Prognostic value of the lymphocyte-to-monocyte ratio and other inflammatory markers in malignant pleural mesothelioma.

OBJECTIVES: Inflammation plays a role in malignant pleural mesothelioma (MPM) prognosis and symptoms. We investigated the roles of the new and old inflammatory indexes and markers in MPM prognosis. METHODS: Two hundred and ninety-two MPM patients (167 male and 125 female) were included in this retrospective study. Demographic parameters were collected from the patients' files. Kaplan-Meier curves and multivariate Cox regression analyses were used for the analysis of prognosis. RESULTS: The mean age of the patients was 58.4 years. The mean survival time was 14.6 ± 13.0 months. Twenty-four potential prognostic factors associated with a poor outcome were calculated in the univariate analysis, and 16 potential prognostic factors were associated with a poor prognosis. These 16 potential prognostic factors were also analyzed in multivariate analysis. Multivariate analysis showed that increased age, stage 3-4 disease, the non-epithelial type, a low Karnofsky performance score, a high white blood cell count, and a low lymphocyte-to-monocyte ratio (LMR) were associated with a poor prognosis. The results of the multivariate analysis showed that a decreased LMR was associated with poor survival. Patients with LMR ≤2.6 had poor survival compared with those with LMR >2.6 (mean 9.6 vs. 17.0 months, respectively; p = 0.004). CONCLUSIONS: LMR is an independent marker of prognosis in patients with MPM and is superior to the other inflammation-based markers. The inexpensive nature and easy reproducibility of the hemogram should encourage the use of the LMR in clinical practice.

High-risk mesothelioma relation to meteorological and geological condition and distance from naturally occurring asbestos.

OBJECTIVES: Very few studies have investigated the incidence and risk of malignant mesothelioma (MM) associated with distinct sources of asbestos exposure, especially exposure to naturally occurring asbestos (NOA). METHODS: Subjects were MM, lung, and breast cancer patients who were diagnosed and followed in Diyarbakir Province between 2008 and 2013. The birthplaces of patients were displayed on a geologic map. Geological and meteorological effects on MM were analyzed by logistic regression. RESULTS: A total of 180 MM, 368 breast, and 406 lung cancer patients were included. The median distance from birthplace to ophiolites was 6.26 km for MM, 31.06 km for lung, and 34.31 km for breast cancer (p < 0.001). The majority of MM cases were seen within 20 km from NOA areas. The MM incidence inside of NOA was 1059/100.000, and out of NOA was 397/100.000; this difference was significant (p = 0.014). The largest concentration of MM residential areas was within ± 30° (34 residential areas 36.6%) of the dominant wind direction. Most MM patients were found in or near the dominant wind direction, especially in the acute angle defined by the dominant wind direction. MM incidence was directly proportional to {[area of NOA (km(2))] * [cosine α of wind direction angle]} and was inversely proportional to the square of the distance (R = 0.291, p = 0.023). CONCLUSIONS: MM was higher near NOA and in the downwind direction. MM incidence and risk were affected by geological and meteorological factors.

Relationship between hepcidin levels and periodic limb movement disorder in patients with obstructive sleep apnea syndrome.

PURPOSE: This study was aimed to assess potential correlations between periodic leg movement (PLM) index, hepcidin levels, and iron status in patients with obstructive sleep apnea syndrome (OSAS). METHODS: Forty-four newly diagnosed OSAS patients and 49 non-apneic controls were enrolled in this study. All patients underwent polysomnographic evaluation. The hepcidin, iron, ferritin, total iron binding capacity, and C-reactive protein levels were measured. RESULTS: The mean age was 47.4 ± 7.2 years (18-68) in the OSAS group and 44.9 ± 11.1 years (23-65) in the control group. There were no differences in age, gender, and smoking between OSAS patients and controls. Mean apnea-hypopnea index (AHI) was 25.1 events/h. Mean serum hepcidin levels were significantly higher in OSAS subjects (725.9 ng/ml) than in control subjects (646.0 ng/ml) (p < 0.001). Serum iron levels were significantly lower in the OSAS and PLM disorder groups than in control subjects (p < 0.001). Serum hepcidin levels were significantly correlated with AHI (r = 0.453) and PLM index (r = 0.114). Serum iron levels were significantly negatively correlated with AHI (r = -0.169) and PLM index (r = -0.180). CONCLUSIONS: In our study, the level of hepcidin was increased in patients with OSAS. Our study indicates that levels of hepcidin correlate with the AHI and PLM index severity of OSAS.

Oxidative status and acute phase reactants in patients with environmental asbestos exposure and mesothelioma.

BACKGROUND AND OBJECTIVES: The aim of this study was to investigate inflammatory indicators and oxidative status in patients with asbestos exposure with and without mesothelioma and to compare results with data from healthy subjects. METHODS: Eighty people with exposure to environmental asbestos and without any disease, 46 mesothelioma patients, and a control group of 50 people without exposure to environmental asbestos were enrolled in this prospective study. Serum total oxidant level (TOL), total antioxidant capacity (TAC), and oxidative stress index (OSI), CRP, transferrin, ceruloplasmin, α-1 antitrypsin, ferritin, and copper levels were measured. RESULTS: Mesothelioma group exhibited higher TOL, OSI, α1-antitrypsin, ferritin and copper levels as compared to the other groups (P < 0.001, P = 0.007, P < 0.0001, P < 0.001, and P < 0.001, resp.). Transferrin was lower in the mesothelioma group than in the other two groups (P < 0.001). The asbestos group had higher TOL, TAC, α1-antitrypsin, and transferrin levels (P < 0.001, P < 0.001, P < 0.001, and P < 0.001, resp.), as well as lower OSI and ferritin levels as compared to the control group (P < 0.001 and P < 0.001). CONCLUSIONS: We believe that elevated acute phase reactants and oxidative stress markers (TOL and OSI) in the mesothelioma group can be used as predictive markers for the development of asbestos-related malignancy.

Clinical characteristics, treatment and survival outcomes in malignant pleural mesothelioma: an institutional experience in Turkey.

PURPOSE: To compare treatment modalities and investigate potential prognostic factors for survival in patients with malignant pleural mesothelioma (MPM). METHODS: The present study has investigated the data of 150 patients with MPM who were examined and treated in our center from 2005 to 2012. RESULTS: The study included 87 male (58% and 63 female (42) patients. Surgical resection (pleurectomy/decortications (P/D), and extrapleural pneumonectomy (EPP)) was performed in 32 (36.7%) patients; 87 patients (58%) received chemotherapy alone and 16 (10.7%) had surgery, chemotherapy and radiotherapy (trimodal treatment). The median progression free and overall survival (PFS and OS) for all patients were 10.6 and 14.8 months, respectively. No statistically significant difference was observed between the patients who received pemetrexed/cisplatin (N=54) and gemcitabine/cisplatin (N=28) in terms of PFS and OS (p=0.145, p=0.244, respectively). Also, no statistically significant difference was registered between operated and non operated patients (PFS and OS, p=0.416, p=0.095, respectively). There was no difference in both PFS and OS rates between patients who had P/D or EPP (p=0.87, p=0.652, respectively). Log rank analysis: Eastern Cooperative Oncology Group performance status (ECOG PS) (p=0.018), histology (p<0.001), stage (p<0.001) and leukocytosis (p=0.005) were found to be significant prognostic factors of OS. At multivariate analysis, ECOG PS (p=0.016) and stage (p<0.001) were independent prognostic factors for OS. CONCLUSION: Median OS was approximately 1 year. ECOG PS, histological type, stage and presence of leukocytosis were prognostic factors that affected both PFS and OS. EPP or P/D surgical options did not provide difference in terms of survival. Survival rates in patients who received a combination of platinum analogues with pemetrexed or gemcitabine as front-line chemotherapy were similar.

The protective role of caffeic acid phenethyl ester against streptomycin ototoxicity.

OBJECTIVE: The aim of this experimental study was to investigate the efficacy of caffeic acid phenethyl ester (CAPE) in the prevention of streptomycin-induced ototoxicity. MATERIALS AND METHODS: Thirty-two adult Wistar albino rats were divided into 4 groups: control (n = 8), streptomycin (n = 8), CAPE (n = 8), and streptomycin + CAPE (n = 8). Rats were tested with distortion product otoacoustic emissions (DPOAEs) before drug administration. The animals in all groups were killed under general anesthesia on the 45th day following last DPOAE measurements. Hearing results were analyzed statistically to determine differences in amplitudes of DPOAE. Also, the cochleas of each rat were evaluated by histopathological and immunohistochemical examination. RESULTS: Significant difference was not observed in cochlear hair cells in the control and CAPE groups. In the streptomycin group, severe degeneration of hair cells and increased apoptotic cells were observed. In the streptomycin + CAPE group, although some deteriorations were observed, hair cells were mostly preserved. The DPgram of the streptomycin and streptomycin + CAPE groups was significantly deteriorated (P < .05). The analysis of the DPgram results revealed statistically significant differences between the groups of streptomycin and streptomycin + CAPE (P < .05). CONCLUSIONS: Caffeic acid phenethyl ester treatment attenuated hair cells injury in the inner ear, possibly via its antioxidant effect. Prophylactic administration of CAPE for streptomycin ototoxicity ameliorated hearing deterioration in rats.

[Prognostic factors in non-small cell lung cancer patients and prognostic importance of PET/CT SUV max value]. / Küçük hücreli disi akciger kanseri olan olgularda prognostik faktörler ve PET/BT'deki SUV max degerinin prognostik önemi.

INTRODUCTION: This study planned to investigate the maximum standard uptake values (SUV max) at fluorodeoxyglucose-positron emission tomography/computed tomography (FDG-PET/CT) whether associated with survival or not and the effect of demographic, clinical and laboratory data on survival in non-small cell lung cancer (NSCLC) patients. MATERIALS AND METHODS: This study was created by examining retrospectively the records of 101 patients with NSCLC that received a definitive diagnosis and FDG-PET/CT used for staging in our center between May 2006-March 2011. Especially FDG-PET/CT, SUV max and the other clinical, histopathologic, laboratory and treatment parameters that effects prognosis were recorded and statistical analysis was performed. RESULTS: Eighty eight (87.1%) of the patients were men and 13 (12.9%) were women. The average survival period was 10.6 ± 8.5 (1-49 months) months. The demographic, clinical, laboratory and radiological parameters were divided into two groups with the median value of SUV max (12.0). There was not a significant difference in survival between the two groups (p= 0.807). The study showed that advanced stage, presence of metastasis, high lactate dehydrogenase (LDH) levels, high white blood cell levels, inoperability, low albumin levels and low performance effect negative on survival. CONCLUSION: It was considered that SUV max does not play an important role in the survival period of NSCLC patients. Knowledge of performance condition, serum LDH, leukocyte and albumin values may provide a better prognostic evaluation.

Risk factors for multidrug-resistant tuberculosis in Diyarbakir, Turkey.

BACKGROUND: Multidrug-resistant (MDR) tuberculosis (TB) is a serious public health problem. This study aimed to investigate probable risk factors for developing MDR in the patients treated for TB at Tuberculosis Control Dispensaries (TCD). MATERIAL/METHOD: The records of 34 patients with MDR-TB and 70 patients with TB sensitive to all first-line drugs (DS), who were treated at TCD between January 2002 and December 2008, were reviewed retrospectively in Diyarbakir, Turkey. RESULTS: The mean age was 34.47+/-16.99 (32.35+/-14.21 in MDR group and 35.50+/-18.19 in control group) with the range from 2 to 76 years. Of the patients, 63 were male and 41 were female. When risk factors for MDR were evaluated with univariate analysis methods, low socio-economic status, the presence of accompanying disease, previous TB history, previously administered TB treatment, inappropriate TB treatment, and noncompliance with TB treatment were all found to be significant risk factors. When these risk factors were analyzed with logistic regression analysis, regardless of other risk factors, MDR risk was significantly increased with previous TB history by 22.31, with previously taking TB medication by 13.19, and with low socio-economic status by 6.03. CONCLUSIONS: Socio-economic factors also play an important role in this issue. To minimize the effect of patients' risk factors, health workers should be able to reach all patients, and therapies must be given under direct observation.

A clinical, radiographic and laboratory evaluation of prognostic factors in 363 patients with malignant pleural mesothelioma.

BACKGROUND: Malignant pleural mesothelioma (MPM) has a poor prognosis. OBJECTIVES: Only few studies in literature investigated the presence of pleural fluid and radiographic findings for the prognosis of MPM. METHODS: We retrospectively investigated the hospital charts of 363 MPM patients who were diagnosed from January 1989 to March 2010. Survival time was calculated by the Kaplan-Meier method. Pretreatment clinical, laboratory and radiographic features of each patient at the time of diagnosis were obtained from patients' charts. RESULTS: The mean age of 363 patients (217 men, 146 women) was 50.6 ± 11.2 years (range 19-85) and the mean survival time was 11.7 ± 8.6 months (range 1-53). Histological types of MPM were epithelial (71.2%), mixed (15.9%) and sarcomatous type (4.9%). The frequency of disease stages were 31.4% for stage 1, 24.2% for stage 2, 28.6% for stage 3 and 15.8% for stage 4. The most frequent symptoms were dyspnea (82.1%), chest pain (68.3%) and weight loss (58.9%). Results of univariate and multivariate analyses revealed that a Karnofsky performance score ≤60, a pleural fluid glucose level ≤40 mg/dl, a C-reactive protein level >50 mg/l, a serum lactate dehydrogenase level >500 U/l, the presence of pleural fluid, pleural thickening >1 cm and a platelet count of >420 × 10(3)/µl were found to be associated with poor prognosis in MPM. CONCLUSIONS: Our data suggest that low pleural fluid glucose and high C-reactive protein, the presence of pleural fluid and pleural thickening were associated with poor MPM prognosis. Further prospective studies are needed to highlight prognostic factors more clearly.

[The opinions of Turkish physicians about the tasks of tuberculosis central dispensary]. / Türkiye'de hekimlerin verem savas dispanseri görevleri hakkindaki bilgileri.

Department of tuberculosis control is the main tuberculosis branch of Minister of Health, with coordinators in cities as intermediate departments and Tuberculosis Central Dispensaries (TCD) as peripheral branches. This study was performed through January-May 2007 in seven different geographical regions to figure out opinions of physicians on tuberculosis dispensaries. A specific questionnaire was distributed to doctors in two cities in each geographical region. A number of 1250 doctor participated in the study as at least fifty doctors in each city. Mean age of the subjects was 32.58 +/- 6.63 (22-65), 52.1% (651) of whom had diagnosed tuberculosis before. It was found in the study that two important functions of tuberculosis central dispensaries for the doctors were the treatment of patients regularly and freely, and scanning the persons who have very close contact with active tuberculosis patient. A number of 157 doctors accepted all seven functions of dispensary as important. Female doctors, pediatricians and chest physicians had better knowledge on the tasks of tuberculosis central dispensaries (p< 0.005). This study showed that Turkish physicians did not have enough knowledge about tuberculosis and its tasks. We believe that practical training procedures for the physicians on the goals and functions of TCD will help to treat tuberculosis.

Risk factors for drug resistant tuberculosis in southeast Turkey.

We undertook a cross-sectional survey of 116 patients at Dicle Hospital, Turkey, who had with bacteriologically confirmed tuberculosis (TB). Demographic and clinical features, including age, gender, pulmonary TB history, associated diabetes mellitus, previous TB treatment, residential area and education, were collected from charts. Eighty-four of the strains were found to be susceptible to all drugs. The resistance to one or more drug(s) was found in 32 strains. Multi-drug resistant (MDR) TB was found in 13 strains (11.3% of the total and 40.7% of the drug resistant strains). The resistance to isoniazid was the most frequently seen (25 strains, 21.5%). In the multivariable analysis, only previous TB treatment (P = 0.000) remained a significant predictor for drug resistance; in MDR, previous TB treatments (P = 0.002) remained significant in the final model. The patient's educational status was found to be negatively correlated with the risk of MRD-TB (P = 0.035). Previous TB treatment and low educational status were found to important risk factors for the development of MDR-TB.

[Factors affecting incidence of tuberculosis in Diyarbakir]. / Diyarbakir ilinde tüberküloz insidansini etkileyen faktörler.

Last decade, there have been important improvements about tuberculosis (Tbc) in the world. Today, 32% of world populations are infected by Tbc basil's, every year about 9 million people have been catching Tbc. We have purposed to determine the incidence of Tbc and the factors affect it, using rate of bacteriology in diagnosis, rate of treatment completion and to constitute an idea for innovation. Diyarbakir, standard monthly data forms used for informing of Tbc in tuberculosis control dispensary are investigated retrospectively among 1996-2004. The mean incidence of yearly Tbc is 37.77/100.000 and pulmonary Tbc is 30.11/100.000. In this period have been determined 3724 new Tbc patient; 2969 (79.7%) are pulmonary Tbc and 755 (20.3%) extrapulmonary Tbc. 842 patient (22.6%) of pulmonary Tbc are smear positive. Tbc pleurisy is the most common type of extrapulmonary Tbc in our series. 3354 (90.1%) of whole patients and 2624 (88.4%) with pulmonary Tbc had completed treatment. There is no data about the rate of cure. This is the most common problem Tbc control system. In 2005, cure rates will have been determined by the way of new form. 162 (4.4%) patient had abandoned treatment. Incidence of Tbc is higher than the incidence of Turkey. It was considered that at the first place highly growing population, the crowded family pattern sharing the same house and bad socioeconomic factors have been playing a major role. Furthermore, it was found that the rate of bacteriological diagnosis was low. In order to increasing of this rates should be carried out necessary studies, should be tried to diagnose all patients with bacteriological methods. End of the treatment cure should be tried to demonstrate by way of examination of sputum. The treatment process should be pursued by directly observed treatment strategy.

[Tuberculosis screening results made at primary schools in Cizre]. / Cizre'de ilkokul çocuklarinda tüberküloz taramasinin sonuçlari

Tuberculosis (Tbc) gained importance as a public health problem in the recent years. The course of the disease is more severe in childhood. Tbc screening was made by The Tuberculosis Control 11th Group Presidency on the primary school students in Cizre, in November 2005. A total of 2242 children have been taken to this study. Of the children, 1130 (50.4%) were boys and 1112 (49.6%) were girls. The mean age of the children was 6.9+/-0.8 (range, 4-14) years. Concerning Bacillus Calmette-Guerin (BCG) vaccine scar, 1676 (74.7%) children had no scar, 536 children (23.9%) had single scar, and 32 children (1.4%) had double scar. The mean diameter of the tuberculin skin test (TST) was 2.1+/-2.7 mm. Regarding sexuality and TST mean diameter, statistically significant relation was not detected between girls and boys (p=0.3). The mean diameter of TST were 1.5+/-1.4 mm, 3.5+/-4.0 mm and 11.2+/-3.3 mm in the children with no BCG scar, in those with single BCG scar, and in those with double BCG scar, respectively. Of the TST results of all children, 2065 (92.1%) were negative, 101 (4.5%) were attributed to BCG, and 76 (3.4%) were positive, respectively. The rate of positiveness of TST was 1.2% in the children with no BCG scar, 8.9% in the children with single BCG scar, and 50% in the children with double BCG scar, respectively. A statistically significant correlation between the increase in the BCG scar number and the increase in the TST mean diameter was detected (p<0.05). Of the children who were likely to have Tbc, 139 (6.2%) were advised to apply at the dispensary. Single BCG vaccination was inadequate in the children. We suggest encouraging the families about postpartal single BCG vaccination. Furthermore, school screenings should be paid greater attention.

Serum Apelin 13 Levels in Patients With Pulmonary Embolism.

INTRODUCTION AND AIM: Expression and peptide immunoreactivity of apelin messenger RNA have been described in a variety of tissues, including gastrointestinal tract, adipose tissue, brain, kidney, liver, cardiovascular system, and lungs. This study aimed to investigate the possible involvement of the endogenous apelin in the pathophysiological events that occur in patients with pulmonary embolism (PE). MATERIALS AND METHODS: In total, 53 patients with PE and 35 healthy volunteers were included the study. This cross-sectional study was conducted at a tertiary care university hospital and among patients diagnosed as having PE. The control group consisted of healthy volunteers who applied to hospital for a routine checkup examination. Serum apelin 13 levels were measured in both the groups and their results were compared. RESULTS: The median ages were 57 and 53 years, and female-male ratios were 30/23 and 20/15, in the PE and control groups, respectively. The mean serum apelin 13 levels were found to be significantly higher in the PE group (76.94 ± 10.70 ng/mL) than in the control group (50.01 ± 7.13 ng/mL; P < .001). CONCLUSION: This study demonstrated that apelin 13 levels are elevated in patients with PE. These results suggest that apelin may be a novel biomarker and a potential therapeutic target in patients with acute PE in the future.

The relationship between inflammatory marker levels and pulmonary tuberculosis severity.

We aimed to investigate the correlation between red cell distribution width (RDW), neutrophil to lymphocyte ratio (NLR), platelet to lymphocyte ratio (PLR), and other inflammatory markers with pulmonary tuberculosis (PTB) severity. Seventy patients with active pulmonary tuberculosis were compared with 50 age-matched and gender-matched healthy controls. The mean age of PTB patients was 50.4 ± 21.8 years. There were no differences in terms of age, gender, and smoking history between PTB patients and controls. Patients with advanced PTB had a significantly higher white blood cell count, neutrophil count, RDW, NLR, and C-reactive protein when compared to patients with mild to moderate PTB. RDW (17.7 versus 15.7 %, p=0.002) and NLR (4.7 versus 3.1, p=0.009) values were higher in patients with advanced PTB as opposed to patients with mild to moderate PTB. NLR and RDW levels may be used as markers of inflammation to help clinically manage patients with TB and to determine disease severity.

The value of inflammatory parameters in the prognosis of malignant mesothelioma.

OBJECTIVE: This study investigated the relationship between potential prognostic parameters that may be associated with increased inflammation and survival in patients with malignant mesothelioma (MM). METHODS: This retrospective study assessed potential prognostic parameters measured at the time of MM diagnosis. Data on asbestos exposure, histopathological subtype of MM and laboratory parameters were collected. RESULTS: In 155 patients with MM (90 male), mean survival time was 13.9 months. In univariate analysis, age ≥ 60 years and neutrophil-to-lymphocyte ratio (NLR) ≥ 3 were associated with significantly shortened median survival times. In multivariate analysis, nonepithelial subtype, red cell distribution width (RDW) ≥ 20% and NLR ≥ 3 were associated with significantly shortened median survival times. Mortality rate was increased 2.77-, 1.67- and 1.52-fold in patients with RDW ≥ 20%, NLR ≥ 3 and nonepithelial subtype, respectively. Nonepithelial subtype, white blood cell count ≥ 11 200 µl and platelet-to-lymphocyte ratio ≥ 300 at baseline were associated with a heightened NLR value. CONCLUSIONS: The NLR and RDW were significant predictive factors for MM prognosis.

Is a complete blood cell count useful in determining the prognosis of pulmonary embolism?

BACKGROUND: Pulmonary embolism (PE) is the third cardiovascular cause of hospital admission, following acute coronary syndrome and stroke. Despite high-tech diagnostic methods and new treatment modalities, PEs continue to have a high mortality rate within the first 3 months. This study was designed to assess the additional prognostic value of a complete blood cell count, renal function markers, C-reactive protein, and simplified pulmonary embolism severity index (sPESI) scoring system in PE 100-day mortality. MATERIALS AND METHODS: The study retrospectively enrolled 208 consecutive patients who were hospitalized with the diagnosis of an acute PE. The patients' demographic characteristics and clinical and laboratory parameters were recorded from the hospital electronic database and patient's case notes. The primary end point of the study was an adverse 100-day outcome, defined as death from any cause. RESULTS: The all-cause mortality in the first 100 days was 14.42 %. The mean age was 57.87 ± 18.17 (range: 16-93) years. We included 79 (38 %) male and 129 (62 %) female individuals. Red cell distribution width (RDW) and sPESI were found to be statistically significant predictors of PE mortality by multivariate regression analysis. On multivariate regression analysis, RDW was associated with a 4.08-fold (95 % confidence interval: 1.229-13.335, P = 0.021) increase in PE mortality. CONCLUSION: The results of this study demonstrated that RDW and sPESI may be a useful guide in predicting 100-day mortality. The elevated RDW may alert physicians to possible poor prognosis.

Relationships between respiratory function disorders and serum copper levels in copper mineworkers.

The aim of this study was to investigate the respiratory function disorders that could be related to dust exposure during the production of copper mine in copper mineworkers (CMWs). The study included 75 male CMWs (mean age, 32.0 ± 7.1 years, 58.6% smokers) and 75 male age- and smoking status-matched healthy control subjects. Serum Cu level was significantly higher in the CMW group (0.80 ± 0.62 µg/ml) than the control group (0.60 ± 0.39 µg/ml) (p = 0.017). Significant negative correlations were found between serum Cu level and forced expiratory volume in first second (r = -0.600; p < 0.001) and between serum Cu level and forced vital capacity (r = -0.593; p = <0.001) in CMWs. Serum Cu level was significantly higher in the restrictive type pulmonary function disorders group (1.36 ± 0.62 µg/ml) than obstructive type (0.90 ± 0.55 µg/ml) and normal pulmonary function pattern group (0.53 ± 0.43 µg/ml) (p < 0.001). Patients with radiological parenchymal abnormalities had significantly higher serum copper levels than those without abnormalities (1.53 ± 0.52 vs. 0.71 ± 0.52 µg/ml, respectively; p = 0.002). In conclusion, result of the study has shown a negative association between pulmonary functions disorders and radiological abnormalities and serum Cu levels in CMWs.