妇科恶性肿瘤与代谢综合征关系的临床分析

Clinical analysis on the relationship between gynecologic malignant neoplasms and metabolic syndrome

目的探讨妇科恶性肿瘤与代谢综合征间的关系，指导妇科恶性肿瘤的预防和治疗。方法选择妇科恶性肿瘤患者359例（研究组，其中卵巢癌142例，子宫内膜癌131例，子宫颈癌86例）和妇科良性肿瘤患者400例（对照组），比较两组患者一般情况、体格检查情况及空腹血糖、空腹胰岛素、稳态模型评估法胰岛素抵抗指数（HOMA-IR）、血脂等实验室指标，统计代谢综合征发生情况。结果两组患者初潮年龄、发病年龄、孕次、产次比较差异均无统计学意义（P〉0.05）。研究组收缩压、舒张压、体质指数、腹围、空腹血糖、空腹胰岛素、HOMA-IR、三酰甘油均明显高于对照组[（129士13）mmHg（1mmHg=0.133kPa）比（112±14）mmHg、（87±11）mmHg比（75±8）mmHg、（26.7±2.8）kg／m^2比（22.2±2.1）kg／m^2、（88±7）cm比（76±9）cm、（6.5±2.9）mmol／L比（4.7±0.9）mmol／L、（9.2±4.7）mU／L比（5.2±3.0）mU／L、3.9±0.8比3.1±0.6、（3.21±1.96）mmol／L比（1.56±1.22）mmol／L]，高密度脂蛋白胆固醇明显低于对照组[（1.25±0.51）rnmol／L比（1.65±0.47）mmo]／L]，差异均有统计学意义（P〈0.05）。研究组代谢综合征发生率为37.60％（135／359），其中卵巢癌患者发生率为37.32％（53／142），子宫内膜癌患者为43.51％（57/131），子宫颈癌患者为29.07％（25／86），均明显高于对照组的12.25％（49／400），差异有统计学意义（P〈0.05）。结论妇科恶性肿瘤患者代谢综合征发生率明显高于妇科良性肿瘤患者，妇科恶性肿瘤与代谢综合征间存在相互促进和影响的关系。重视代谢综合征在妇科恶性肿瘤发生和发展中可能产生的影响，并积极控制代谢综合征，对妇科恶性肿瘤的预防和治疗具有重要意义。

Objective To investigate the relationship between gynecologic malignant neoplasms and metabolic syndrome （MS）,in order to give a direction to the prevention and treatment of gynecologic malignant neoplasms. Methods A total of 359 cases of gynecologic malignant neoplasms （including 142 cases of ovarian cancer, 131 eases of endometrial cancer, 86 cases of cervix cancer） were enrolled as study group ,and 400 cases of gynecologic benign neoplasms were enrolled as control group. The general conditions, physical examination, fasting blood glucose, fasting insulin, homeostatic model assessment insulin resistance index （HOMA-IR）, blood fat were compared between two groups. Clinical characteristics between two groups were compared. The occurrence of MS was counted. Results There was no significant difference in menarche age, onset age, gravidity and parity between two groups （P〉0.05）. The level of systolic pressure, diastolic pressure, body mass index, abdominal circumference, fasting blood glucose, fasting insulin, HOMA-IR, triacylglyeerol in study group was higher than that in control group [（129±13） mm Hg （1 mm Hg =0.133 kPa） vs. （112±14） mm Hg, （87±11） mm Hg vs. （75 ±8） mm Hg, （26.7±2.8） kg/m2 vs. （22.2±2.1） kg/m2, （88±7） cm vs.（76±9） cm, （6.5±2.9） mmol/L vs. （4.7±0.9） mmol/L, （9.2±4.7） mU/L vs.（5.2±3.0） mU/L,3.9 ±0.8 vs. 3.1 ＋ 0.6, （3.21 ±1.96） mmol/L vs. （1.56±1.22） mmol/L],and the level of high density lipoprotein cholesferol was lower than that in control group [（1.25±0.51） mmol/L vs. （1.65±0.47） mmol/L], and there were significant difference between two groups （P〈 0.05）. The occurrence of MS in study group was 37.60%（135/359） ,among of them, 37.32%（53/142） in ovarian cancer, 43.51% （57/131） in endometrial cancer, 29.07% （25/86） in cervix cancer,which was higher than that in control group [12.25% （49/400）],and there was significant difference （P 〈 0.05）. Conclusions The occurrence of MS in gynecologic malignant neoplasms is higher than that in gynecologic benign neoplasms, and there is a mutual promotion and influence of the relationship between gynecologic malignant neoplasms and MS. It suggests that there is a possible role of MS in the occurrence and development of gynecologic neoplasms, gynecologist should pay attention to it and control MS actively, those measures could make important significance of prevention and treatment for gynecologic malignant neoplasms.