小细胞肺癌合并低钠血症2例病例汇报及相关文献复习
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摘要
低钠血症是临床上最常见的电解质紊乱症状。也是小细胞肺癌(SCLC)相关的临床表现之一,当肿瘤伴发低钠血症时,其发生机制目前主要考虑与抗利尿激素分泌异常综合征(SIADH)相关。本文就我科近期收治了2例小细胞肺癌伴低钠血症的患者,通过对这该病例的学习,希望更多的临床医生对由小细胞肺癌所导致的抗利尿激素分泌失调综合症(SIADH)能有更深刻的印象。同时需警惕临床医师,当出现难以纠正的低钠血症时,应考虑到肺癌的可能性,尽量明确诊断,避免漏诊、误诊,早期诊断是治疗本病的关键。
Hyponatremia is the most common electrolyte disorder in clinical practice.It is also one of the clinical manifestations associated with small cell lung cancer(SCLC).When the tumor is accompanied by hyponatremia,the pathogenesis of SCLC is mainly related to the syndrome of abnormal secretion of antidiuretic hormone(SIADH).Two cases of small cell lung cancer(SCLC) with hyponatremia were treated recently in our department.Through the study of the case,we hope that more clinicians will be more impressed with SIADH caused by SCLC.At the same time,clinicians should be alert.When hyponatremia is dif?cult to diagnose,we should consider the possibility of lung cancer,try to make a clear diagnosis,avoid missed diagnosis,misdiagnosis,early diagnosis is the key to the treatment of this disease.
Hyponatremia is the most common electrolyte disorder in clinical practice.It is also one of the clinical manifestations associated with small cell lung cancer(SCLC).When the tumor is accompanied by hyponatremia,the pathogenesis of SCLC is mainly related to the syndrome of abnormal secretion of antidiuretic hormone(SIADH).Two cases of small cell lung cancer(SCLC) with hyponatremia were treated recently in our department.Through the study of the case,we hope that more clinicians will be more impressed with SIADH caused by SCLC.At the same time,clinicians should be alert.When hyponatremia is dif?cult to diagnose,we should consider the possibility of lung cancer,try to make a clear diagnosis,avoid missed diagnosis,misdiagnosis,early diagnosis is the key to the treatment of this disease.
引文
[1]Berardi R,Caramanti M,Castagnani M,etal.Hyponatremia is apredictor of hospital length and cost of stay and outcome in cancer patients[J].supportive care in cancer,2015,23(10):3095-4101.
[2]Yoon J,Ahn SH,Lee YJ,etal.Hyponatremia as an independent prognostic factor in patients with terminal cancer[J].Supportive Care in Cancer,2015,23(6):1-6.
[3]赵展光,宋世辉,张鹏.小细胞肺癌合并低钠血症的临床分析[J].天津医科大学学报,2011,17(2):222-223.
[4]Rosner MH,Dalkin AC.Electrolyte disorders associated with cancer[J].Adv Chronic Kidney Dis,2014,21(1):7-17.
[5]Castillo J J,Vincent M,Justice E.Diagnosis and management of hyponatremia in cancer patients[J]Oncologist,2012,17(6):756-765.
[6]Hansen O,Sorensen P,Hansen K H.The occurrence of hyponatremia in SCLC and the influence on prognosis:a retrospective study of 453 patients treated in a single institution in a 10-year period[J].Lung Cancer,2010,68(1):111-114.
[7]Kana N,Watanabe N,Kita N,etal.Paraneo plastic syndromes associated with lun gcancer[J].World J Clin Oncol,2014,5(3):197-223.
[8]朱晶,马丽霞,王胜,等.小细胞肺癌并发低钠血症的临床特点并12例临床分析[J].吉林医学,2011,32(25):5311-5312.
[9]周祎,张均.以低钠血症为首发表现的小细胞肺癌1例及文献复习[J].南京医科大学学报(自然科学版).2017.37(1):126-128.
[10]胡义德,钱桂生.小细胞肺癌综合治疗:从指南到实践[J].中华肺部疾病杂志(电子版),2011,4(5):356-359.
[11]Karczmarek-Borowska B.Zielinska K.Bukala A.Hyponatremia in the course of small cell lung cancer-a case repon[J].Pol Merkur Lekarski,2014,37(217):49-52.
[12]R Berardi,M Santoni,TNewsom-Davis,et al.Hyponatremia normalization as an independent prognostic factor in patients with advanced non-small cell lung cancer treated with first-line therapy[J].Oncotarget,2017,8(14):23871-23879.
[13]李旭,胡雪晴,张子瑾,等.肺癌合并中重度低钠血症的预后分析[J].中华肿瘤防治杂志2016,10(23):672-675.
[14]赵亮,单锦露,冯燕,等.低钠血症对小细胞肺癌预后及治疗效果的影响[J].重庆医学,2016,27(45):3814-3816.
[15]Kalemkerian GP,Akerley W,Bogner P,et al.NCC Nguidelines O Rsmall cell lung cancer[J].J Natl Compr Canc Netw,2013,11(1):78-98.
[16]Peri A.Clinical review:the use of vaptans in clinical endocrinology[J].J Clin Endocrinol Metab,2013,98(4):1321-1332.
[2]Yoon J,Ahn SH,Lee YJ,etal.Hyponatremia as an independent prognostic factor in patients with terminal cancer[J].Supportive Care in Cancer,2015,23(6):1-6.
[3]赵展光,宋世辉,张鹏.小细胞肺癌合并低钠血症的临床分析[J].天津医科大学学报,2011,17(2):222-223.
[4]Rosner MH,Dalkin AC.Electrolyte disorders associated with cancer[J].Adv Chronic Kidney Dis,2014,21(1):7-17.
[5]Castillo J J,Vincent M,Justice E.Diagnosis and management of hyponatremia in cancer patients[J]Oncologist,2012,17(6):756-765.
[6]Hansen O,Sorensen P,Hansen K H.The occurrence of hyponatremia in SCLC and the influence on prognosis:a retrospective study of 453 patients treated in a single institution in a 10-year period[J].Lung Cancer,2010,68(1):111-114.
[7]Kana N,Watanabe N,Kita N,etal.Paraneo plastic syndromes associated with lun gcancer[J].World J Clin Oncol,2014,5(3):197-223.
[8]朱晶,马丽霞,王胜,等.小细胞肺癌并发低钠血症的临床特点并12例临床分析[J].吉林医学,2011,32(25):5311-5312.
[9]周祎,张均.以低钠血症为首发表现的小细胞肺癌1例及文献复习[J].南京医科大学学报(自然科学版).2017.37(1):126-128.
[10]胡义德,钱桂生.小细胞肺癌综合治疗:从指南到实践[J].中华肺部疾病杂志(电子版),2011,4(5):356-359.
[11]Karczmarek-Borowska B.Zielinska K.Bukala A.Hyponatremia in the course of small cell lung cancer-a case repon[J].Pol Merkur Lekarski,2014,37(217):49-52.
[12]R Berardi,M Santoni,TNewsom-Davis,et al.Hyponatremia normalization as an independent prognostic factor in patients with advanced non-small cell lung cancer treated with first-line therapy[J].Oncotarget,2017,8(14):23871-23879.
[13]李旭,胡雪晴,张子瑾,等.肺癌合并中重度低钠血症的预后分析[J].中华肿瘤防治杂志2016,10(23):672-675.
[14]赵亮,单锦露,冯燕,等.低钠血症对小细胞肺癌预后及治疗效果的影响[J].重庆医学,2016,27(45):3814-3816.
[15]Kalemkerian GP,Akerley W,Bogner P,et al.NCC Nguidelines O Rsmall cell lung cancer[J].J Natl Compr Canc Netw,2013,11(1):78-98.
[16]Peri A.Clinical review:the use of vaptans in clinical endocrinology[J].J Clin Endocrinol Metab,2013,98(4):1321-1332.