结直肠癌患者血脂代谢水平的特征和临床意义

Characteristics and clinical value of serum lipid metabolism in patients with colorectal cancer

目的探讨结直肠癌患者血脂代谢水平的特征和临床意义。方法以2012年9月至2014年9月在广西医科大学第一附属医院结直肠肛门外科住院手术治疗的669例结直肠癌患者为例,检测血总胆固醇(TC)、甘油三酯(TG)、载脂蛋白AⅠ(apo AⅠ)、载脂蛋白B(apo B)、高密度脂蛋白-胆固醇(HDL-C)、低密度脂蛋白-胆固醇(LDL-C)和脂蛋白a(Lpa)水平,分析临床病理资料和术前血脂检测值的关系。结果术前血脂各指标水平与年龄、神经浸润、脉管浸润和组织学类型无关。女性结直肠癌患者的TC、apo AⅠ和HDL-C显著高于男性患者(均P<0.05)。结肠癌患者的TC、apo AⅠ、apo B、LDL-C和HDL-C水平显著低于直肠癌患者(均P<0.05)。TC、apo AⅠ和HDL-C与肿瘤浸润层次有关(均P<0.05)。apo AⅠ、Lpa和HDL-C与结直肠癌TNM分期有关(均P<0.05)。术前血脂各个指标与结直肠癌术后生存期无关(均P>0.05)。结论血脂代谢水平与结直肠癌临床病理进展有关,但与预后无关。

Objective To investigate the characteristics and clinical significance of serum lipid metabolism in patients with colorectal cancer. Methods 669 cases of colorectal cancer who received surgical therapy at Department of Colon, Rectum Anus Surgery, the first affiliated hospital of Guangxi Medical University from September 2012 to September 2014 were recruited. Total cholesterol（TC）,triglyceride（TG）, high-density lipoprotein cholesterol（HDL-C）, low-density lipoprotein cholesterol（LDL-C）, apolipoprotein A I（apo A I）, apolipoprotein B（apo B） and lipoprotein a（Lpa） were measured. The relationships between clinicopathological findings and preoperative blood lipid level were analyzed. Results Lipid profile had no correlation with age, nerve invasion, vessel invasion and histology type. TC, apo A I and HDL-C were markedly higher in female patients with CRC than that in male patients（P〈0.05）. TC,apo B, apo A I, LDL-C and HDL-C in patients with colon cancer were significantly lower than those with rectum cancer（P〈0.05）.TC, apo A I and HDL-C had significant correlation with infiltration. There was also significant correlation between apo A I, Lpa, HDL-C and TNM staging. Lipid profile had no significant correlation with prognosis（all P〉0.05）. Conclusion The level of blood lipid metabolism was related to the clinicopathological progress of colorectal cancer, but these lipid parameters had no significant correlation with prognosis.