血清总胆固醇及低密度脂蛋白水平对乳腺癌预后的影响  

The serum levels of total cholesterol and LDL-cholesterol in prognostic effect for breast tumor

作　　者：林晓榕 黄迪[1] 陈静琦[2] 吴智勇[3] 

机构地区：[1]中山大学孙逸仙纪念医院乳腺肿瘤中心,广州510120 [2]广州医科大学附属第二医院肿瘤科,广州510260 [3]中山大学附属汕头医院乳腺疾病诊疗中心,广东汕头515000

出　　处：《岭南现代临床外科》2015年第1期17-21,共5页Lingnan Modern Clinics in Surgery

基　　金：国家自然科学基金(81172537;81272900);国家自然科学基金(81272900)

摘　　要：目的探讨血清中脂蛋白水平对乳腺癌预后的影响。方法回顾分析2003年11月至2008年9月在中山大学孙逸仙纪念医院初诊的244例乳腺癌患者及同期99例健康体者的临床资料。比较两者血清代谢指标的变化,Spearman相关分析总胆固醇、LDL-C与乳腺癌的肿瘤大小的关系,Cox回归模型评估影响无病生存率(DFS)的预后因素。结果乳腺癌患者血清总胆固醇(TC)、甘油三酯、低密度脂蛋白(LDL-C)、血糖较正常人高,而高密度脂蛋白(HDL-C)较正常人低;血清总胆固醇、LDL-C水平在ER/PR阳性乳腺癌患者中较Her-2阳性及三阴型乳腺癌低。血清总胆固醇、LDL-C与肿瘤的大小呈正相关。TC≥5.2 mmol/L组或LDL-C>3.08 mmol/L组的DFS较TC<5.2 mmol/L组或LDL-C≤3.08mmol/L组明显降低(TC 68%vs 77.7%,LDL-C 73.4%vs 86.3%,P<0.05)。结论高胆固醇、高LDL-C血症是乳腺癌独立的预后因素。Objective To investigate the value of plasma level of lipoprotein at prognosis of breast tumor. Methods Clinical data of 244 patients with breast cancer under therapy in the Sun Yat-sen Memorial Hospital and 99 healthy donors during November 2003 to September 2008. First,the plasma metabolic indexes were compared between the healthy donors and breast cancer patients.Furthermore, Spearman association showed breast cancer patients with high TC or LDL-C had larger tumor size and ER / PR deficiency. Cox regression model was used to analyze the disease free survival（DFS） curve and evaluate the prognostic factors of DFS. Results The plasma level of total cholesterol, LDL-C, triglyceride, glucose were higher in breast cancer patients than those in healthy donors, while HDL-C was reverse. The high plasma level of total cholesterol, LDL-C were more inclined to present at Her-2 positive or triple negative breast cancer, than ER / PR positive substyle.There was positive correction between tumor size and TC or LDL-C. Moreover, Cox regression model showed poorer DFS in the group with TC ≥5.2 mmol / L or LDL-C 〉3.08 mmol / L than that with TC 〈5.2 mmol / L or LDL-C≤3.08 mmol / L（TC 68% vs 77.7%, LDL-C 73.4% vs 86.3%, P〈0.05）,which revealed that TC or LDL-C was independent prognostic factors of breast cancer progression.Conclusion Plasma level of TC or LDL-C was an independent prognostic factor of breast cancer progression.

关 键 词：总胆固醇 低密度脂蛋白 无病生存率 乳腺癌 

分 类 号：R737.9[医药卫生—肿瘤]