代谢综合征组分及相关疾病在不同阶段结直肠肿瘤患者中的表现

Expression of components of metabolic syndrome and related diseases in patients with colorectal tumor at different stages

目的通过分析代谢综合征（MS）组分及相关疾病在不同阶段结直肠肿瘤患者中的表现，评价其与结直肠肿瘤发展的关系。方法以2003年1月至2010年10月住院行内镜下或手术切除结直肠肿瘤的患者为研究组，并将研究组分为非进展性肿瘤组和进展性肿瘤组；以行结肠镜检查排除结直肠肿瘤和IBD的患者作为对照组。比较各组患者MS组分及相关疾病（肥胖、高血糖、高血压、血脂异常、高尿酸血症、非酒精性脂肪性肝病）的患病率，分析MS组分及相关疾病与不同阶段结直肠肿瘤的关系。统计学处理采用X^2检验。结果共有405例患者纳入研究，男女比为1.66：1，其中非进展性肿瘤组132例，进展性肿瘤组273例（包括36例原位癌或浸润癌）。对照组76例，男女比为1.11：1。研究组高血压患病率高于对照组[48.6％（197／405）比32.9oA（25／76），；（X^2=6.3851，P=0.0115]。进展性肿瘤组高血压患病率（53.8％，147／273）高于非进展性肿瘤组（37.9％，50／132，；[X^2=9.0809，P=0.0026）和对照组（X^2=10.4406，P=0.0012），高血糖患病率（22.3％，61／273）也高于非进展性肿瘤组（13.6％，18／132，X^2=4.2971，P=0.0382）和对照组（11.8％，9／76，X^2=4.0894，P=0.0432）。伴发≥1项MS组分的患者在研究组中占76.5％（310／405），高于对照组的63.2％（48／76，X^2=6.0240，P=0.0141）。伴发≥1项MS组分的患者在进展性肿瘤组中占81.0％（221／273），高于非进展性肿瘤组的67.4％（89／132，）[X^2=9.0695，P=0.0026）。伴发MS组分数量的增加与进展性肿瘤所占比例升高相关（X^2=9.1508，P=0.0274）。结直肠癌在伴发MS组分者的结直肠肿瘤患者中占10.6％（33／310），高于不伴发MS组分者的3.2％（3／95,X^2=5.0334，P=0.0249）。结论伴发MS组分可能与结直肠肿瘤发展相关。

Objective Through analyzing the expression of components of metabolic syn- drome （MS） and related diseases in patients with colorectal tumor at different stages to assess their relationship with the development of colorectal tumor. Methods From January 2003 to October 2010, hospitalized patients who received endoscopic or surgical resection of colorectal tumor were set as research group. The research group was divided into non-progressive tumor group and progressive tumor group. Patients underwent colonoseopy examination and excluded of colorectal tumor and inflammatory bowel diseases （IBD） were set as control group. The prevalence of MS components and related diseases （obesity, hypertension, hyperglycemia, dyslipidemia, hyperuricemia and nonalcoholic fatty liver disease） in patients of each group were compared. The relationship between MS components, related diseases and different stages of colorectal tumor was analyzed. Chi-square test was performed in statistics analysis. Results A total of 405 patients were enrolled in research group. The male to female ratio was 1.66：1. Among them there were 132 cases in non-progressive tumor group and 273 cases in progressive tumor group （including 36 carcinomas in situ or invasive carcinomas）. There were 76 patients in control groups the male to female ratio was 1.11：1. The prevalence of hypertension in research group was significantly higher than that of control group [48.6% （ 197/405 ） vs 32.9%（25/76）,X^2=6.3851, P=0.0115]. The prevalence of hypertension in progressive tumor group 53.8^（147/273） was significantly higher than that of non-progressive tumor group （37.9%, 50/132,X^2= 9.0809, P=0.0026） and control group （X^2=10.4406, P=0.0012）. And the prevalence of hyperglycemia was also significantly higher than that of non-progressive tumor group [22.3%（61/273） vs 13.6%（18/132）,X^2=4.2971, P= 0.0382] and control group （11.8%, 9/76,X^2=4.0894, P=0.0432）. In research group, the percentage of cases with at least one MS component was 76.5%（310/405）, which was higher than that of control group （63.2%,48/76,X^2=6.0240, P=0.0141）. The percentage of cases with at least one MS component in progressive tumor group was 81.0%（221/273）, which was higher than that of non-progressive group （ 67.4%, 89/132,X^2=9.0695, P=0.0026）. The increasing of MS component was associated with the increasing percentage of progressive tumor （X^2=9.1508, P=0.0274）. The percentage of colorectal cancer was 10.6%（33/310） in patients with colorectal tumor and MS components, which was higher than that of patients without MS components （3.2%, 3/95,X^2=5.0334, P= 0.0249）. Conclusion Concomitant MS components could be associated with the development of colorectal tumor.