Sengupta Amitabha, Banerjee Sourindra Nath, Biswas Nirendra Mohan, Jash Debraj, Saha Kaushik, Maji Arnab, Bandyopadhyaya Ankan, Agarwal Sandip
Associate Professor, Department of Pulmonary Medicine, N.R.S. Medical College , India .
J Clin Diagn Res. 2013 Aug;7(8):1678-82. doi: 10.7860/JCDR/2013/5900.3225. Epub 2013 Aug 1.
Hyponatraemia is one of the common electrolytic disorders which are associated with lung cancer. Hyponatraemia may influence the ECOG performance status at presentation. Also, to the best of our knowledge, we found only limited Indian studies where the ECOG score was correlated with the serum sodium status in lung cancer patients on presentation.
To assess the incidence of hyponatraemia among the patients of carcinoma of the lung before putting them into the specific treatment category for cancer and to check the effects on their ECOG performance status.
A cross-sectional, observational study was conducted on 116 consecutive patients of lung cancer during the period from November 2011 to October 2012.
The patients with a histologically proven diagnosis of lung cancer were grouped initially according to their ECOG performance statuses. The serum sodium value of each patient was measured and the hyponatraemic patients were given treatment according to the protocol. The correlation of the ECOG performance status with the serum sodium of the lung cancer patients was measured. To check for any laboratory error in serum sodium, we selected (n = 58) age, sex and socioeconomic matched control patients.
At presentation 44.8% of the lung cancer patients showed hyponatraemia [52/116]. The ECOG score was significantly poor in the advanced clinical stages (ECOG ≤2 Vs ECOG ≥ 3 in NSCLC cases, χ(2) =11.25, P=.0008). The ECOG performance status score at admission showed a negative correlation with the serum sodium status which was measured on admission among all the patients (Pearson correlation coefficient = - 0.186). The clinical stage of the lung cancer also showed a positive correlation with the ECOG score at admission in our study (Pearson correlation coefficient = 0.295).
Hyponatraemia is not an uncommon condition and it should be suspected and screened in each patient, as it may influence the ECOG performance status score, which serves as an important factor in the prognosis of lung cancer.
低钠血症是与肺癌相关的常见电解质紊乱之一。低钠血症可能会影响初诊时的东部肿瘤协作组（ECOG）体能状态。此外，据我们所知，我们发现仅有有限的印度研究将ECOG评分与肺癌患者初诊时的血清钠状态相关联。
评估肺癌患者在进入特定癌症治疗类别之前低钠血症的发生率，并检查其对ECOG体能状态的影响。
2011年11月至2012年10月期间，对116例连续的肺癌患者进行了一项横断面观察性研究。
组织学确诊为肺癌的患者最初根据其ECOG体能状态进行分组。测量每位患者的血清钠值，低钠血症患者按照方案接受治疗。测量肺癌患者的ECOG体能状态与血清钠之间的相关性。为检查血清钠的任何实验室误差，我们选择了（n = 58）年龄、性别和社会经济状况相匹配的对照患者。
初诊时，44.8%的肺癌患者出现低钠血症[52/116]。在晚期临床阶段，ECOG评分明显较差（非小细胞肺癌病例中ECOG≤2与ECOG≥3相比，χ(2)=11.25，P = 0.0008）。所有患者入院时的ECOG体能状态评分与入院时测量的血清钠状态呈负相关（Pearson相关系数 = - 0.186）。在我们的研究中，肺癌的临床分期与入院时的ECOG评分也呈正相关（Pearson相关系数 = 0.295）。
低钠血症并非罕见情况，应在每位患者中进行怀疑和筛查，因为它可能会影响ECOG体能状态评分，而这是肺癌预后的一个重要因素。
