Pedersen L M, Milman N
Department of Pulmonary Medicine, Gentofte Hospital, University of Copenhagen, Denmark.
Eur J Cancer. 1998 Jan;34(1):76-80. doi: 10.1016/s0959-8049(97)10003-x.
In a prospective study of 102 outpatients with histologically proven lung cancer, the prevalence and prognostic significance of microalbuminuria (urinary albumin excretion > 20 micrograms/min) were analysed. 65 consecutive outpatients with benign lung disorders served as controls. An immunoturbidimetric assay, sensitive at low concentrations, was used to quantify the albumin excretion rate in timed overnight urine samples. Patients with malignancies had a significantly higher frequency of microalbuminuria (32.4% compared with controls, 13.8%, P < 0.01) and median urinary albumin excretion rate (13.4 versus controls, 8.9 micrograms/min, P < 0.003). Urinary albumin excretion was significantly higher in lung cancer patients with TNM stage III and IV. Patients with malignancies and microalbuminuria had a significantly lower survival rate than patients with normoalbuminuria (probability of survival 1 and 3 years after diagnosis 66% and 16% versus controls, 22% and 4%, P < 0.00001). In a multivariate model, which adjusted for age, sex, performance status, histological type and TNM stage, microalbuminuria continued to be a significant predictor of survival. In conclusion, an increased prevalence of microalbuminuria has been demonstrated in patients with lung cancer. The presence of microalbuminuria was associated with advanced disease stage and poor survival.
在一项对102例经组织学证实的肺癌门诊患者的前瞻性研究中，分析了微量白蛋白尿（尿白蛋白排泄>20微克/分钟）的患病率及其预后意义。65例连续的良性肺部疾病门诊患者作为对照。采用对低浓度敏感的免疫比浊法，对定时过夜尿样中的白蛋白排泄率进行定量分析。恶性肿瘤患者微量白蛋白尿的发生率显著更高（32.4%，而对照组为13.8%，P<0.01），尿白蛋白排泄率中位数也更高（13.4对对照组的8.9微克/分钟，P<0.003）。TNM分期为III期和IV期的肺癌患者尿白蛋白排泄显著更高。有微量白蛋白尿的恶性肿瘤患者的生存率显著低于白蛋白尿正常的患者（诊断后1年和3年的生存概率分别为66%和16%，而对照组为22%和4%，P<0.00001）。在一个对年龄、性别、体能状态、组织学类型和TNM分期进行校正的多变量模型中，微量白蛋白尿仍然是生存的显著预测因素。总之，已证实在肺癌患者中微量白蛋白尿的患病率增加。微量白蛋白尿的存在与疾病晚期和生存不良相关。
