血清低、高密度脂蛋白胆固醇比值与结直肠癌病理分期的关系  

Relationship Between Ratio of Serum Low Density Lipoprotein Cholesterol to High Density Lipoprotein Cholesterol and Pathological Staging of Colorectal Cancer

作　　者：李浩[1] 姚梦洁 邹博远 徐建[1] 杜晓辉[1,3] 

机构地区：[1]解放军总医院普通外科,北京100853 [2]南开大学医学院临床医学院,天津300071 [3]解放军总医院海南分院普外科,海南三亚572013

出　　处：《中国普外基础与临床杂志》2015年第3期289-292,共4页Chinese Journal of Bases and Clinics In General Surgery

基　　金：国家自然科学基金(项目编号:61170123);海南省自然科学基金(项目编号:813226)~~

摘　　要：目的探讨结直肠癌患者术前血清低密度脂蛋白胆固醇（LDL-C）与高密度脂蛋白胆固醇（HDL-C）水平比值（简称L/H值）与结直肠癌病理分期的关系。方法回顾性分析2009年7月至2014年6月期间在解放军总医院接受手术治疗的187例结直肠癌患者的临床资料。结果不同TNM分期、N分期以及M分期患者的L/H值不同或不全相同（P〈0.05）,其中,TNMⅣ期高于Ⅰ、Ⅱ及Ⅲ期,N2期高于N1和N0期,M1期高于M0期;但不同T分期患者的L/H值比较差异无统计学意义（P〉0.05）。logistic回归分析结果显示,在控制其他混杂因素的情况下,L/H值对结直肠癌TNM分期（OR=4.34,95%CI：2.837~6.644,P〈0.000 1）、T分期（OR=1.72,95%CI：1.175~2.512,P=0.005 3）、N分期（OR=2.15,95%CI：1.422~3.254,P=0.000 3）及M分期（OR=3.04,95%CI：1.733~5.332,P=0.000 1）的影响均有统计学意义,L/H值越高者其TNM分期、T分期、N分期及M分期越高。结论术前血清L/H值的升高是结直肠癌TNM分期、T分期、N分期及M分期进展的独立危险因素。Objective To evaluate the relationship between low density lipoprotein cholesterol（LDL-C）/high density lipoprotein cholesterol（HDL-C） of preoperation（L/H value for short） and the pathological staging of colorectal cancer. Methods The clinical data of 187 patients with colorectal cancer who treated in PLA General Hospital from July 2009 to June 2014 were analyzed retrospectively. Results There were statistical significance in L/H value among different TNM stagings, N stagings, and M stagings（P〈0.05）： L/H value of TNM Ⅳ staging was higher than those of TNM Ⅰ, Ⅱ, and Ⅲ staging, L/H values of N1 staging and N0 staging were lower than that of N2 staging, L/H value of M1 staging was higher than that of M0 staging. However, there was no statistical significance in L/H value among different T stagings of colorectal cancer（P〉0.05）. Logistic regression results showed that L/H value were positively associated with TNM staging（OR=4.34, 95% CI： 2.837-6.644, P〈0.000 1）, T staging（OR=1.72, 95% CI： 1.175-2.512, P=0.005 3）, N staging（OR=2.15, 95% CI： 1.422-3.254, P=0.000 3）, and M staging（OR=3.04, 95% CI： 1.733-5.332, P=0.000 1） of colorectal cancer, and patient with higher L/H value took more risk of progression of tumor, lymph node metastases, and distant metastasis. Conclusions Raise of preoperative L/H value is an independent risk factor for the progression of TNM staging, T staging, N staging, and M staging in colorectal cancer.

关 键 词：低密度脂蛋白胆固醇 高密度脂蛋白胆固醇 结直肠癌 肿瘤分期 淋巴结转移 远处转移 

分 类 号：R735.34[医药卫生—肿瘤]