大肠肿瘤合并代谢综合征患者的临床特点

Clinical features of colorectal neoplasm patients with metabolic syndrome

目的:探讨并分析大肠肿瘤合并代谢综合征患者的临床特点,明确代谢综合征对大肠肿瘤患者的临床诊断与预后的影响.方法:收集2012-05/2015-05住院治疗并诊断为大肠肿瘤合并代谢综合征患者的临床资料,进行回顾性分析.结果:共纳入107例,男性72例、女性35例,平均年龄66.84岁±10.58岁,其中大肠腺瘤40例,大肠癌67例,在代谢组分分析中,大肠腺瘤组与大肠癌组比较,低高密度脂蛋白-胆固醇(high density lipoproteincholesterol,HDL-C)降低[29(72.5%)vs53(79.1%)]差异无统计学意义(P>0.05),而甘油三酯(triacylglycerol,TG)升高[14(35.0%)vs 45(67.2%)]差异有统计学意义(P<0.05);而在肿瘤标志物分析中,癌胚抗原(carcinoembryonic antigen,CEA)、糖链抗原199(carbohydrate antigen 199,CA199)升高在大肠腺瘤组与大肠癌组中无明显差异(P>0.05);CA125含量升高以及同时检测三项标志物时,其中2项及以上标志物均升高时,在大肠腺瘤组与大肠癌组中差异有统计学意义(P<0.05);最终随访结果示合并代谢综合征的大肠癌患者中,发生转移20例,死亡16例,中位生存时间为33 mo.结论:大肠肿瘤合并代谢综合征患者的发病年龄偏高,而其中TG的升高可能对于腺瘤转向癌的过程中产生一定影响,且多项肿瘤标志物联合检测对代谢综合征合并大肠肿瘤患者良恶性的早期诊断有预测作用.

AIM：To investigate the clinical features of colorectal neoplasm patients with metabolic syndrome（MS）.METHODS：A retrospective analysis was performed of clinical data for patients who were diagnosed with colorectal neoplasm with MS from May 2012 to May 2015.RESULTS：A total of 107 patients were included.There were 72 males and 35 females,and their mean age was 66.84 years ＋ 10.58 years.There were 40 cases of adenomas and67 cases of colorectal cancer.There was no significant difference（P〉0.05） in the rate of reduced high density lipoprotein-cholesterol（HDL-C）[29（72.5%） vs 53（79.1%）]between patients with adenomas and those with colorectal cancer,but the rate of elevated triacylglycerol[14（35.0%） vs 45（67.2%）]differed significantly（P〈0.05）.The rates of elevated CEA and CA199 showed no significant difference between patients with adenomas and colorectal cancer（P〈0.05）;however,the rate of elevated CA125 and the rate of elevation of two or more of the three tumor markers were significantly higher in the colorectal cancer group than in the adenoma group（P〉0.05）.In colorectal neoplasm patients with MS,20 developed carcinoma metastases,and 16 cases died;the median survival time was 33 mo.CONCLUSION：Colorectal neoplasm patients with metabolic syndrome are always diagnosed at old ages,and high level of TG may play a role in the evolution of colorectal adenomas to colorectal cancer.Joint detection of multiple tumor markers can be used to distinguish benign and malignant lesions in these patients.