术前脂蛋白水平与胃癌淋巴结转移的相关性及其对胃癌预后的预测价值  

Correlation analysis between preoperative lipoprotein level and lymph node metastasis in gastric cancer and the value of prediction efficacy and prognosis

作　　者：李仲 朱正秋 Li Zhong;Zhu Zhengqiu(Department of Oncology,Affiliated Hospital of Xuzhou Medical University,Jiangsu Xuzhou 221000,China)

机构地区：[1]徐州医科大学附属医院肿瘤科,江苏徐州221000

出　　处：《现代肿瘤医学》2020年第9期1502-1507,共6页Journal of Modern Oncology

摘　　要：目的:探讨胃癌患者术前脂蛋白水平与淋巴结转移的相关性及其对胃癌预后的预测价值。方法:收集徐州医科大学附属医院于2015年8月至2018年8月期间收治的220例经病理学确诊的胃癌患者为胃癌组,另选取同期健康体检者或胃息肉患者100例作为对照组,对比两组血清脂蛋白(HDL-C、LDL-C、ApoA 1等)水平差异,分析胃癌患者术前脂蛋白水平与胃癌淋巴结转移及临床病理参数的相关性,采用KaplanMeier法分析术前脂蛋白水平与生存的关系,利用Cox比例风险回归模型探讨其在胃癌预后中的预测价值。结果:与对照组相比,胃癌组LP(a)明显较高,HDL-C明显较低(P <0. 05);胃癌患者的血清HDL-C水平与肿瘤长径、淋巴结转移和肿瘤浸润深度显著相关(P <0. 05),而LDL-C则与性别和肿瘤分化程度显著相关(P <0. 05),ApoB与淋巴结转移有关(P <0. 05)。生存分析结果显示,术前HDL-C水平≥1. 40 mmol/L,ApoB水平≥0. 90 g/L时,患者的生存期显著较长(P <0. 05)。Cox比例风险回归模型结果显示,术前HDLC和ApoB水平为胃癌患者预后不良的独立危险因素(P <0. 05)。结论:胃癌患者血清ApoB和HDL-C水平异常,且与淋巴结转移有关。检测胃癌患者术前HDL-C和ApoB等指标有助于预测患者预后。Objective:To study the correlation between preoperative lipoprotein level in patients with gastric cancer and lymph node metastasis,as well as evaluate the value of prediction efficacy and prognosis.Methods:A total of 220 patients with gastric cancer in Xuzhou Medical University Affiliated Hospital between August 2015 to August 2018 were selected as the gastric cancer group,and 100 healthy people were the control group.The serum level of HDL-C,LDL-C and ApoA1 were compared between the two groups,and the correlation between the above indexes and gastric cancer lymph node metastasis and clinical pathological parameters was analyzed.Cox proportional hazard regression model was used to evaluate the value of prediction efficacy and prognosis.Results:Compared with the control group,the gastric cancer group had significantly higher LP(a)level and lower HDL-C level(P<0.05).HDL-C was significantly associated with lymph node metastasis,tumor diameter and depth(P<0.05),and LDL-C was significantly correlated with gender and degree of differentiation(P<0.05),while ApoB was significantly correlated with lymph node metastasis(P<0.05).Preoperative HDL-C level≥1.40 mmol/L and ApoB≥0.90 g/L had significantly longer survival time(P<0.05).Cox proportional hazard regression model showed that preoperative HDL-C level and ApoB level were the risk factors of worse clinical outcome.Conclusion:Patients with gastric cancer have abnormal level of serum HDL-C and ApoB,and the indexes are correlated with lymph node metastasis,which can be used to evaluate the prognosis.

关 键 词：脂蛋白 胃癌 淋巴结转移 预后 

分 类 号：R735.2[医药卫生—肿瘤]