不同病理学类型肺癌患者合并代谢综合征和非酒精性脂肪性肝病发生率调查

Incidence of metabolic syndrome and non-alcoholic fatty liver diseases in patients with different histological types of lung cancer

目的探讨肺癌患者代谢综合征(MetS)和非酒精性脂肪性肝病(NAFLD)的患病率。方法回顾性分析2013年上海市肺科医院经病理学确诊的肺癌患者的临床资料,使用日立700全自动生化分析仪检测血生化指标,使用美国GE公司高档Vivid7彩色多普勒超声诊断仪或美国西门子公司SONOLINE G50彩色多普勒超声诊断仪诊断NAFLD。结果在675例肺癌患者中,男性391例(57.9%),女性284例(42.1%),平均年龄(59.7±9.71)岁。其中165例(24.4%)患者合并MetS;在148例鳞癌、456例腺癌、11例小细胞肺癌、60例其他病理类型患者中,分别有33例(22.3%)、117例(25.7%)、2例(18.2%)、13例(21.7%)患者合并MetS,不同病理类型的肺癌患者之间MetS患病率无显著统计学差异(x^2=1.244,P=0.743);148例鳞癌与456例腺癌患者合并肥胖症、低HDL血症、高血糖和高血压百分比无显著性相差,仅腺癌患者合并高TG血症百分比显著高于鳞癌患者(25.4%对17.4%,P=0.046);456例腺癌与219例非腺癌患者合并MetS或NAFLD百分比均无显著性相差(P>0.05)。结论高TG血症和NAFLD可能与肺腺癌的发生相关。

Objective To explore the prevalence of metabolic syndrome （MetS） and non-alcoholic fatty liver diseases （NAFLD） in patients with lung cancer. Methods We retrospectively analyzed the clinical data of patients with lung cancer in Shanghai Pulmonary Hospital in 2013. The resuhs of biochemical indexes were obtained by Hitachi 700 full-automatic biochemical analyzers,and the diagnosis of NAFLD was made by Vivid 7 color dropper ultasound instruments from GE company or SONOLINE 50 color dropper ultasound instruments from SIMENS company. Results Among 675 patients with lung cancer,391 （57.9%） were male and 284 （42.1%） female with the average age of （59.7±9.71） yr old;165 （24.4%） cases had MetS,and the prevalences of MetS in patients with adenocarcinoma,squamous cell carcinoma, small cell lung cancer and other types of lung cancer was 25.7% （117/456）,22.3% （33/148）,21.1%（15/71）and 21.1% （15/71）,and the differences among them were not significantly （χ^2=1.244,P=0.743）;the proportion of elevated serum triglycerides in pulmonary adenocarcinoma was higher than in with squamous cell lung carcinoma（25.4% vs. 17.4%,P=0.047）;There was no significant difference as respect to the prevalence of MetS and/or NAFLD between 456 patients with adenocarcinoma and 219 with non-adenocarcinoma （P〉0.05）. Conclusion Hypertriglyceridemia and NAFLD might be the risk factors for the occurrence of lung adenocarcinoma.