术前血脂异常和非转移性乳腺癌患者临床病理参数的相关性和临床意义  

Correlation of Dyslipidemia with the Clinicopathological Parameters of Non-metastatic Breast Cancer Patients and its Clinical Significance

作　　者：游俊浩[1] 崔美琦 刘辉[1] 李方[1] 颜兵[1] YOUJun-hao;CUI Mei-qi;LIU Hui;LI Fang;YAN Bing(Department of Oncology,Hainan Hospital of PL A General Hospital,Sanya,Hainan,572000,China;Department of Out-patient,Hainan Hospital ofPLA General Hospital,Sanya,Hainan,572000,China)

机构地区：[1]解放军总医院海南医院肿瘤科,海南三亚572000 [2]解放军总医院海南医院门诊部,海南三亚572000

出　　处：《现代生物医学进展》2019年第4期704-709,共6页Progress in Modern Biomedicine

基　　金：三亚市医疗卫生创新项目(2018YW06;2016YW08);海南省自然科学基金项目(817352);国家自然科学基金项目(81503391)

摘　　要：目的:分析术前血脂(总胆固醇[Total cholesterol,TC]、甘油三酯[Triglyceride,TG]、高/低密度脂蛋白胆固醇[High/Low density lipoprotein cholesterol,HDL-C/LDL])异常和乳腺癌患者临床病理参数的相关性。方法:根据纳入排除标准收集我院自2013年1月-2017年1月经病理证实的乳腺病病例共224例,其中浸润性乳腺癌88例(病例组),乳腺良性疾病136例(对照组),收集患者年龄、肿瘤位置、肿瘤细胞分化程度、肿瘤标记物(癌胚抗原、CA153、CA125)、TNM分期、肿瘤体积、阳性/活检淋巴结数、Luminal分型、初潮年龄、绝经状态、生育子女数、体重指数(BMI)、体表面积(BSA)等临床病理参数,同时收集术前1月内患者血脂检测结果进行统计分析。结果:①病例组术前TC值(p=0.02)、HDL-C/LDL值(p=0.04,p=0.00)与对照组相比差异具有统计学差异;②术前TC取值为4.62 mmol/L、TG取值为0.92 mmol/L、LDL取值为2.86 mmol/L时预测乳腺癌的灵敏度分别为54.5%、69.3%和61.6%,特异度分别为32.4%、45.9%和33%,曲线下面积分别为0.62(95%CI:0.54-0.69,p=0.00)、0.64(95%CI:0.57-0.71,p=0.00)和0.64(95%CI:0.56-0.73,p=0.00);③以上述取值为分割点分析,在病例组中TG和LDL升高更多见于BMI(分别为:21.66±3.09 vs 25.11±3.37,p=0.00;22.99±3.70 vs 24.91±3.48,p=0.03)偏高的患者,而TC和TG升高更多见于已绝经患者(分别为p=0.01;p=0.00)的患者。结论:乳腺癌患者术前存在一定程度血脂异常,该异常对协助诊断乳腺癌具有一定意义,术前BMI偏高和已绝经的患者存在TG和LDL值异常升高的可能性更大。Objective: To analyze the correlation of dyslipidemia(Total cholesterol [TC], triglyceride [TG] with high/low density lipoprotein cholesterol [HDL-C/LDL]) and clinicopathological parameters in non-metastatic breast cancer patients and its clinical significance. Methods: 224 pathologically confirmed breast disease cases were collected from January 2013 to 2017 in our hospital according to the including and excluding criteria, among them are 88 cases of breast cancer(case group) and 136 paralleled breast benign lesions(control group). Clinicopathological parameters including age, tumor location, tumor cell differentiation, tumor markers(Carcinoembryonic antigen [CEA], Carbohydrate antigens 125 [CA125], Carbohydrate antigens 153 [CA153]), TNM stage, tumor size, positive/resected lymph node numbers, luminal style, menarche age, menopausal status, children numbers, body mass index(BMI) and body surface area(BSA) of those patients, were recorded and further analyzed in line with the data of serum lipids 1 month before surgery. Results: ①Significant differences in pre-operative total cholesterol(p=0.02), HDL-C/LDL(p=0.04/p=0.00) could be found between case group and control group;②With a cut-off value for pre-operative TC at 4.62 mmol/L, TG at 0.92 mmol/L and LDL at 2.86 mmol/L, the sensitivity to detected cancer is 54.5%, 69.3% and 61.6% and the specificity is 32.4%, 45.9% and 33% respectively, the corresponding AUC is 0.62(95%CI: 0.54-0.69, p=0.00), 0.64(95%CI: 0.57-0.71, p=0.00) and 0.64(95%CI: 0.56-0.73, p=0.00);③ With aforementioned cut-off value,high value of TG and LDL was more prevalent in high BMI(21.66±3.09 vs 25.11±3.37, p=0.00;22.99±3.70 vs 24.91±3.48, p=0.03,respectively) patients in cases group, in addition, high value of TC and TG was more detectable in postmenopausal(with respective p=0.01 and p=0.00) patients. Conclusions: Pre-operative dyslipidemia was commonly found in breast cancer and could play a role in collaborative diagnosis, high BMI and postmenopausal patients before surgery were mor

关 键 词：乳腺癌 总胆固醇 甘油三脂 高低密脂蛋白胆固醇 低密度脂蛋白胆固醇 

分 类 号：R737.9[医药卫生—肿瘤]