Güntülü AK, Selma METİNTAŞ, Şenay YILMAZ, Muzaffer METİNTAŞ

ASBEST TEMASININ AKCİĞER KANSERİNİN KLİNİĞİNE YANSIMASI

Giriş: Bu çalışmada asbest teması olan akciğer kanserli hastaların, asbest teması olmayan hastalar ile karşılaştırarak sosyo demografik, klinik ve radyolojik özelliklerini ayırt etmeyi amaçladık. Gereç ve Yöntem: Çalışma grubu 2637 akciğer kanserli hastadan oluşmaktaydı. Hastalar asbest teması öyküsü ve asbestin radyolojik bulguları açısından 3 ayrı gruba ayrıldı; temas öyküsü ve radyolojik bulgusu olmayan hastalar (1136), temas öyküsü olan ancak radyolojik bulgusu olmayan hastalar (1338) ve hem temas öyküsü hem de radyolojik bulgusu olan hastalar (135). Bir ve üçüncü gruplar karşılaştırıldı. Bulgular: Asbeste bağlı lezyonların radyolojik bulguları 107 kişide plevral plak, 5 kişide asbestozis, 30 kişide diffüz plevral fibrozis ve 3 kişide yuvarlak atelektaziydi. Asbest temas öyküsü ve radyolojik bulgusu olan grupta yaş ortalaması (63.9±8.8), temas öyküsü ve radyolojik bulgusu olmayan gruptan (60.1±9.6) daha yüksekti (p<0.001). İki grup arasında sosyo demografik ve klinik özellikler bakımından fark yoktu. Asbest temas öyküsü ve radyolojik bulgusu olan grupta lezyon daha çok alt zon ve periferik yerleşim gösteriyorken, diğer grupta santral yerleşim gösteriyordu (p=0.004, p=0.028, p=0.003). İki grup arasında histopatolojik alt tipler bakımındanfark yoktu (p<0.656). Ancak, evre 4 hastalık oranı asbest temas öyküsü ve radyolojik bulgusu olan grupta diğer gruba göre daha düşüktü (%40.2 karşın %49.2; p=0.048). Tartışma: Akciğer kanserinden şüphelenilen asbest temaslı kişilerde alt ve periferik akciğer alanlarının dikkatli değerlendirilmesi hastalığın ileri evrede yakalanma oranını azaltabilir. Bu grupta ileri evre hastalık oranı daha az olduğu için tedavi ve dikkatli takip ile sağ kalım iyileştirilebilir.

Anahtar Kelimeler:

Akciğer kanseri, Asbest teması

REFLECTION OF ASBESTOS EXPOSURE TO THE LUNG CANCER CLINIC

Introduction: In this study we aimed to differentiate sociodemographic, clinical and radiological characteristics of patients with asbestos exposed lung cancer compared to patients with asbestos unexposed lung cancer. Material and Methods: The study group consisted of 2637 patients with lung cancer. Patients were classified into three groups regarding asbestos exposure history and asbestos–related radiological findings: asbestos unexposed and no asbestos– related radiological findings (1136); asbestos exposed and no asbestos–related radiological findings (1338); asbestos exposed and asbestos– related radiological findings (135). First and third groups were compared. Results: Asbestos–related radiological findings were pleural plaque in 107 patients, asbestosis in 5, diffuse pleural thickening in 30 and round atelectasis in 3 patients. The mean age was higher in the group with asbestos exposed and asbestos– related radiological findings than the other group (63.9±8.8 v.s. 60.1±9.6; p<0.001). There were no difference between two groups regarding sociodemographic and clinical findings. Tumor showed lower lobe and peripheral origin in the group with asbestos exposed and asbestos–related radiological findings whereas the other group showed central origin (p=0.004, p=0.028, p=0.003). Histopathological subtypes were not different between two groups (p<0.656). However, stage 4 disease was less common in the group with asbestos exposed and asbestos–related radiological findings (40.2% v.s. 49.2%; p=0.048). Discussion: Careful evaluation of the lower and peripheral lung areas in asbestos-exposed individuals suspected of lung cancer may reduce the rate of diagnosing the disease in the advanced stage. Treatment and careful follow-up can improve survival because the rate of advancedstage disease in this group is lower.

Keywords:

Lung cancer, Asbestos exposure,

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