Akciðer Kanserlerine Eþlik Eden Plevra Sývýsý

Ýt has been known that prognosis is poor in lung cancer vvith pleural effusion. The records of 44 lung cancer patients vvith pleural effusion admitted to our clinic betvveen 2003-2009 were evaluated. Thirty nine patients (88.6%) were male and five of them were (11.4%) femaie. Mean age of patients was 62.8 ± 11.7 (minimum 36-maximum 93) years. Thirty three patients (75.0%) were diagnosed as non small celi lung cancer (NSCLC) whereas remaining (25.0%) were presented as small celi lung cancer. Most of the cases (16/33) were diagnosed as sçuamous celi cancer in patients vvith NSCLC vvhereas the remaining were ade-nocarcinoma (seven cases), large celi cancer (two cases) and non-classified NSCLC (eight cases). The stages in most of the cases were presented as T4 (43.2%), N1 (27.3%), MO (43.2%) and stage (36.4%). Pleural effusion was in right side (43.2%) and minimal (45.5%) in size in the majority of cases. Most of the pleural effusions were in the same side vvith tumor (88.6%>), were exudative (61.4%>) and were not evaluated microscopically (61.4%). The ratio of the patients undement chemotherapy and presented vvith regression in pleural effusion was high after the first course then it decreased in the later courses (39.1 %> -»9.1 %>). The ratio of patients vvhose effusions remained stable after the first course increased in the later courses and remained above 50% (56.6%> -»63.6%>). The ratio of patients vvith Progressive pleural effusions increased in the later courses (4.3%> ->27.3%o). Ýn conclusion; pleural effusion might be mostly seen in the later stages of lung cancer. Most of the pleural effusions were minimal and located at the same side vvith tumor. The regression response that was achieved in the first course of chemotherapy decreased in the later courses. Progression in pleural effusions increased in the later courses.

Pleural Effusions Associated vvith Lung Cancers

Plevra sývýsýnýn eþlik ettiði akciðer kanseri tablosunda prognozun sýklýkla kötü olduðu bilinmektedir. Kliniðimizde 2003-2009 yýllarý arasýnda görülmüþ plevra sývýsýnýn eþlik ettiði 44 akciðer kanseri hastasýnýn kayýtlarý deðerlendirildi. Olgularýn 39 (%88.6)’u erkek, 5 (%11.4)'i kadýndý. Olgularýn yaþ ortalamasý 62.8 ± it.7 (36-93) idi. Küçük hücreli dýþý akciðer kanseri (KHDAK) tamlý olgu sayýsý 33 (%75.0) iken, küçük hücreli akciðer kanseri tamlý olanlarýn sayýsý 11 (%25.0) idi. KHDAK olgularýnýn çoðunluðunu (16 olgu) yassý hücreli akciðer Ca oluþtururken, kalanlarý (yedi olgu) adenokanser, büyük hücreli (iki olgu) ve tiplendirilememiþ (sekiz olgu) idi. Olgularýn çoðunlukla T4 (%43.2), N1 (%27.3), MO (%43.2) ve evre 4 (%36.4) daðýlýmýna uyduðu gözlendi. Olgularýn plevra sývýsý sýklýkla sað akciðerde (%43.2), minimal (%45.5), kitle ile ayný tarafta (%88.6), eksüda içeriðinde (%61.4), mikroskobik olarak direkt muayene ile deðerlendirilmemiþti (%61.4). Kemoterapi uygulanan ve sývýda regresyon gözlenen olgularýn oraný ilk kürde yüksek iken sonraki kürlerde azaldý (%39.1 -» %9.1). Plevra sývýsý stabil kalan olgularýn oraný ilk kürden itibaren artarak tüm kürlerde %50’nin üstünde seyretti (%56.6 -> %63.6). Plevra sývýsýnda progresyon gözlenen olgularýn oraný ilk kürden son kürlere giderek artýþ gösterdi (%4.3 -> %27.3). Sonuçta; akciðer kanserlerinde plevra sývýsýnýn daha sýklýkla ileri evrelerde izlenebildiði, olgularýn çoðunun minimal sývýlý olduðu ve kitle ile sývýnýn ayný tarafta yer aldýðý gözlendi, ilk kürde saðlanan sývýda regresyon yanýtýnýn diðer kürlerde azaldýðý ve sývýda progresyon oranýnýn ilerleyen kürlerde arttýðý gözlendi.