乙状结肠癌患者血脂水平变化及其诊断价值探究

Invesgation of the Serum Lipids Level Changes and Its' Diagnostic Value in Sigmoid Colon Cancer

目的分析乙状结肠癌患者血脂相关指标的变化,探讨指标对该病的临床意义和诊断价值。方法收集2014年1月~2017年6月在解放军总医院手术治疗的乙状结肠癌患者118例、乙状结肠息肉92例和健康对照344例的临床资料,对患者基本信息及血脂相关指标进行统计分析。结果单因素统计分析显示乙状结肠癌患者的总胆固醇(TC)、总三酰甘油(TG)、高密度脂蛋白胆固醇(HDL-C)、磷脂(PL)、载脂蛋白AⅠ(ApoAⅠ)、载脂蛋白AⅡ(ApoⅡ)和载脂蛋白CIII(ApoC-III)含量显著低于乙状结肠息肉组与正常对照组(F=14.68,8.49,15.18,24.82,6.72,20.95,35.54,均P<0.05);乙状结肠癌患者血清脂蛋白(a)[Lp(a)]、载脂蛋白B(ApoB)则高于其他两组(F=24.07,2.52,P<0.05);TC+ApoB组合对乙状结肠癌的诊断较优,ROC曲线下面积(AUC)=0.77,95%CI:0.70~0.83,敏感度为70.3%,特异度为72.8%,其二分类Logistic回归模型对乙状结肠癌的诊断准确度为71.9%。结论血清总胆固醇和ApoB是较为理想的血液检测指标组合,有助于乙状结肠癌的早期筛查。

Objective To analyze the lipid level changes, as well as to investigate the diagnostic value of these biomarkers in sigmoid colon cancer. Methods Clinical data of 118 patients with sigmoid colon cancer who underwent operation,92 patients with sigmoid polyp and 334 normal controls in Chinese PLA General Hospital from January 2014 to June 2017 were retro- spectively analyzed. Results Univariate analysis showed that the levels of TC, TG, HDL-C, PL, ApoA Ⅰ , ApoA Ⅱ and ApoC-Ⅲ in sigmoid colon cancer group were significantly lower than other groups （F= 14.68,8.49,15.18,24.82,6.72, 20.95,35.54,all P〈0.05） ,while its levels of Lp （a） and ApoB were significantly higher （F=24.07,2.52,P〈0.05）. The combined TCq-ApoB was the optimal （70.3% sensitivity and 72.8% specificity,AUC= 0.77,95% CI：0.70~0.83）. The diagnostic accuracy of the binary Logisctic analysis model for sigmoid colon cancer was 71.90/00. Conclusion The combina- tion of TC and ApoB is more suitable as a diagnostic model for the screening of sigmoid colon cancer.