血脂异常与非小细胞肺癌预后的关系

Relationship between dyslipidemia and prognosis in patients with non-small cell lung cancer

目的回顾性分析非小细胞肺癌(NSCLC)患者血脂水平与临床病理特征及预后的关系。方法选取2011年6月-2015年5月泸州市人民医院就诊的晚期NSCLC初治患者367例,根据患者血脂水平是否正常分为血脂阳性组和血脂阴性组,分析血脂水平与NSCLC临床病理特征及与患者生存期的关系,并采用Logistic回归分析评估肺鳞癌及肺腺癌患者预后差异的独立影响因素。结果两组年龄、性别、组织学类型、临床分期、颅内转移、肝转移及胸膜转移比较,差异有统计学意义(P <0.05)。126例肺鳞癌患者中,血脂阳性组与血脂阴性组年龄、肝转移比较,差异有统计学意义(P <0.05)。241例肺腺癌患者中,血脂阳性组与血脂阴性组年龄、性别、临床分期、淋巴结转移及胸膜转移比较,差异有统计学意义(P <0.05)。肺鳞癌患者血脂阳性组与血脂阴性组中位生存时间分别为23.4和14.6个月;3年累积生存率分别为15.3%和3.4%,差异有统计学意义(P <0.05)。肺腺癌患者血脂阳性组与血脂阴性组中位生存时间分别为21.3和13.1个月;3年累积生存率分别为6.3%和0.0%,差异有统计学意义(P <0.05)。血脂异常、原发灶部位和组织学类型是NSCLC患者预后的独立影响因素(P <0.05)。结论血脂水平与NSCLC生存相关,可作为该类肺癌患者的预后指标。

Objective To identify the relationships of dyslipidemia with the clinical pathological characteristics and survival time in patients with non-small cell lung cancer.Methods According to inclusion and exclusion criteria,A total of 367 patients with non-small cell lung cancer were diagnosed by pathology and tested the serum lipoprotein level in our hospital during June 1,2011 to May 31,2015.According to the levels of serum lipoprotein,patients were divided into the normal level group (negative group) and abnormal level group (positive group).The differences of patients’ clinical pathological characteristics and survival time in the two groups were analyzed.And logistic regression analysis was used to determine the independent impact factors of the differences of prognosis in both squamous cell carcinoma and adenocarcinoma of lung in this study.Results Among the 367 patients,the blood lipid-positive group was significantly different from the lipid-negative group in terms of age,gender,histological features,clinical stage,intracranial metastasis,liver metastasis,and pleural metastasis (P < 0.05).Among them,126 patients with squamous cell carcinoma,the blood lipid-positive group was different from the lipid-negative group in age and liver metastasis (P < 0.05);among the 241 adenocarcinomas,the blood lipid-positive group was significantly different from the lipid-negative group in terms of age,gender,clinical stage,lymph node metastasis,and pleural metastasis (P < 0.05).In different histological classification between the two groups of serum lipoprotein,the median survival period of squamous cell carcinoma was 23.4 months and 14.6 months,adenocarcinoma was 21.3 months and 13.1 months,the abnormal group were all significantly higher than those in the normal group (P < 0.05).The multivariate logistic analysis has indicated that only dyslipidemia,the location of primary lesion and the histological type can independently result in the different prognosis of non-small cell lung cancer.Conclusions The level of serum lipoprotein is an important indicator for prognosis in non-small cell lung cancer.