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ASBEST TEMASININ AKCİĞER KANSERİNİN KLİNİĞİNE YANSIMASI

Yıl 2017, Cilt: 31 Sayı: 1, 1 - 7, 01.05.2017

Öz

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.

Kaynakça

  • 1. Ferlay J, Shin HR, Bray F, et al. Estimates of worldwide burden of cancer in 2008: Globocan 2008. Int J Cancer 2010; 127: 2893-917. doi: 10.1002/ijc.25516.
  • 2. Türk Toraks Derneği / Akciğer ve Plevra Maligniteleri Çalışma Grubu ve T.C. Sağlık Bakanlığı Kanserle Savaş Dairesi. Türkiye’nin akciğer kanseri haritası projesi raporu.
  • 3. Alberg AJ, Brock MV, Ford JG, et al. Epidemiology of lung cancer. Diagnosis and management of lung cancer, 3rd ed: American College of Chest Physicians evidence-based clinical practice guidelines. Chest 2013; 143: e1S–29S. doi: 10.1378/chest.12-2345.
  • 4. Doll R. Mortality from lung cancer in asbestos workers. Br J Ind Med 1955; 12: 81–6.
  • 5. Swiatkowska B, Szubert Z, Sobala W, et al. Predictors of lung cancer among former asbestosexposed workers. Lung Cancer 2015; 89: 243–8. doi: 10.1016/j.lungcan. 2015.06.013.
  • 6. Ngamwong Y, Tangamornsuksan W, Lohitnavy O, et al. Additive synergism between asbestos and smoking in lung cancer risk: A systematic review and meta-analysis. Plos One 2015; 10: e0135798. doi: 10.1371/journal.pone.0135798.
  • 7. Metintas S, Metintas M, Ak G, Kalyoncu C. Environmental asbestos exposure in rural Turkey and risk of lung cancer. Int J Environ Health Res 2012; 22: 468-79. doi: 10.1080/09603123.2011. 654330.
  • 8. Turkey Asbestos Control Strategic Plan–Final Report. Turkish Mesothelioma Working Group, Public Health Institute of Turkey, Eskisehir Osmangazi University. Turk Thorac J 2015; 16: S1–S26.
  • 9. Frank AL, Joshi TK. The global spread of asbestos. Ann Glob Health 2014; 80: 257–62. doi: 10.1016/j.aogh.2014.09.016.
  • 10. Asbestos, asbestosis and cancer: the Helsinki criteria for diagnosis and attribution. Consensus report. Scand J Work Environ Health 1997; 23: 311–6. doi:10.5271/sjweh.226
  • 11. Maxim LD, Niebo R, Utell MJ. Are pleural plaques an appropriate endpoint for risk analyses? Inhal Toxicol 2015; 27: 321–34. doi: 10.3109/ 08958378.2015.1051640.
  • 12. Weiss W. Asbestosis: A marker for the increased risk of lung cancer among workers exposed to asbestos. Chest 1999; 115: 536–49. doi: 10. 1378/ chest.115.2.536.
  • 13. Reid A, de Klerk N, ambrosini GL, et al. The effect of asbestosis on lung cancer risk beyond the dose related effect of asbestos alone. Occup Environ Med 2005; 62: 885–9. doi:10.1136/oem.2005. 020834
  • 14. Metintas M, Metintas S, Hillerdal G, et al. Nonmalignant pleural lesions due to environmental exposure to asbestos: a fieldbased, cross-sectional study. Eur Respir J 2005; 26: 875–80. DOI: 10.1183/09031936.05. 00136404
  • 15. Hillerdal G, Henderson DW. Asbestos, asbestosis, pleural plaques and lung cancer. Scand J Work Environ Health 1997; 23: 93–103. doi: 10. 5271/ sjweh.186.
  • 16. Weiss W. Asbestosis and lobar site of lung cancer. Occup Environ Med 2000; 57: 358–60. doi: 10.1136/ oem.57.5.358.
  • 17. Lee BW, Wain JC, Kelsey KT, et al. Association of cigarette smoking and asbestos exposure with location and histology of lung cancer. Am J Respir Crit Care Med 1998; 157: 748–55. doi.org/10. 1164/ajrccm.157.3.9707025.
  • 18. Brodkin CA, McCullough J, Stover B, et al. Lobe of origin and histologic type of lung cancer associated with asbestos exposure in the Carotene and Retinol Efficacy Trial (CARET). Am J Ind Med 1997; 32: 582–91. 10.1002/(SICI)1097- 0274(199712)32:6<582::AID-AJIM2>3.0.CO;2-S.
  • 19. Churg A. Lung cancer cell type and asbestos exposure. JAMA 1985; 253: 2984–5. doi: 10.1001/jama.1985.03350440062032.
  • 20. Metintas S, Ak G, Yilmaz S, Bogar F, Metintas M. Validity and reliability of the asbestos knowledge and awareness questionnaire for environmental asbestos exposure in rural area. Eurasian J Pulmonol 2017; Ahead of print: EJP-57441. Doi:10.5152/ejp.2016.57441.

REFLECTION OF ASBESTOS EXPOSURE TO THE LUNG CANCER CLINIC

Yıl 2017, Cilt: 31 Sayı: 1, 1 - 7, 01.05.2017

Öz

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.

Kaynakça

  • 1. Ferlay J, Shin HR, Bray F, et al. Estimates of worldwide burden of cancer in 2008: Globocan 2008. Int J Cancer 2010; 127: 2893-917. doi: 10.1002/ijc.25516.
  • 2. Türk Toraks Derneği / Akciğer ve Plevra Maligniteleri Çalışma Grubu ve T.C. Sağlık Bakanlığı Kanserle Savaş Dairesi. Türkiye’nin akciğer kanseri haritası projesi raporu.
  • 3. Alberg AJ, Brock MV, Ford JG, et al. Epidemiology of lung cancer. Diagnosis and management of lung cancer, 3rd ed: American College of Chest Physicians evidence-based clinical practice guidelines. Chest 2013; 143: e1S–29S. doi: 10.1378/chest.12-2345.
  • 4. Doll R. Mortality from lung cancer in asbestos workers. Br J Ind Med 1955; 12: 81–6.
  • 5. Swiatkowska B, Szubert Z, Sobala W, et al. Predictors of lung cancer among former asbestosexposed workers. Lung Cancer 2015; 89: 243–8. doi: 10.1016/j.lungcan. 2015.06.013.
  • 6. Ngamwong Y, Tangamornsuksan W, Lohitnavy O, et al. Additive synergism between asbestos and smoking in lung cancer risk: A systematic review and meta-analysis. Plos One 2015; 10: e0135798. doi: 10.1371/journal.pone.0135798.
  • 7. Metintas S, Metintas M, Ak G, Kalyoncu C. Environmental asbestos exposure in rural Turkey and risk of lung cancer. Int J Environ Health Res 2012; 22: 468-79. doi: 10.1080/09603123.2011. 654330.
  • 8. Turkey Asbestos Control Strategic Plan–Final Report. Turkish Mesothelioma Working Group, Public Health Institute of Turkey, Eskisehir Osmangazi University. Turk Thorac J 2015; 16: S1–S26.
  • 9. Frank AL, Joshi TK. The global spread of asbestos. Ann Glob Health 2014; 80: 257–62. doi: 10.1016/j.aogh.2014.09.016.
  • 10. Asbestos, asbestosis and cancer: the Helsinki criteria for diagnosis and attribution. Consensus report. Scand J Work Environ Health 1997; 23: 311–6. doi:10.5271/sjweh.226
  • 11. Maxim LD, Niebo R, Utell MJ. Are pleural plaques an appropriate endpoint for risk analyses? Inhal Toxicol 2015; 27: 321–34. doi: 10.3109/ 08958378.2015.1051640.
  • 12. Weiss W. Asbestosis: A marker for the increased risk of lung cancer among workers exposed to asbestos. Chest 1999; 115: 536–49. doi: 10. 1378/ chest.115.2.536.
  • 13. Reid A, de Klerk N, ambrosini GL, et al. The effect of asbestosis on lung cancer risk beyond the dose related effect of asbestos alone. Occup Environ Med 2005; 62: 885–9. doi:10.1136/oem.2005. 020834
  • 14. Metintas M, Metintas S, Hillerdal G, et al. Nonmalignant pleural lesions due to environmental exposure to asbestos: a fieldbased, cross-sectional study. Eur Respir J 2005; 26: 875–80. DOI: 10.1183/09031936.05. 00136404
  • 15. Hillerdal G, Henderson DW. Asbestos, asbestosis, pleural plaques and lung cancer. Scand J Work Environ Health 1997; 23: 93–103. doi: 10. 5271/ sjweh.186.
  • 16. Weiss W. Asbestosis and lobar site of lung cancer. Occup Environ Med 2000; 57: 358–60. doi: 10.1136/ oem.57.5.358.
  • 17. Lee BW, Wain JC, Kelsey KT, et al. Association of cigarette smoking and asbestos exposure with location and histology of lung cancer. Am J Respir Crit Care Med 1998; 157: 748–55. doi.org/10. 1164/ajrccm.157.3.9707025.
  • 18. Brodkin CA, McCullough J, Stover B, et al. Lobe of origin and histologic type of lung cancer associated with asbestos exposure in the Carotene and Retinol Efficacy Trial (CARET). Am J Ind Med 1997; 32: 582–91. 10.1002/(SICI)1097- 0274(199712)32:6<582::AID-AJIM2>3.0.CO;2-S.
  • 19. Churg A. Lung cancer cell type and asbestos exposure. JAMA 1985; 253: 2984–5. doi: 10.1001/jama.1985.03350440062032.
  • 20. Metintas S, Ak G, Yilmaz S, Bogar F, Metintas M. Validity and reliability of the asbestos knowledge and awareness questionnaire for environmental asbestos exposure in rural area. Eurasian J Pulmonol 2017; Ahead of print: EJP-57441. Doi:10.5152/ejp.2016.57441.
Toplam 20 adet kaynakça vardır.

Ayrıntılar

Diğer ID JA62YY85GG
Bölüm Araştırma Makalesi
Yazarlar

Güntülü Ak Bu kişi benim

Selma Metintaş Bu kişi benim

Şenay Yılmaz Bu kişi benim

Muzaffer Metintaş Bu kişi benim

Yayımlanma Tarihi 1 Mayıs 2017
Yayımlandığı Sayı Yıl 2017 Cilt: 31 Sayı: 1

Kaynak Göster

APA Ak, G., Metintaş, S., Yılmaz, Ş., Metintaş, M. (2017). ASBEST TEMASININ AKCİĞER KANSERİNİN KLİNİĞİNE YANSIMASI. İzmir Göğüs Hastanesi Dergisi, 31(1), 1-7.