胃癌患者术前BMI及血脂水平在评估预后及个体化医疗中的意义  

Preoperative body mass index and blood lipids levels predict postoperative prognosis and their significance in individualized medicine for gastric cancer patients

作　　者：刘斌正 陶林[1] 李旭哲[1] 马雅静[2] 李述刚[3] 张文杰[1] 

机构地区：[1]石河子大学医学院病理系,新疆石河子832002 [2]石河子大学第一附属医院检验科,新疆石河子832002 [3]石河子大学医学院预防医学系,新疆石河子832002

出　　处：《石河子大学学报（自然科学版）》2016年第4期440-446,共7页Journal of Shihezi University(Natural Science)

基　　金：国家科技支撑计划项目(2009BAI82B02);新疆自治区研究生科研创新计划项目(XJGRI2015056)

摘　　要：为了探讨胃癌患者术前体质指数(BMI),甘油三酯(TG),总胆固醇(TC),高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)水平与临床特征及生存预后的关系,本研究收集本院病理科121例胃癌患者的临床资料并随访80个月。经统计学分析临床病理特征与BMI、甘油三酯等指标两两之间相关性采用Spearman等级相关分析;生存曲线和生存期描述采用Kaplan-Meier法;胃癌单因素及多因素危险因素分析采用Cox比例风险回归模型。结果显示:(1)BMI分别与肿瘤浸润深度(T)和临床分期(TNM)呈负相关,TG水平与肿瘤浸润深度(T)呈负相关;(2)与BMI正常及以上体重患者比较,低体重患者预后最差(P<0.001),术前TG水平较低者预后比较高者差(P=0.005);(3)Cox分析结果表明,BMI(hazard ratio,HR=0.462,P=0.021)和细胞分化(HR=3.733,P=0.008)分别是预测胃癌患者生存预后的独立因素。由此可知,术前BMI指数和TG水平与癌浸润深度和/或远处转移、临床TNM分期呈负相关并影响胃癌患者生存预后。This study tested body mass index（BMI）, serum total cholesterol（TC）, triglyceride（TG）, high-density lipoprotein cholesterol（HDL-C）, low-density lipoprotein cholesterol（LDL-C） and analyzed their relationships with clinical data and survival prognosis for patients with gastric cancer（GC）. A total of 121 GC patients, with complete demographic and clinical information,were collected from our pathology department and followed-up for 80 months. Spearman＇s rank correlation method was used to analyze correlations between bio-indicators and clinical features. Survival curves were drawn by Kaplan-Meier method.Univariate and multivariate risks for GC survival were analyzed using Cox proportional hazards regression model. Three major findings were obtained：（1） preoperative BMI levels were negatively correlated with tumor invasion depth（T） and TNM staging;similarly, TG levels were negatively correlated with tumor invasion depth（T）;（2） GC patients with a low BMI showed poor survival than those with a high BMI（P0.001）, and GC patients with lower TG levels had poor survival than those with higherTG levels（P=0.005）; and（3） Cox multi-factorial regression analyses demonstrated that BMI（P=0.021） and cell differentiation status（P=0.008） were independent factors, respectively, in predicting overall survival among GC patients. There is negative correlations of BMI and blood TG levels with cancer invasion, metastasis and survival in GC patients.

关 键 词：胃癌 体质指数 甘油三酯 预后 个体化医疗 

分 类 号：R735.2[医药卫生—肿瘤]