145 مجلة إبن الهيثم للعلوم الصرفة و التطبيقية 2012 السنة 25 المجلد 2 العدد Ibn Al-Haitham Journal for Pure and Applied S cience No. 2 Vol. 25 Year 2012 Evaluation Of liver And Kidney Functions In Lung And Bladder Cancer Patients R.A. Mahmood Department Optical ,College of Medical and Health Technology, Foundation of Technical Technology . Received in: 5 March 2012 Accepted in: 16 July 2012 Abstract This study was performed at Nuclear Radiation Hospital in Baghdad for the period from January 2011 to May 2011. 44 Blood samples were collected from patients suffered lung and bladder cancer and 24 samples as healthy control individuals. Routine liver functions tests were studied by measuring S.GPT, S.GOT and Kidney function was evaluated by estimation of blood urea and creatinine in serum samples of individuals studied. It was observed that the incidence of lung and bladder cancer was higher in males than females patients ( male 81.82 %, 72.73%, female18 .18%, 27.27% respectively). Insignificant difference was noted among age of lung and bladder cancer patients compared with control group. The results of biochemical analysis of lung and bladder cancer showed an increase in the mean of values of GPT, GOT, blood urea and serum creatinine among patients when compared with the healthy individuals. Key wards: Cancer, Lung Cancer,Bladder cancer,Blood Urea,S.Cratinine. Introduction Cancer is a complex disease. , the survival of patients with cancer depends on the localization of the tumor, histology/ pathology, tumor stage, host–tumor interaction and subjective assessment of the other diseases, illnesses or conditions [1].The disease is the leading cause of death in economically developed countries and the second leading cause of death in developing countries. The burden of cancer is increasing in economically developing countries as a result of population aging and growth as well as, increasingly, an adoption of cancer-associated lifestyle choices including smoking [1] Lung cancer is the leading cause of cancer-related mortality worldwide. The possibility that a patient with lung cancer will be alive after five years from the diagnosis is approximately 15% [2]. The World Health Organization(WHO) classification defines seven histology types of primary malignant epithelial tumors of the lung and more than 20 different variants [3].The most common lung cancer histology type is adenocarcinoma, followed by squamous-cell carcinoma and small cell lung cancer (SCLC). Diagnosis of lung cancer and staging is mainly based on the following procedures; imaging techniques (chest X-ray, CT scan and PET scan, nowadays usually in combination with CT to merge metabolic and anatomical information), minimally invasive approaches (bronchoscopy, endobronchial ultrasound, fine-needle and middle-needle aspiration biopsies [4]. The small cell type of lung cancer has a propensity for early and wide dissemination and is best treated by chemotherapy and radiation. Several studies indicated that smoking and alcohol consumption behaviors are related to the survival of lung cancer patients[4]. 146 مجلة إبن الهيثم للعلوم الصرفة و التطبيقية 2012 السنة 25 المجلد 2 العدد Ibn Al-Haitham Journal for Pure and Applied S cience No. 2 Vol. 25 Year 2012 Other studies pointed out that health behaviors affect lung cancer patients’ survival.Early current treatment of lung cancer varies according to the histologic type and anatomic extent, or stage, of the tumor. An organ such as the bladder consists of complex, interacting set of tissues and cells. Inflammation has been implicated in every major disease of the bladder, including cancer, interstitial cystitis, and infection [5] Bladder cancer is a common urologic cancer. Almost all bladder cancers originate in the urothelium, which is a 3-7-cell mucosal layer within the muscular bladder. In North America, South America, Europe, and Asia, the most common type of urothelial tumor diagnosed is transitional cell carcinoma (TCC); TCC constitutes more than 90% of bladder cancers in those regions. TCC can arise anywhere in the urinary tract, including the renal pelvis, ureter, bladder, and urethra, but it is usually found in the urinary bladder. Carcinoma in situ (CIS) is frequently found in association with high-grade or extensive TCC. [6] The classic presentation of bladder cancer is painless gross hematuria, which is seen in approximately 80-90% of patients. Physical examination results are often unremarkable (see Clinical Presentation). Cystoscopy, cytology, and biopsy when necessary are the principal diagnostic tests [7]. Aim of the study This study is aimed to 1-study the incidence of lung and bladder cancer among male and females patients . 2-determine the values of GPT, GOT, blood urea and serum creatinine among patients with lung and bladder cancer healthy individuals compared with control group. Materials and methods This study was performed at Nuclear Radiation Hospital in Baghdad, for the period from January 2011 to May 2011; 44 blood samples were collected from patients suffered from lung and kedny cancer and 24 blood samples collected from healthy as control group in test tubes, medical history of each individual was obtained by questionnaire included (age, sex, area of residence and a history of diseases). Routine liver functions test studied by measurings were S.GPT, S.GOT, according to [8]procedure. Kidney function was evaluated by estimation of creatinine [9] , urea by modified urease- Berthgot method [10] and using ANOVA test [11]. Results Table (1) shows the distribution of lung and bladder cancer among males and females individuals.It is clear that the incidence of lung and bladder cancer is higher in male than females patients (male 81.82 %, 72.73), (female18 .18%, 27.27%) respectively. Table (2) shows insignificant difference among the mean of age of lung and bladder cancer patients and control group. using ANOVA test [11].The results of blood biochemical analysis of lung and bladder cancer showed elevation in the mean of values of AST, ALT, blood urea and serum creatinine in patients in comparison with the at P < 0.05 using ANOVA test [11]. Discussion The present study shows that there was no significant differences in age of lung and bladder cancer patients and control group.These result is not in agreement with Anand et al.[ 12] who mentioned that lung cancer is a disease of the elderly, with more than 40% of cases diagnosed in subjects aged >70 years. 147 مجلة إبن الهيثم للعلوم الصرفة و التطبيقية 2012 السنة 25 المجلد 2 العدد Ibn Al-Haitham Journal for Pure and Applied S cience No. 2 Vol. 25 Year 2012 Wala & Amal ]13[ found that about 9 out of 10 people with bladder cancer are over the age of 55 which did not agree with the current study . Our study showed that lung and Bladder cancer was more frequent in male than in female individuals. The result agree with [13]which hormonesrelated –this may be due to sex and cell proliferation a role in the development of cancer by promoting play]14[. Elevation in values of GPT, GOT, total serum bilirubin,PT,PTT were noticed among lung and bladder cancer patients .Alanine aminotransferase (ALT) is an enzyme present in hepatocytes ,when a cell is damaged, it leaks this enzyme into the blood, where it is measured. Alanine transaminase (ALT) rises dramatically in acute liver damage, such as viral hepatitis or paracetamol (acetaminophen) overdose ]15[ Aspartate aminotransferase ( AST) is similar to ALT which is another enzyme associated with liver parenchymal cells. The ratio of AST to ALT is sometimes useful in differentiating between causes of liver damage. [15] Blood urea also elevated in serum of patients with lung and bladder cancer ,this may occur as a result of impairment of renal function because of its sensitivity in detecting early renal failure[13].Level of creatinine also increased in serum of patients studied. Measuring serum creatinine is a simple test and it is the most commonly used indicator of renal function. A rise in blood creatinine level is observed only with marked damage to functioning nephrons. -------Therefore, this test is not suitable for detecting early-stage kidney disease. A better estimation of kidney function is given by the creatinine clearance (CrCl) test [16, 17]. References 1- Kinzler, K; W and Vogelstein, B;(2002) The genetic basis of human cancer (2nded.). New York: McGraw-Hill, Medical Pub. Division. p.5. 2. Travis W.D.; Brambilla,E.; Muller-Hermelink, H.K. and Harris,C.C. ( 2004 ) Pathology and genetics of tumours of the lung, pleura, thymus and heart. Lyon: the International Agency for Research on Cancer (IARC) Press. 3. World Health Organization(2008) The Global Burden of Disease: Update. Geneva 4. Jemal, A.; Siegel, R.; Xu, J. and Ward, E. (2010)Cancer Statistics. CA Cancer J Clin; 300.-(5):27760 5. Luigi De Petris(2010) Doctoral Thesis,Stockholm(Discovery and valdation of protein biomarker for lung cancer),p2. 6- Heyns, C.F.and van der Merwe, A.(2008) Bladder cancer in Africa. Can J Urol. 908.-(1):3899;15 7. Hurle, R.; L. A. and Manzetti, A. ( 1999) Upper urinary tract tumors developing after treatment of superficial bladder cancer: 7-year follow-up of 591 consecutive patients. 8.–(6): 1144;53Urology 8-Reitman, S. and Frankel, S. (1957) A colorimetric determination of serum glutamic .63-(1):5628oxaloacetic and glutamic pyruvic transaminase. Am. J. Clin. Path., 9-Siest,G.; Hennny,J.; Schiele, F. and Young, D.S. (1985) "Kinetic determination of creatinine." Interpretation of Clin. Lab. Tests, p., 220-234. 10-Patton, C.J. and Crouch, S.R. (1977) Spectrophotometer investigation of urea. Anal 469.-: 464(3)49Chem., 11-SPSS 14 (2006) Statistical Package for Social Science, SPSS for windows Release 14.0.0, 12 June, 2006. Standard Version, Copyright SPSS Inc., 1989-2006, All Rights Reserved, Copyright ® SPSS Inc. Cancer is a preventable disease that requires (2008) .B.A ,, Kunnumakkara.andP ,Anand-12 2116.–(9): 2097 25 ..Pharm. Resmajor lifestyle changes http://en.wikipedia.org/wiki/Hormone http://en.wikipedia.org/wiki/Cell_proliferation http://en.wikipedia.org/wiki/Enzyme http://en.wikipedia.org/wiki/Hepatocyte http://en.wikipedia.org/wiki/Viral_hepatitis http://en.wikipedia.org/wiki/Viral_hepatitis http://en.wikipedia.org/wiki/Paracetamol#Toxicity http://en.wikipedia.org/wiki/Parenchymal_cells http://en.wikipedia.org/wiki/AST/ALT_ratio http://en.wikipedia.org/wiki/Nephron http://en.wikipedia.org/wiki/Kidney_disease http://en.wikipedia.org/wiki/Creatinine_clearance http://books.google.com/?id=pYG09OPbXp0C http://www.pubmedcentral.nih.gov/articlerender.fcgi?tool=pmcentrez&artid=2515569 http://www.pubmedcentral.nih.gov/articlerender.fcgi?tool=pmcentrez&artid=2515569 148 مجلة إبن الهيثم للعلوم الصرفة و التطبيقية 2012 السنة 25 المجلد 2 العدد Ibn Al-Haitham Journal for Pure and Applied S cience No. 2 Vol. 25 Year 2012 13-Jaseem, Wala, E. and Farhan, Amal, R.,( 2006) The relation between level of blood urea 93.-,1:8819Taqani,-and in elder people (male and female) J.Al Hormones and the Etiology of (2000)B. and Ronald, K, R. .M,LeslieHenderson,B.E.-14 ). (5th ed. Frei Cancer Medicine-Holland In: Bast, R.C.; Kufe, D.W.and Pollock, R.E . Cancer .1-113-55009-1 ISBN Hamilton, Ontario: B.C. Decker. 15- Nyblom,H.;Björnsson,E.;Simrén,M.;Aldenborg,F.;Almer,,S.and Olsson,R.(2006).The AST/ALT ratio as an indicator of cirrhosis in patients with PBC. Liver Int. 26 (7): 840–845. 16. Cokkinides ,V.; Bandi, P.; Ward ,E.; Jemal ,A. and Thun, M. Progress and opportunities 142.-:13556in tobacco control . CA Cancer J Clin 2006; 17.Ya-Hsin, Li; Shwn-Huey, S. and Chih-Yi, Chen (2011)influence of Health Behaviors on 37–(3)36541Survival in lungcncerPatients in Taiwan, Jpn J Clin Oncol; Table (1): Distribution of patients with lung and bladder cancer by gende Bladder cancer Female ( N) (6) Lung Cancer Female ( N) 4 Male (16) Male (N) 18 Female (%) 27.27 Female (%) 18.18 Male (%) 72.73 Male (%) 81.82 Table (2): Age and biochemical analysis of patients with lung and bladder compared with control group. Age GOT (N.V.up to 20 U/L) GPT (N.V.up to 20U/L) B.Urea (N.V=2.5-7.5 m.mol/L) S.Creatinine (N.V.=62- 124 m.mol/L) Control 55.00 ± 4.17 6.33 ± 0.23 a 5.13 ± 0.19 a 3.80 ± 0.14 a 73.25 ± 1.06 a Lung Cancer 60.82 ± 2.80 16.23 ± 2.16 b 13.95 ± 2.34 b 6.28 ± 0.38 b 92.28 ± 5.30 b Bladder Cancer 61.55 ± 1.59 13.95 ± 1.87 b 13.73 ± 1.68 b 8.07 ± 1.71b 111.89 ± 7.79 c F- calculated 1.157 11.709# 10.858# 5.326# 14.844# Values are mean ± S.E. # Significant at P < 0.05 using ANOVA test a, b, c insignificant difference between similar letter using Duncan Multiple Range test for comparative of means. http://www.ncbi.nlm.nih.gov/books/NBK20759/ http://www.ncbi.nlm.nih.gov/books/NBK20759/ http://en.wikipedia.org/wiki/Special:BookSources/1-55009-113-1 http://en.wikipedia.org/wiki/International_Standard_Book_Number http://www3.interscience.wiley.com/resolve/openurl?genre=article&sid=nlm:pubmed&issn=1478-3223&date=2006&volume=26&issue=7&spage=840 http://www3.interscience.wiley.com/resolve/openurl?genre=article&sid=nlm:pubmed&issn=1478-3223&date=2006&volume=26&issue=7&spage=840 149 مجلة إبن الهيثم للعلوم الصرفة و التطبيقية 2012 السنة 25 المجلد 2 العدد Ibn Al-Haitham Journal for Pure and Applied S cience No. 2 Vol. 25 Year 2012 تقييم وظائف الكبد والكلية في المرضى المصابين بسرطان الرئة والمثانة ... رفاه علي محمود كلية التقنيات الصحية والطبية، بغداد ، هيئةالتعليم التقني قسم التقنيات البصرية، 2012تموز 16قبل البحث في: 2012أذار 5استلم البحث في: الخالصة: ولغايــــة 2011أجريـــت الدراســـة الحاليــــة فـــي مستشــــفى االشـــعاع الـــذري فــــي محافظـــة بغــــداد للفتـــرة مـــابين كــــانون الثـــاني عينـــة أخـــرى 24عينـــة دم مـــن مرضـــى كـــانوا يعـــانون مــن ســـرطان الرئـــة والمثانـــة إضـــافة إلـــى 44حيـــث جمعـــت 2011أيــار جمعت من اشخاص اصحاء استخدمت كمجاميع سيطرة. و األالنــين تـم عمـل بعــض التحاليـل الروتينيـة النزيمــات الكبـد لكافــة االفـراد موضـوع الدراســة والتـي تضـمنت كــل مـن لكـل فـرد مـن افـراد الكريـاتينين الـدم و الكلى وهما يوريا تم قياس بعض معايير وظائف وأيضافيريز اسبارتيت وأالالنين ترانس 82 ، ٪72ر 73الـذكور الدراسة. ولوحظ إن نسبة حدوث مرض سـرطان الرئـة والمثانـة فـي الـذكور اعلـى منـه فـي االنـاث ( على التوالي).٪27ر27،٪18ر18،االناث ٪81ر لـم تســجل الدراسـة الحاليــة وجـود فروقــا معنويـة فــي متوسـط اعمــار المرضـى المصــابين بالمرضـين انفــي الـذكر مقارنــة بمتوسـط اعمـار االشــخاص االصـحاء (مجــاميع السـيطرة )، بينمـا تــم تسـجيل مســتويات عاليـة وفروقـا ت معنويــة فـي متوســط ) لالشـــخاص المرضــى موضـــوع الكريــاتينينالـــدم و يوريــاو النــين ترانســـفيريز األالنــين اســـبارتيت وأال (انزيمــات الكبــد والكلـــى الدراسة بالمقارنة مع متوسط عينة االشخاص االصحاء. .السرطان،سرطان المثانة،سرطان الرئة،سيرم كرياتنين :الكلمات المفتاحية Table (2) shows insignificant difference among the mean of age of lung and bladder cancer patients and control group. using ANOVA test ]11[.The results of blood biochemical analysis of lung and bladder cancer showed elevation in the mean of va... Discussion