结直肠癌远处转移与血脂变化的关系研究

The changes of blood lipids in colorectal carcinoma patients with and without distant metastases

目的:测定结直肠癌患者的血脂相,包括总胆固醇(TC)、甘油三酯(TG)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C),探讨结直肠癌的远处转移与血脂变化的关系。方法:使用自动微粒化学发光免疫分析法分别检测123例伴有或不伴远处转移的结直肠癌患者的餐前血脂谱,并测定患者的体重指数(BMI)及血清白蛋白,以评估患者的营养状态,分别以Mann-Whitney检验及Logistic多元回归法对测定结果进行统计学分析。结果:具有远处转移的结直肠癌患者血清TC、LDL-C水平及LDL-C/HDL-C比率高于未发生远处转移的患者(P<0.05)。血清TC、LDL-C水平及LDL-C/HDL-C比率等3项因素与结直肠癌远处转移的联系强度较大,具有统计学意义。而性别、年龄和体重指数与远处转移无关。结论:结直肠癌的远处转移关联于血清TC、LDL-C水平及LDL-C/HDL-C比率的升高。密切监测血脂变化可能有助于预测结直肠癌的远处转移。

Objective：To investigate the levels of serum lipid profile, including total cholesterol （TC）, triglyceride （TG）, high-density lipoprotein cholesterol （HDL-C） and low-density lipoprotein cholesterol （LDL-C） in colorectal carcinoma（CRC） patients, and in order to verify whether the presence of distant metastases was associated to serum lipids changes. Methods ： The fasting blood lipids was examined in 123 CRC patients with and without distant metastases using automated microparticle chemiluminescent immunoas- say methods. To determine the nutritional status, the body mass index （BMI） was calculated and serum albumin was measured. The results were statistically analysed by methods of Mann-Whitney test and multiple logistic regression analysis respectively. Results：Pa- tients with distant metastases showed statistically higher concentration of TC, LDL-C and the LDL-C/HDL-C ratio than patients without distant metastases （P 〈 0.05 ）. Three indexes were obviously significant in the multi-factor stepwise analysis, which including TC, LDL-C and the LDL-C/HDL-C ratio. There were greater strength of relationship between the three indexes and the distant metastases. The presence of distant metastases was independent of sex, age and BMI. Conclusion： The increase of serum TC, LDL-C levels and the LDL-C/HDL-C ratio are significantly associated with the distant metastases in CRC patients. Repeated monitoring of serum lipids in CRC patients maybe facilitate to predict the distant metastasis of CRC.