ASBEST TEMASININ AKCİĞER KANSERİNİN KLİNİĞİNE YANSIMASI

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

Güntülü Ak Selma Metintaş Şenay Yılmaz Muzaffer Metintaş

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.

Anahtar Kelimeler

Akciğer kanseri, Asbest teması

REFLECTION OF ASBESTOS EXPOSURE TO THE LUNG CANCER CLINIC

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.

Anahtar Kelimeler

Lung cancer, Asbestos exposure

Kaynakça

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