Bose Chinmoy K, Dey Subhashis, Mukhopadhyay Ashis
Department of Clinical Research, Netaji Subhash Chandra Bose Cancer Research Institute, Park Street, Kolkata, West Bengal, India.
Indian J Med Paediatr Oncol. 2011 Jul;32(3):139-42. doi: 10.4103/0971-5851.92810.
Hyponatremia is a hazardous complication of lung cancer and its treatment. It is seen at presentation in approximately 15% of patients with small-cell lung cancer (SCLC) and 1% of patients with non-small cell lung cancer (NSCLC). Platinum compounds used as first-line agents along with taxols frequently cause hyponatremia. Till date there is no data on its prevalence in patients with advanced lung cancer in the Indian subcontinent.
This study was undertaken to find out its incidence before and after institution of chemotherapy and to observe the results of treatment of hyponatremia in a group of lung cancer patient.
Forty patients with advanced lung cancer (25 patients with stage III disease and 15 with stage IV disease) were included in the study. Variables looked at included, but were not limited to, serum sodium, serum albumin, serum alkaline phosphatase, serum lactate dehydrogenase, and hemoglobin. These variables were measured as per the standard clinical laboratory procedure. No ethics approval was required as these parameters are routinely measured in such patients.
In the chemo-naïve state, one out of five cases with SCLC (20%) had hyponatremia at presentation; among the 35 cases of NSCLC, 7 patients (20%) had hyponatremia at presentation, which is in sharp contrast to earlier reports of 1% prevalence of hyponatremia in this group. Among the 27 cases who died within 6 months, 11 had hyponatremia; this finding was statistically highly significant.
In India, NSCLC patients are at high risk of having hyponatremia at presentation and this is significantly associated with a worse outcome.
低钠血症是肺癌及其治疗的一种危险并发症。在约15%的小细胞肺癌（SCLC）患者和1%的非小细胞肺癌（NSCLC）患者初诊时可见。作为一线药物与紫杉类药物联用的铂类化合物常导致低钠血症。迄今为止，在印度次大陆，尚无关于晚期肺癌患者中低钠血症患病率的数据。
本研究旨在查明化疗开始前后低钠血症的发生率，并观察一组肺癌患者低钠血症的治疗结果。
本研究纳入了40例晚期肺癌患者（25例Ⅲ期疾病患者和15例Ⅳ期疾病患者）。观察的变量包括但不限于血清钠、血清白蛋白、血清碱性磷酸酶、血清乳酸脱氢酶和血红蛋白。这些变量按照标准临床实验室程序进行测量。由于这些参数在这类患者中常规测量，因此无需伦理批准。
在未接受化疗的状态下，5例SCLC患者中有1例（20%）初诊时存在低钠血症；在35例NSCLC患者中，7例（20%）初诊时存在低钠血症，这与该组低钠血症患病率为1%的早期报告形成鲜明对比。在6个月内死亡的27例患者中，11例存在低钠血症；这一发现具有高度统计学意义。
在印度，NSCLC患者初诊时发生低钠血症的风险很高，且这与更差的预后显著相关。
