The place of initial serum sodium and globulin ratio in the prognosis estimation of patients with lung cancer

Abstract

Aims: Since lung cancer is a disease with a high mortality and morbidity rate, determining its prognosis has a very important place. Studies in the literature have shown that electrolyte disturbance and inflammation may be associated with a poor prognosis in lung cancer, however, further studies are needed on this subject. In this study, it was planned to investigate the role of the sodium and globulin ratio measured at the time of diagnosis in the prognosis prediction of patients with lung cancer diagnosis. Methods: The study was carried out retrospectively from the patient files and hospital records of 165 patients who were followed up with the diagnosis of lung cancer between January 1, 2015 and January 1, 2021 in XXXX University (KKU) Faculty of Medicine, Department of Internal Medicine, and Medical Oncology Department. Patients with achievable sodium, albumin, and total protein values at the time of diagnosis were included in the study. The hemogram parameters of the patients included in the study were creatinine and estimated glomerular filtration rate (eGFR), alanine aminotransferase (ALT) level, albumin level, total protein level and globulin level, C-reactive protein (CRP) level, CEA, and TSH levels. In addition, the sodium/globulin ratio (SGR) and the CRP/albumin ratio (CAR) were evaluated. Results: 87.3% of the patients were male, and 12.7% were female. The mean age at presentation was 62.5 ± 9.1 years. Adenocancer accounts for 46.1% of cancers with 76 patients, squamous cell carcinoma for 41.8% with 69 patients, and small cell carcinoma for 12.1% with 20 patients. 11 (6.7%) of the patients were stage 1, 25 (15.2%) stage 2, 58 (35.2%) stage 3, and 71 (43%) stage 4 patients. 111 (67.3%) of the patients died. The average follow-up time is 16.6 months. In the regression analyzes performed in our study, mortality and sodium/globulin ratio (SGR) and progression-free survival and sodium/globulin ratio (SGR) were found to be unrelated. There was a weak negative correlation between the sodium/globulin ratio (SGR) and the CRP/albumin ratio (CAR). In the multivariate regression analysis, the stage of the disease, diabetes, and CRP level were found to be the independent variables affecting mortality and the stage of the disease affecting progression-free survival. (p<0.001). Conclusion: Independent prognostic factors in patients with lung cancer; stage of disease for mortality, diabetes, and CRP level were found to be stages for progression-free survival. Considering the weak relationship between sodium/globulin ratio (SGR) and CRP/albumin ratio (CAR), SGR can be used as a future biomarker to predict prognosis in cancer patients. Further studies are needed to learn more about the relationship between SGR and lung cancer.