血脂水平与结直肠肿瘤关系的研究

Study on Correlation between Blood Lipid Level and Colorectal Neoplasms

背景：研究显示代谢综合征（MS）为结直肠肿瘤的危险因素,血脂异常是MS的重要组分.目的：探讨血脂水平与结直肠肿瘤的关系.方法：纳入2011年1月～ 2012年8月扬州市第一人民医院收治的347例结直肠息肉、结直肠腺瘤以及结直肠癌患者作为结直肠病变组,选取同期335例无结直肠病变者作为对照组,采集入选患者的临床资料,包括性别、年龄、血脂水平、结直肠病变特性等,分析血脂水平与结直肠病变的关系.结果：结直肠病变组血清TC、TG、LDL-C、apo-B水平较对照组显著升高,血清HDL-C、apo-A1水平较对照组显著降低（P＜0.05）.结直肠病变组中血清TC、TG、HDL-C、LDL-C水平异常的比例较对照组显著升高（P＜0.05）.血清TC、TG、HDL-C、LDL-C水平异常与结直肠息肉、腺瘤、进展期腺瘤的发生相关,血清TG、HDL-C水平异常与结直肠癌的发生相关（P＜0.05）;血清TC、TG、HDL-C水平异常与结直肠息肉部位相关（P＜0.05）;血清HDL-C、LDL-C水平异常与结直肠息肉大小相关（P＜0.05）;血清HDL-C、LDL-C水平异常与结直肠腺瘤组织分型相关（P＜0.05）.结论：血脂水平异常可能影响结直肠肿瘤的发生发展.

Background： Several studies demonstrated that components of metabolic syndrome （MS） were risk factors for colorectal neoplasm. Dyslipidemia is an important component of MS. Aims： To investigate the correlation between blood lipid level and colorectal neoplasms. Methods： A total of 347 subjects with colorectal polyp, colorectal adenoma or colorectal cancer from Jan. 2011 to Aug. 2012 at Yangzhou First People＇ s Hospital were enrolled; 335 subjects with no colorectal lesion were served as controls. A retrospective analysis was conducted based on clinical data of the subjects, which include gender, age, blood lipid level and character of colorectal lesion. Correlation between blood lipid level and colorectal lesion was analyzed. Results ： Serum levels of TC, TG, LDL-C and apo-B were significantly higher and serum levels of HDL-C and apo-A1 were significantly lower in colorectal lesion group than those in control group （ P 〈 0.05 ）. The ratio of patients with abnormal serum levels of TC, TG, HDL-C was significantly higher in colorectal lesion group than those in control group （P 〈 0.05 ）. Abnormal serum levels of TC, TG, HDL-C and LDL-C were significantly associated with occurrence of colorectal polyp, colorectal adenoma and advanced colorectal adenoma, abnormal serum levels of TG and HDL-C were significantly associated with occurrence of colorectal cancer （P 〈 0.05）. Abnormal serum levels of TC, TG, and HDL-C were significantly associated with distribution of colorectal lesion （ P 〈 0.05 ）. Abnormal serum levels of HDL- C and LDL-C were significantly associated with size of colorectal polyp （P 〈 0.05）. Abnormal serum levels of HDL-C and LDL-C were significantly associated with histological types of colorectal adenoma （ P 〈 0.05 ）. Conclusions ： Abnormal levels of blood lipid may affect the development and progression of colorectal neoplasms.