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Atrial Natriuretic Factor and Arginine Vasopressin Production in Tumor Cell Lines from Patients with Lung Cancer and Their Relationship to Serum Sodium¹

National Cancer Institute-Navy Medical Oncology Branch and Department of Medicine, Uniformed Services University of the Health Sciences, and the National Naval Medical Center, Bethesda, Maryland 20889-5105 [A. J. G., D. P. B., J. B., P. T. L., A. S., R. P., J. L. M., D. C. I., B. E. J.]; Biostatistics and Data Management Section, National Cancer Institute, Bethesda, Maryland 20892 [S. M. S.]; and Department of Medicine, Washington Hospital Center, Washington, DC 20422 [J. G. R.]

Patients with lung cancer (n = 263) were studied to determine the relationship among ectopic production of atrial natriuretic factors (ANF) and arginine vasopressin (AVP), serum sodium, and patient outcome. Of 133, 21 (16%) patients with small cell lung cancer (SCLC) had hyponatremia (serum sodium, <130 mmol/liter), compared to none of 130 (0%) patients with non-small cell lung cancer (P < 0.0001). Patients with extensive-stage SCLC and hyponatremia had shorter survival than patients with extensive stage SCLC and normal serum sodium values (P = 0.012). Of the 11 hyponatremic patients with SCLC and tumor cell lines available for study, 9 produced ANF mRNA, 7 of 11 produced AVP mRNA, and 5 of 11 produced both ANF mRNA and AVP mRNA. All 11 cell lines produced either ANF mRNA and ANF peptide or AVP mRNA and AVP peptide, or both. The quantity of AVP peptide in the tumor cell lines was more closely associated with hyponatremia in the patients (P = 0.0026, r² = 0.28) than was the production of ANF peptide (P = 0.066, r² = 0.12), although neither association was strong. All tumor cell lines studied from SCLC patients with hyponatremia produce ANF and/or AVP mRNA and peptides.

¹ This is a U.S. government work. There are no restrictions on its use. The opinions and assertions contained herein are the private views of the authors and are not construed as official or as reflecting the views of the Department of the Navy or the Department of Defense.

² To whom requests for reprints should be addressed, at National Cancer Institute-Navy Medical Oncology Branch, National Naval Medical Center, Bldg 8, Rm 5105, Bethesda, MD 20889-5101.

Received 7/ 8/92. Accepted 10/14/92.

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