Küçük Hücreli Dışı Akciğer Kanserinde Rezeksiyon Öncesi ve Sonrasında Serum Endokan ve VEGF Düzeylerinin Karşılaştırılması

Lung cancer is the most widely diagnosed cancer worldwide and the leading cause of cancer deaths. Angiogenesis, which means the growth of new blood vessels from existing vessels, is critical in tumor development, progression and metastasis. Vascular endothelial growth factor (VEGF) is the main mediator of angiogenesis, and it has been shown that increased serum levels in non-small cell lung cancer (NSCLC) are associated with poor prognosis. Additionally, studies demonstrate that endocan, a soluble proteoglycan specific to endothelial cells, can be used in the diagnosis and prognosis of some cancers. A total of 67 patients (38 lung cancer and 29 benign patients) were included in our study. The preoperative median serum VEGF values in the patient group was 92.38 pg/dl, and it was significantly higher than the control group (57.14 pg/dl) (p = 0.001). Serum VEGF levels were found to decrease on the 1st, 7th and 30th days after surgery in the NSCLC group (p <0.001). The pre-operative median serum endocan value in the patient group was 379.82 pg/dl, and there was no significant difference compared to the control group (562.68 pg/dl) (p = 0.160). Serum endocan values measured on the 1st, 7th and 30th days after surgery were found to increase significantly (p <0.001). In the literature, there is no study demonstrating serum endocan and VEGF levels before and after resection in early stage NSCLC. We think that serum VEGF levels can be used as a biomarker for lung cancer screening and follow-up. In terms of serum endocan levels, which were similar between patients and controls, it appears that there is not enough evidence to suggest use as a marker of screening or follow-up in patients with lung cancer.Akciğer kanseri; dünya genelinde en çok tanı alan ve kansere bağlı ölümlerde ilk sırada yer alan kanserdir. Mevcut damarlardan yeni kan damarlarının büyümesi olan anjiyogenez, tümör gelişimi, progresyonu ve metastazında kritik öneme sahiptir. Vasküler endotelyal büyüme faktörü (VEGF) anjiyogenezin ana mediatörüdür, küçük hücreli dışı akciğer kanserinde (KHDAK) serum seviyelerinin yükselmesinin kötü prognozla ilişkili olabileceği gösterilmiştir. Endotel hücresine spesifik solubl bir proteoglikan olan endokanın bazı kanserlerde tanı ve prognoz tahmininde kullanılabileceği gösterilmiştir. Çalışmamıza 38 akciğer kanseri hastası ve 29 benign (kontrol hastası) olmak üzere toplam 67 hasta dahil edildi. Hasta grubunda preoperatif ortanca serum VEGF değerleri 92.38 pg/dl bulundu, ve kontrol grubuna göre (57.14 pg/dl) anlamlı olarak yüksekti (p = 0.001). Hasta grubunda cerrahi sonrasında 1. 7. ve 30. günlerde serum VEGF düzeylerinin anlamlı olarak düştüğü tespit edildi (p<0.001). Hasta grubunda preoperatif serum endokan ortanca değeri 379.82 pg/dl bulundu, ve kontrol grubuna (562.68 pg/dl) kıyasla anlamlı fark görülmedi (p = 0.160). Rezeksiyon sonrasında 1. 7. ve 30. günlerde alınan serum endokan değerlerinin ise anlamlı olarak arttığı tespit edildi (p <0.001). Literatürde erken evre KHDAK'de serum endokan ve VEGF düzeylerini rezeksiyon öncesi ve sonrası karşılaştıran bir çalışma yoktur. Çalışmamıza göre serum VEGF düzeylerinin akciğer kanseri taraması ve takibinde bir biyobelirteç olarak kullanılabileceğini düşünmekteyiz. Hasta ve kontrol grupları arasında istatistiksel anlamlı bir fark gösterilemeyen serum endokan düzeylerinin ise; akciğer kanseri taramasında ve takibinde kullanılması konusunda yeterli bulgu ve kanıt olmadığını düşünmekteyiz

Prognostic Significance of the Glasgow Prognostic Score in Patients Undergoing Pulmonary Metastasectomy

Pulmonary metastasectomy is considered the standard treatment for various cancer types when the primary tumour is under control. The Glasgow Prognostic Score (GPS), which is determined by serum levels of C-reactive protein (CRP) and albumin, is found to be a potential prognostic tool for variable primary cancer types. The aim of this study is to evaluate the prognostic role of the GPS in patients undergoing pulmonary metastasectomy for different subgroups of cancer types. Data of 142 patients who underwent pulmonary metastasectomy at in a single institution were retrospectively analyzed from a prospectively collected database. Primary tumour histologic subtypes were classified into five categories: Gastrointestinal tumours (Colorectal, gastric and colangiocellular carcinomas, n= 43), sarcomas (osteosarcoma, chondrosarcoma and synovial sarcoma, n= 38), breast carcinoma (n= 16), genitourinary system carcinomas (Cervix and endometrium carcinomas, n= 10) and miscellaneous (n= 35). High GPS is found to be correlated with worse survival rates in the subgroups of pulmonary metastasectomy for gastrointestinal, genitourinary and miscellaneous cancers (p= 0.050, p= 0.046 and p= 0.003, respectively). Although there is an evident decline of mean survival in breast cancer and sarcoma patients, the effect of GPS score on overall survival was statistically insignificant (p= 0.081 and p= 0.056, respectively). In conclusion, GPS appears to be a useful predictor of overall survival in pulmonary metastases for the majority of cancer types.WoSScopu