血脂及脂蛋白代谢改变在胃癌中的临床意义

Clinical value of changes of serum lipids and lipoprotein metabolism in gastric cancer

目的探讨血脂及脂蛋白代谢改变与胃癌临床病理特征和预后的关系。方法比较山东大学齐鲁医院收治的127例胃癌患者(胃癌组)和100例健康体检者(对照组)的血脂、脂蛋白水平;胃癌组血脂、脂蛋白水平与临床病理特征的关系;Kaplan-Meier生存曲线及COX回归分析其与患者预后的关系。结果胃癌组的TC、TG、HDL-C、LDL-C水平明显低于对照组(P<0.05);胃癌患者血脂及脂蛋白水平与临床病理特征有不同程度的相关性;Kaplan-Meier生存分析显示TC、HDL-C与胃癌患者的总生存和无进展生存相关(P<0.05),COX回归分析提示TC水平、TNM分期、术后辅助化疗是胃癌的独立预后因素。结论胃癌患者存在脂代谢异常,血脂及脂蛋白水平可能作为进展期胃癌患者病情评估、预后判断的探索性指标。

Objective To investigate the changes of serum lipids and lipoprotein metabolism in gastric cancer and their prognostic value.Methods Serum levels of lipids and lipoprotein in patients with gastric cancer were compared with healthy controls.The relationship of serum lipids and lipoprotein with clinical pathological features was analyzed.Survival curves were presented as Kaplan-Meier curves.Cox proportional hazards model was used to assess the prognostic value of individual variables associated with OS and DFS.Results Serum levels of TC,TG,HDL-C,LDL-C in gastric cancer group were significantly lower than those in normal control group(P<0.05).Serum levels of lipids and lipoprotein were associated with clinical pathological features.Low TC and low HDL-C were significantly associated with poor OS and DFS.Serum TC,TNM and postoperative chemotherapy were independent prognostic factors for OS by COX regression analysis.Conclusion Metabolism of serum lipids and lipoprotein in gastric cancer patients is disordered.Serum levels of lipids and lipoprotein may be used as important indicators in diagnosis,progression and prognosis.