空腹血糖及血脂与结直肠癌术后远处转移的相关性  

Relationship of fasting plasma glucose and lipid level with distant metastasis of colorectal neoplasms after operation

作　　者：陈秀清[1] 杨立勇[1] 沈喜妹[1] 严孙杰[1] 赵淑好[1] 刘东晖[1] 吴佩文[1] 

机构地区：[1]福建医科大学附属第一医院内分泌科,福州350005

出　　处：《中华糖尿病杂志》2016年第12期729-734,共6页CHINESE JOURNAL OF DIABETES MELLITUS

摘　　要：目的探讨空腹血糖（FPG）及血脂与结直肠癌患者术后远处转移的相关性。 方法回顾性分析2008年6月到2011年9月在福建医科大学附属第一医院胃肠外科住院行根治性手术的结直肠癌患者412例的临床资料，其中男231例，女181例，年龄21~ 88岁。比较术后随访期间发生转移组与未转移组糖脂代谢情况，采用单因素及多因素Cox回归模型分析糖脂代谢与远处转移的相关性。 结果截至2015年10月，平均随访时间（54±22）个月，术后97例患者发生远处转移，与未转移组相比，转移组术前FPG、甘油三酯（TG）较高[分别为5.41（4.90~ 6.44）比5.18（4.70~ 5.71） mmol/L、1.11（0.81~ 1.61）比1.01（0.77~ 1.33） mmol/L，z=-3.024、-2.213，均P〈0.05]，而年龄较低[（58±14）比（61±12）岁，t= 2.076，P〈0.05]。与未转移组相比，转移组FPG≥6.1 mmol/L的比例较高（33.0%比15.6%，χ2=14.271，P〈 0.05）。与未转移组相比，转移组TG≥1.1 mmol/L的比例较高（53.6%比40.3%，χ2=5.332，P〈0.05）。Kaplan-Meier分析显示，FPG≥6.1 mmol/L组30及50个月转移率分别为29.6%及39.5%，而FPG〈 6.1 mmol/L组则分别为16.1%和19.1%（χ2=15.898，P〈0.05）；TG≥1.1 mmol/L组30及50个月转移率分别为24.1%及28.6%，而TG〈1.1 mmol/L组则分别为15.5%及18.9%（χ2=4.117，P〈0.05）。多因素Cox回归分析显示，远处转移与FPG、TG、肿瘤TNM分期、神经周围侵犯呈正相关[比值比=2.898、1.574、10.918 （TNM分期Ⅲ期与Ⅰ期比较）、1.991，均P〈0.05]，与年龄呈负相关（比值比=-0.619，P〈0.05）。 结论FPG及TG与结直肠癌患者术后远处转移呈正相关。ObjectiveTo evaluate the impact of fasting plasma glucose（FPG） and lipid on distant metastasis of postoperative colorectal neoplasms. MethodsA total of 412 patients with colorectal neoplasms confirmed pathologically in the First Affiliated Hospital of Fujian Medical University from June 2008 to December 2011 were included in this study. There were 231 men and 181 women （aged 21 to 88 years） in this study. The patients were divided into two groups according to follow-up results： patients with distant metastasis and patients without distant metastasis. The glucose and lipid metabolism were compared between the two groups. The univariate analysis and multivariate Cox regression analysis were applied to investigate the relationship between distant metastasis and glucose and lipid metabolism. ResultsThe mean follow-up period was （54 ± 22） months till October 2015, and 97 cases were found with distant metastasis. Compared with patient without metastasis, the patients with metastatic colorectal neoplasms had higher degrees of FPG, triglyceride（TG） [5.41（4.90-6.44） vs 5.18（4.70-5.71） mmol/L;1.11（0.81-1.61） vs 1.01 （0.77-1.33） mmol/L, z=-3.024, -2.213, both P〈0.05], and was younger[（58±14） vs （61±12）years, t=2.076, P〈0.05]. Compared with those in patients without distant metastasis, the rate of FPG≥6.1 mmol/L and TG≥1.1 mmol/L in patients with distants metastasis were both significantly higher（33.0% vs 15.6% and 53.6% vs 40.3%, χ2=14.271, 5.332, both P〈0.05）. The distant metastasis rate of 30 and 50 months was 29.6% and 39.5% in patients with a FPG≥6.1 mmol/L, and 16.1% and 19.1% in patients with a FPG〈6.1 mmol/L（χ2=15.898, P〈0.05）. The distant metastasis rate of 30 and 50 months was 24.1% and 28.6% in patients with a TG≥1.1 mmol/L, and 15.5% and 18.9% in patients with a TG〈1.1 mmol/L（χ2=4.117, P〈 0.05）.The Cox multivariate regression analysis showed that FPG, TG, TNM stages, perineural invasion were positively correlated with distant

关 键 词：结直肠肿瘤 空腹血糖 血脂 肿瘤转移 

分 类 号：R735.34[医药卫生—肿瘤]