AKCİĞER KANSERLİ OLGULARDA SERUM LİPİD PROFİLİ

Çalışmamızda, akciğer kanser (AK)'li olgularda lipid profili değişikliklerini incelemeyi, histopatolojik tip ve evreyle serum lipid düzeyleri arasındaki ilişkiyi ortaya koymayı amaçladık. Çalışma grubuna AK tanısı alan, herhangi bir tedavi almamış 68 erkek, 28 kadın, toplam 96 olgu, kontrol grubuna cinsiyet ve yaşça uyumlu 50 sağlıklı erişkin alındı. Olguların serum total kolesterol (KS), trigliserid (Trg), HDL, LDL ve VLDL düzeyleri ölçüldü. Serum total KS çalışma grubunda 176,5 mg/dl, kontrol grubunda 195,8 mg/dl idi (p: 0.007). Serum LDL çalışma grubunda 110,3 mg/dl, ve kontrol grubunda 123,1 mg/dl idi (p: 0.036). Diğer lipid düzeyleri iki grup arasında farklı değildi. Akciğer kanseri histopatolojik tipleri arasında lipid düzeyleri farklılık göstermedi. Evre-III B'de total KS (p: 0.000), LDL (p: 0.000), Trg (p: 0.049) ve VLDL (p:0.029) düzeyleri kontrol grubuna göre daha düşük bulundu. Sınırlı evre KHAK olgular ında Trg (p: 0.009) ve VLDL (p:0.009) düzeyleri, yaygın evreye göre daha düşük idi. Sigara içmeyen AK'li olgularda serum total KS (p: 0.03) ve Trg (p: 0.003) düzeyleri sigara içenlere göre belirgin şekilde düşük bulundu. Sigara kullanım süresi, metastaz yeri veya metastaz olup olmamasına göre serum lipid düzeyleri farklılık göstermedi. Çalışmamızda; akciğer kanseri histopatolojik tipleri, sigara kullanım süresi, metastaz yeri, metastaz varlığına göre serum lipid düzeylerinin farklılık göstermediğini, Evre-III B KHDAK'li olgularda total KS, LDL, Trg ve VLDL; sınırlı evre KHAK'li olgularda Trg ve VLDL düzeylerinin daha düşük olduğunu tespit ettik. Akciğer kanserli olgularda tanı anında, total KS ve LDL düzeylerini belirgin şekilde düşük bulduk. Çok basit yöntemlerle ölçülebilen serum lipidi düşük düzeylerinin akciğer kanseri şüphesi olan olgularda dikkat çekici olduğunu düşünmekteyiz.

SERUM LIPID PROFILE IN CASES WITH LUNG CANCER

In our study, we aimed to examine the lipid profile changes in cases with lung cancer (LC) and define the relationship between histopathologic types, stage and serum lipid levels. Sixty eight men and 28 women, totally 96 cases of LC and who did not have any treatment were included in the study group; and 50 healthy adults with similar sex and age were included in control group. Serum total cholesterol (CS), trigliceride (Trg), HDL, LDL and VLDL levels were measured. Serum total CS was 176,5 mg/dl in the study group and 195,8 mg/dl in control group (p: 0.007). Serum LDL was 110,3 mg/dl in the study group and 123,1 mg/dl (p: 0.036) in control group. Other lipid levels were not different between two groups. Lipid levels did not differ in histopathologic types of LC. Total CS (p: 0.000), Trg (p: 0.0049), LDL (p: 0.000) and VLDL (p: 0.029) levels in stage-III B NSCLC were significantly lower than the other stages. In limited stage SCLC, Trg (p:0.009) and VLDL (p: 0.009) levels were lower than extensive disease. In nonsmoker cases with LC; serum total CS (p: 0.03) and Trg (p: 0.003) levels were significantly lower than smokers. Serum lipid levels did not differ according to period of cigarette smoking, localization of methastases or presence of methastases. In our study; we revealed that serum lipid levels did not differ according to histopathologic types of LC, duration of smoking, and localization or presence of methastases, and total CS, LDL, Trg and VLDL levels in stage-III B NSCLC were significantly lower than other stages. In limited stage SCLC; Trg and VLDL levels were lower than extensive disease . We found significantly lower total CS and LDL levels, in the initial diagnosis period of cases with LC. We think that lower levels of serum lipids measured via very simple methods, draws attention to the cases with suspect of LC.

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  • 1. Stein EA. Lipids, lipoproteins and apolipoproteins. In: Norbert W.Tiedz (ed). Textbook Of Clinical Chemistry. 3rd ed. USA: WB Saunders, 1986; 829-97.
  • 2. Thompson GR. A Handbook of Hyperlipidemia. London: Current Science, 1990; 12-48.
  • 3. Dessi S, Batetta B, Pulisci D, Spano O, Cherchi R, Lanfranco G, Tessitore L, Costelli P, Baccino FM, Anchisi C, Pani P. Altered pattern of lipid metabolism in patients with lung cancer. Oncology 1992; 49: 436-41.
  • 4. Shekelle RB, Rossof AH, Stamler J. Dietary cholesterol and incidence of lung cancer:The Western Electric Study. Am J Epidemiology 1991; 134(5): 480-4.
  • 5. Cooper GR, Myers GL, Smith SJ, Schlant RC. Blood lipid measurements. Variations and practical utility. JAMA 1992; 267(12): 1652-60.
  • 6. Agurs-Collins T, Kim KS, Dunston GM, AdamsCampbell LL. Plasma lipid alterations in AfricanAmerican women with breast cancer. J Cancer Res Clin Oncol 1998; 124(3-4): 186-90.
  • 7. Winawer SJ, Flehinger BJ, Buchalter J, Herbert E, Shike M. Declining serum cholesterol levels prior to diagnosis of colon cancer. JAMA 1990; 263: 2083-5.
  • 8. Mountain CF. Revisions in the international system for staging lung cancer. Chest 1997;111: 1710.
  • 9. Siemianowicz K, Gminski J, Stajszczyk M, Wojakowski W, Goss M,Machalski M, Telega A, Brulinski K, Molendowska H. Serum total cholesterol and triglicerides levels in patients with lung cancer. Int J Mol Med 2000; 5: 201-5.
  • 10. Baggetto LG. Deviant energetic metabolism of glycolytic cancer cells. Biochimie 1992; 74(11): 959-74.
  • 11. Buchwald H. Cholesterol inhibition, cancer, and chemotherapy. Lancet 1992; 339: 1154-6.
  • 12. Alexopoulos CG, Blatsios B, Avgerinos A. Serum lipids and lipoprotein disorders in cancer patients. Cancer 1987; 60: 3065-70.
  • 13. Umeki S. Decreases in serum cholesterol levels in advanced lung cancer. Respiration 1993; 60: 178-81.
  • 14. Siemianowicz K, Gminski J, Stajszczyk M, Wojakowski W, Goss M, Machalski M, Telega A, Brulinski K, Molendowska H. Serum HDL cholesterol concentration in patients with squamous cell and small cell lung cancer. Int J Mol Med 2000; 6: 307-11.
  • 15. Fiorenza AM, Branchi A, Sommariva D. Serum lipoprotein profiles in patients with cancer. A comparison with non cancer subjects. Int J Clin Lab Res 2000; 30(3): 141-5
  • 16. Craig WY, Palomaki GE, Haddow JE. Cigarette smoking and serum lipid and lipoprotein concentrations: an analysis of published data. BMJ 1989; 298: 784-8.
  • 17. Sirisali K, Kanluan T, Poungvarin N, Prabhant C. Serum lipid, lipoprotein-cholesterol and apolipoproteins AI and B of smoking and non smoking males. J Med Assoc Thai 1992; 75(12): 709-13.