of lung cancer.The prognosis of patients with SCLC is generally poor.It has the characteristics of early metastasis,high invasion,low differentiation,grows very rapidly and high malignancy.Patients with hyponatremia have higher mortality,longer hospitalization time and worse prognosis.Objective to explore and analyze the curative effect and clinical prognostic factors of SCLC patients with hyponatremia,provide theoretical basis for the treatment and prognosis prediction of SCLC patients with hyponatremia.Methods:According to the Inclusion and exclusion criteria,with SCLC patients who were first seen in China-Japan Friendship Hospital from June 2014 to November 2017.The patients were selected into the study as follows.The basic data,serum sodium level and treatment data were collected.Patients were followed up by telephone or wechat to obtain the survival data of patients.SPSS 20.0 system was used to analyze the results.Measurement data were expressed by t-test for two independent samples and one-way analysis of variance for multiple groups of independent samples;percentage was used for counting data,and chi square test was used between groups.Kaplan Meier method was used to draw survival curve,log rank method was used for univariate prognosis analysis,and Cox regression model was used for multivariate analysis.P<0.05 was considered statistically significantResults:A total of 180 patients with SCLC were enrolled in the study ? After 4 cycles of EP chemotherapy,the total clinical effective rate of patients in the low-sodium group was 72.5%,which was significantly lower than that of the normal group(89.6%)(P<0.05).The comparison between the two groups found that the effective rate of the combined Chinese medicine treatment group was higher than that of the non-used Chinese medicine group(P<0.05).?Comparing the ECOG scores of the two groups of patients before and after treatment,it was found that after treatment the ECOG scores were significantly reduced.But after treatment in the low sodium group,The ECOG score was(0.93±0.63)points.The degree of improvement is lower than the normal group(P<0.05).Two groups of patients combining with the treatment of traditional Chinese medicine were again grouped and compared.In the low sodium combining with traditional Chinese medicine treatment,the ECOG score was(0.61±0.72)points.The degree of improvement is higher than that of the untreated traditional Chinese medicine treatment group(P<0.05).In the normal group combining with traditional Chinese medicine treatment,the ECOG score was(0.38±0.40)points,and the degree of improvement is higher than that of untreated traditional Chinese medicine treatment group(P<0.05).?The two groups had statistically significant differences in the three indicators of paraneoplastic syndrome,serum albumin level,and hemoglobin level(P<0.05).The patients in the low-sodium group presented with paraneoplastic syndrome and low albumin.hypoalbuminemia and hypohemoglobinemia in hyponatremia group was higher.? By the end of the follow-up,40 patients in the low-sodium group had an mOS of 314(95%CI:199-429)days,an average survival time of 358(95%CI:303-414)days,and 1-and 2-year survival rates.40.0%and 12.5%,respectively;67 patients in the normal group,mOS was 497(95%CI:473-521)days,mean survival was 484(95%Cl:433-534)days,and 1-and 2-year survival The rates were 72%and 21.5%,respectively.Comparing the survival curves of the two groups,it was found that the survival time of the normal group was better than that of the low sodium group,and the difference was statistically significant(?2=7.811,P=0.005).?Univariate analysis showed that the prognosis of patients with SCLC combined with hyponatremia was related to the five indicators of whether they were associated with paraneoplastic syndrome,whether adjuvant Chinese medicine treatment,TNM staging,serum albumin level,and hemoglobin level,and related to gender,age,Smoking history,BMI,hypertension,and diabetes were not related.Further multivariate analysis showed that the combination of the four indicators of paraneoplastic syndrome,TNM stage,serum albumin level,and hemoglobin level were independent prognostic factors for patients with SCLC and hyponatremia.Conclusion:?The short-term effect of patients with SCLC combined with hyponatremia after chemotherapy is worse than that of patients with normal sodium SCLC,and adjuvant Chinese medicine treatment can improve the short-term effect to some extent.?The short-term survival rate of SCLC patients with hyponatremia is lower than that of patients with normal serum sodium.?Combination of other paraneoplastic syndrome,TNM stage,serum albumin level,and hemoglobin level are independent prognostic factors in patients with SCLC and hyponatremia.