DETERMINATION OF SERA NGAL LEVELS IN PATIENTS WITH LUNG CANCER AND ITS RELATION WITH APOPTOSIS
Gun, Fatma Gul
Sunam, Guven Sami
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The NGAL synthesis induces in neoplasms; therefore, probably, it is benefited from the level of this protein for the determination of carcinogenesis and the progress stages of human tumors. In this study, it was aimed to investigate the expression of NGAL (neutrophil gelatinase associated lipocalin) in lung cancer patients and its relation with apoptosis. The study was conducted on the patients between the ages of 40 and 70 years accepted by the Thoracic Surgery Clinic (Selcuk University, Faculty of Medicine) based on their lung cancer diagnosis. The patients aged between 40 and 70 were included in the study from the thoracic surgery clinic of the Selcuk University as they were administered into the clinic based on their lung cancer diagnosis and had operation before. Patients who have acute stroke, rheumatic diseases, chronic kidney disease, congestive heart failure, chronic infection and other organ and system cancers (except lung cancer) were excluded from the study. Two groups including a lung cancer group (N=40) and a normal group (N=40) were formed to determine the NGAL and M30 levels in sera of patients using the ELISA method. According to the analysis results, the NGAL levels for the lung cancer group and the normal group were observed as 424.03 +/- 74.49 and 374.04 +/- 90.34 ng/mL, respectively. This increase in the lung cancer group was found statistically significant according to the normal group (p < 0.01). The M30 levels, marker for apoptosis in circulation, were obtained as 144.08 +/- 45.91 and 118.76 +/- 46.16 U/L for the lung cancer group and the normal group, respectively. This increase in the lung cancer group was found statistically significant according to the normal group (p < 0.01). A positive correlation was obtained between the NGAL and M30 data by means of Spearman's correlation test (r(40)=0.58, p < 0.01). The antigen levels of caspase 3, 8 and 9 were determined by the immunohistochemical staining methods in the samples of cancerous tissues and normal tissues adjacent to the cancerous tissue, and the apoptotic indexes were calculated. The apoptotic indexes of the cancerous tissues were significantly lower than the normal tissues (p < 0.01). This result demonstrates that the predominant type of cell death might be other cell death pathways rather than the apoptotic pathways in lung cancer. In addition, these results support the opinion about the fact that apoptosis may be inhibited by cancer cells in cancerous tissues. The significant increase in the M30 and NGAL levels supports the claims of the previous studies about the fact that it causes the consumption of cellular iron reserves and NGAL induced apoptosis in cancer patients.