血清血脂水平与Ⅳ期非小细胞肺癌患者生存预后的相关性  

Correlation Between Serum Lipid Level and Prognosis of Patient of Non-small Cell Lung Cancer StageⅣ

作　　者：徐力立 骆莹滨 吴建春[1] 张博 郭鹏[1] 李雁[1] XU Li-li;LUO Ying-bin;WU Jian-chun;ZHANG Bo;GUO Peng;LI Yan(Shanghai Municipal Hospital of Traditional Chinese Medicine,Shanghai University of Traditional Chinese Medicine,Shanghai 200071,China)

机构地区：[1]上海中医药大学附属市中医医院,上海200071

出　　处：《肿瘤学杂志》2021年第11期939-945,共7页Journal of Chinese Oncology

基　　金：国家自然科学基金面上项目(81973795);上海申康医院发展中心临床三年行动计划(SHDC2020CR4052);上海市浦江人才计划(2020PJD057);上海中医药大学预算内项目(2019LK094)。

摘　　要：[目的]评估Ⅳ期NSCLC患者血清血脂水平与预后的关系,寻找Ⅳ期NSCLC预后的潜在因子。[方法]回顾性分析239例Ⅳ期NSCLC患者的临床资料,收集治疗前血清总胆固醇(total cholesterol,TC)、甘油三酯(triglyceride,TG)、高密度脂蛋白胆固醇(high density lipoprotein cholesterol,HDL-C)和低密度脂蛋白胆固醇(low density lipoprotein cholesterol,LDLC)水平。无进展生存期(progression free survival,PFS)和总生存期(overall survival,OS)是主要结局指标。用X-tile软件确定各个指标的最佳截断值,生存分析采用Kaplan-Meier法和Cox风险比例模型分析。[结果]与血脂低水平组相比,TC高值组(TC≥5.02 mmol/L)具有更好的PFS(P=0.021)和OS(P=0.001)。TG高值组(TG≥0.97 mmol/L)具有更好的OS(P=0.024)。HDLC高值组(HDL-C≥1.19 mmol/L)具有更好的PFS(P<0.001)和OS(P=0.024)。LDL-C高值组(LDL-C≥3.27 mmol/L)具有更好的OS(P=0.006)。Cox多因素回归分析表明,HDL-C是影响Ⅳ期NSCLC患者PFS(P=0.012)和OS(P=0.030)的独立预后因素。[结论]治疗前血清TC、TG、HDL-C和LDL-C水平可能是Ⅳ期NSCLC患者的重要预后因素。[Objective]To investigate the relationship between pretreatment serum lipid levels and prognosis in patients with stageⅣnon-small cell lung cancer(NSCLC).[Methods]The clinical data and blood lipids levels,including total cholesterol(TC),triglyceride(TG),high density lipoprotein cholesterol(HDL-C)and low density lipoprotein cholesterol(LDL-C)of 239 patients with stageⅣNSCLC were retrospectively analyzed.The progression free survival(PFS)and overall survival(OS)of patients were calculated.The best cut-off value was determined by X-tile tool.For survival analysis,Kaplan-Meier method and Cox regression analysis were also used.[Results]Compared with patients with low lipid levels,patients with high TC levels(≥5.02 mmol/L)had better PFS(P=0.021)and OS(P=0.001),patients with high TG levels(≥0.97 mmol/L)had better OS(P=0.024),patients with high HDL-C levels(≥1.19 mmol/L)had better PFS(P<0.001)and OS(P=0.024),patients with high LDL-C levels(≥3.27 mmol/L)had better OS(P=0.006).Multivariate Cox regression analysis showed that HDL-C was an independent prognostic factor of PFS(P=0.012)and OS(P=0.030)in patients with stageⅣNSCLC.[Conclusion]The pretreatment serum lipid levels including TC,TG,HDL-C and LDL-C can be significant prognostic factors for stageⅣNSCLC.

关 键 词：非小细胞肺癌 总胆固醇 甘油三酯 高密度脂蛋白胆固醇 低密度脂蛋白胆固醇 预后 

分 类 号：R734.2[医药卫生—肿瘤]