Survival analysis and factors affecting survival in patients who presented to the medical oncology unit with non-small cell lung cancer

Background/aim: This study aimed to investigate the effect of clinical and pathological indicators at the time of the diagnosis on overall survival in patients recently diagnosed with non-small cell lung cancer. Materials and methods: The study population consisted of patients who were diagnosed at the Faculty of Medicine at Isparta Süleyman Demirel University Hospital between January 1, 2010 and December 31, 2017 and presented to the medical oncology outpatient clinic. Results: A total of 518 patients were evaluated, including 260 patients with squamous cell carcinoma, 207 patients with adenocarcinoma, 50 patients with non-small cell lung cancer-not otherwise specified, and 1 patient with large cell carcinoma. The average life expectancy was found to be 11.50 ± 1.40 months in patients with squamous cell carcinoma, 12.60 ± 1.59 months in patients with adenocarcinoma, and 8.70 ± 1.87 months in the other patients. The estimated 5-year relative survival rate for non-small cell lung cancer was 8% (7% for men and 18% for women). In the multivariate analysis, sex being male (HR, 2.41; P < 0.001), a performance status >2 (HR, 1.70; P < 0.001), the stage of cancer (HR, 1.37; P = 0.045), the presence of bone or liver metastasis (HR, 1.44, P = 0.009, HR, 1.57; P = 0.016, respectively), and the patient not having received radiotherapy (HR, 3.25; P < 0.001) or chemotherapy (HR, 1.85; P = 0.001) were defined as statistically significant predictive factors that reduced the overall survival. Conclusions: In this study, sex, stage, performance status, the presence of liver or bone metastases, and treatment had an effect on overall survival.

New risk factors in diabetic nephropathy: microRNA-196-3p and microRNA-203.

BACKGROUND: The aim of this study was to evaluate changes in the serum levels of miR-98, miR-184, miR-185, miR-203 and miR-196a-3p in type 2 diabetes mellitus (T2DM) patients with diabetic nephropathy (DN) and to associate the changes in microRNA levels with urinary albumin excretion (UAE). METHODS: The study included 35 healthy individuals aged between 18-65 years, 40 T2DM patients with normoalbuminuria, 40 T2DM patients with microalbuminuria, and 35 T2DM patients with macroalbuminuria. Metabolic laboratory parameters, microalbumin levels in 24-hour urine samples were measured in all groups. Serum levels of vascular endothelial growth factor-A (VEGF-A) and transforming growth factor-ß (TGF-ß) were measured quantitatively by Enzyme-Linked Immunosorbent Assay (ELISA). Circulating miRNA levels were determined by real-time quantitative PCR. RESULTS: Serum miR-196a-3p levels were reduced in the normoalbuminuria group compared to the healthy control group. In the macroalbuminuria and microalbuminuria groups, miR-196a-3p levels were higher compared to the normoalbuminuria group. In addition, increase in miR-196a-3p levels in the macroalbuminuria group was more prominent than the microalbuminuria group. Serum miR-203 levels were significantly higher in the macroalbuminuria group compared to healthy controls, microalbuminuria and normoalbuminuria groups; these levels were also higher in the microalbuminuria group compared to normoalbuminuria group. In logistic regression analysis, serum miR-196a-3p and miRNA-203 levels were independently correlated to UAE. CONCLUSIONS: Increased serum levels of miR-203 and miR-196a-3p are independent risk factors of UAE which is a marker of DN.

Serum zonulin levels in type 2 diabetes patients with diabetic kidney disease.

INTRODUCTION: Recent data have shown that diabetic kidney disease (DKD) is associated with abnormal gut microbiota composition. Zonulin is a physiological tight junction modulator and an intestinal permeability marker. In this study we aimed to investigate serum levels of zonulin and interleukin 6 (IL-6) in patients with type 2 diabetes mellitus (T2DM) and different levels of albuminuria. MATERIAL AND METHODS: Ninety patients with T2DM and 30 healthy controls (HC) aged between 18 and 65 years were enrolled in the study. T2DM patients were divided into three groups as patients with normoalbuminuria (n = 30), microalbuminuria (n = 30), and macroalbuminuria (n = 30). Serum zonulin and IL-6 levels were measured by ELISA method. RESULTS: There was no significant difference between groups in terms of age, gender, serum ALT, LDL-C, HDL-C, and zonulin levels (p > 0.05). Significant differences between groups were present for the duration of diabetes (p < 0.001), body mass index (p < 0.001), fasting blood glucose (p < 0.001), creatinine (p < 0.001), uric acid (p = 0.037), triglyceride (p = 0.003), total cholesterol (p < 0.001), glycated haemoglobin (p < 0.001), and IL-6 (p < 0.001) levels. IL-6 levels were significantly increased in the microalbuminuria and macroalbuminuria groups compared to the HC group, but no significant difference was determined between the HC and normoalbuminuria group. In patients with diabetic kidney disease, a significant positive correlation was found between zonulin with IL-6 and proteinuria (rho = 0.296, p = 0.008; rho = 0.190, p < 0.047, respectively). The serum IL-6 level was positively correlated with microalbuminuria and proteinuria (rho = 0.451, p < 0.001; rho = 0.425, p < 0.001, respectively). CONCLUSIONS: We suggest that the serum zonulin level is not a promising biomarker to assess the severity of DKD in patients with long-standing T2DM.