结直肠癌患者体质量指数及临床特征与远期预后的相关性

Correlation among body mass index,clinical features and long-term prognosis in 110 patients with colorectal cancer

目的研究结直肠癌患者的体质量指数、血清脂肪因子及一般临床特征,探索体质量指数对结直肠患者远期预后的影响。方法 110例结直肠癌患者依据入院BMI值,分为体质量正常组(对照组,n=62)和超重肥胖组(观察组,n=48),比较两组患者血清脂联素、瘦素、TNF-α与VEGF水平;比较结直肠癌患者不同BMI组基线特征;对术后五年生存情况进行回归分析。结果超重肥胖组患者血清瘦素、TNF-α与VEGF水平均较对照组显著降低,脂联素水平显著高于对照组,差异均具有统计学意义(P <0.05);相关性分析结果表明:BMI与脂联素呈负相关(P <0.05),与瘦素、TNF-α及VEGF呈显著正相关(P <0.05);对两组患者男性比例、年龄、肿瘤大小、肿瘤位置、肿瘤分化程度、淋巴结转移以及TNM分期等资料比较,差异无统计学意义(P> 0.05);生存曲线结果表明:两组患者的生存时间分布差异具有统计学意义(χ^(2)=4.976,P=0.026)。Logistic回归分析结果表明,肿瘤分化程度、淋巴结转移以及TNM分期是五年生存率的危险因素(P <0.05),BMI不是五年生存率的危险因素(P> 0.05)。结论超重肥胖的结直肠癌患者血清脂联素、瘦素、TNF-α与VEGF水平异常表达,其指标水平与BMI有相关性;影响患者远期预后的主要因素是肿瘤分化程度、淋巴结转移以及TNM分期;体质量指数对五年生存率有一定的影响。

Objective To explore the correlation among BMI,serum adipocytokines and general clinical characteristics of colorectal cancer patients.Methods According to BMI,110 patients with colorectal cancer were divided into the normal weight group(control group,n=62),and overweight and obese group(experimental group,n=48).Serum levels of adiponectin,leptin,TNF-αand VEGF in two groups were compared.The baseline characteristics of patients with colorectal cancer in different BMI groups were compared,and regression analysis was performed on their postoperative survival for five years.Results Serum levels of leptin,TNF-αand VEGF in the overweight and obese group were significantly lower than those in the control group,and adiponectin level was significantly higher than that in the control group(P<0.05).There were no significant differences in male ratio,age,tumor size,tumor location,tumor differentiation,lymph node metastasis and TNM stage between the two groups(P>0.05).A significant negative correlation was observed between BMI and adiponectin(P<0.05),and a significant positive correlation was also found among leptin,TNF-αand VEGF(P<0.05).The results of the survival curve showed that the difference in survival time distribution was statistically significant between the two groups(χ^(2)=4.976,P=0.026).Logistic regression analysis showed that tumor differentiation degree,lymph node metastasis and TNM stage were risk factors for 5-year survival(P<0.05),while BMI was not an influential factor for 5-year survival(P>0.05).Conclusion sAbnormal expression of serum adiponectin,leptin,TNF-αand VEGF in overweight colorectal cancer patients showed a certain correlation with BMI.The main factors influencing the long-term prognosis were tumor differentiation,lymph node metastasis and TNM stage.Body mass index has a certain effect on five-year survival,and the mechanism involved needs to be further investigated.