浸润性乳腺癌的血脂代谢特点及其与分子分型的关系研究

Characteristic of serum lipid and its relationship with molecular classification in invasive breast carcinoma

目的探讨浸润性乳腺癌的血脂代谢特点,分析血脂表达与分子分型的相关性。方法选择330例浸润性乳腺癌(浸润组),以同期150例良性乳腺病(良性组)为对照,所有患者术前1周内采静脉血进行血脂检测并分析,根据术后免疫组化对乳腺癌行分子分型,观察不同分型的血脂表达,探讨血脂差异与分子分型的关系。结果浸润组的TG、TC、LDL-C、V-LDL-C、Apo B及Apo E明显高于良性组(P <0. 05),HDL-C及FFA明显低于良性组(P <0. 01)。分子分型后:Luminal A型组所有血脂指标与良性组比较差异无统计学意义(P> 0. 05),Luminal B型组HDL-C明显低于良性组(P <0. 01),Her-2过表达型组的TG、V-LDL-C、Apo B均明显高于良性组(P <0. 05),三阴型组的HDL-C明显低于良性组(P <0. 05)。浸润组合并高血压、糖尿病的比例明显高于良性组(P <0. 01),合并组的TG、Apo B及FFA均明显高于非合并组(P <0. 05),HDL-C明显低于非合并组(P <0. 01)。浸润组去除高血压及糖尿病后再分子分型,除Her-2过表达型组的载脂蛋白外,其余各组血脂表达均与合并高血压及糖尿病时的数据一致。结论浸润性乳腺癌不同分子亚型血脂代谢有差异,分亚型分析可能是乳腺癌脂质代谢研究的新方向。

Objective To investigate the characteristics of serum lipid in invasive breast carcinoma,and analyze the relationship with molecular classification. Methods The expressions of serum lipid were detected in one week before surgery in 330 cases of invasive breast carcinoma（invasive group） and 150 control cases of benign breast diseases（benign group）. The molecular sub-types were classified according to the immmunohistochemistry,and the characteristics of serum lipid were analyzed in order to investigate the relationships between serum lipid and molecular classification in invasive breast carcinoma.Results The triglyceride（TG）,total cholesterol（TC）,low-density lipoprotein cholesterol（LDL-C）,very low-density lipoprotein cholesterol（V-LDL-C）,Apolipoprotein B（Apo B） and Apolipoprotein E（Apo E） in invasive group were obviously higher than the ones in benign group（P〈0. 05）,while high-density lipoprotein cholesterol（HDL-C） and free fatty acid（FFA） in invasive group were significantly lower than the ones in benign group（P〈0. 01）. An interesting results appeared after the molecular classification of invasive breast carcinoma. And the difference of serum lipid between luminal A group and benign group was not statistically significant（P〈0. 05）. The HDL-C in Luminal B group was significantly lower than that in benign group（P〈0. 01）. The TG,V-LDL-C,Apo B in Her-2 over-expression group were obviously higher than the ones in benign group（P〈0. 05）,and the HDL-C in three negative group was significantly lower than the one in benign group（P〈0. 05）. The ratio of hypertension and diabetes in invasive group was significantly higher than that in benign group（P〈0. 01）. The TG,Apo B and FFA in invasive breast carcinoma accompanying with hypertension and（or） diabetes（accompany group） were obviously higher than the ones in non-accompany group（P〈0. 05）,while HDL-C in accompany group was obviously lower than the one in non-accompany group（P〈0. 01）. The results of serum lipid in different sub-types comparing with benign breast diseases in non-accompany group were almost similar to the ones in accompany group except apolipoprotein in Her-2 over-expression group. Conclusion Different molecular sub-type of invasive breast carcinoma has different expression of serum lipid,which suggests that sub-type analysis may be a new direction in lipid metabolic study of breast cancer.