ASBEST TEMASININ AKCÝÐER KANSERÝNÝN KLÝNÝÐÝNE YANSIMASI

Giriþ: Bu çalýþmada asbest temasý olan akciðer kanserli hastalarýn, asbest temasý olmayan hastalar ile karþýlaþtýrarak sosyo demografik, klinik ve radyolojik özelliklerini ayýrt etmeyi amaçladýk. Gereç ve Yöntem: Çalýþma grubu 2637 akciðer kanserli hastadan oluþmaktaydý. Hastalar asbest temasý öyküsü ve asbestin radyolojik bulgularý açýsýndan 3 ayrý gruba ayrýldý; 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 karþýlaþtýrýldý. Bulgular: Asbeste baðlý lezyonlarýn radyolojik bulgularý 107 kiþide plevral plak, 5 kiþide asbestozis, 30 kiþide diffüz plevral fibrozis ve 3 kiþide yuvarlak atelektaziydi. Asbest temas öyküsü ve radyolojik bulgusu olan grupta yaþ ortalamasý (63.9±8.8), temas öyküsü ve radyolojik bulgusu olmayan gruptan (60.1±9.6) daha yüksekti (p<0.001). Ýki grup arasýnda sosyo demografik ve klinik özellikler bakýmýndan fark yoktu. Asbest temas öyküsü ve radyolojik bulgusu olan grupta lezyon daha çok alt zon ve periferik yerleþim gösteriyorken, diðer grupta santral yerleþim gösteriyordu (p=0.004, p=0.028, p=0.003). Ýki grup arasýnda histopatolojik alt tipler bakýmýndan fark yoktu (p<0.656). Ancak, evre 4 hastalýk oraný asbest temas öyküsü ve radyolojik bulgusu olan grupta diðer gruba göre daha düþüktü (%40.2 karþýn %49.2; p=0.048). Tartýþma: Akciðer kanserinden þüphelenilen asbest temaslý kiþilerde alt ve periferik akciðer alanlarýnýn dikkatli deðerlendirilmesi hastalýðýn ileri evrede yakalanma oranýný azaltabilir. Bu grupta ileri evre hastalýk oraný daha az olduðu için tedavi ve dikkatli takip ile sað kalým iyileþtirilebilir.

REFLECTION OF ASBESTOS EXPOSURE TO THE LUNG CANCER CLINIC

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.