胰腺癌患者血脂水平的变化及其临床意义

Changes and clinical significance of serum lipids in patients with pancreatic cancer

目的探讨胰腺癌患者血脂水平的变化及其临床意义。方法比较157例胰腺癌患者(胰腺癌组)、115例胰腺良性疾病患者(胰腺良性疾病组)和150例健康体检者(对照组)的空腹血脂水平。绘制ROC曲线,比较各指标对胰腺癌的诊断效能。将胰腺癌组进一步分为早期组65例和晚期组92例,比较胰腺癌不同分期患者和胰腺良性疾病组的空腹血脂水平。结果胰腺癌组的TC和HDL-C水平低于对照组(P<0.01),脂蛋白a[Lp(a)]、TC/HDL-C和LDL-C/HDL-C水平高于对照组(P<0.05),TC、LDL-C、Lp(a)、TC/HDL-C和LDL-C/HDL-C水平高于胰腺良性疾病组(P<0.05)。Lp(a)联合LDL-C/HDL-C诊断胰腺癌的灵敏度为58.0%,特异度为83.8%,AUC为0.722[95%CI(0.669~0.775)]。与胰腺良性疾病组相比,胰腺癌早期组的LDL-C和Lp(a)水平升高(P<0.05),晚期组的HDL-C水平降低(P<0.05),LDL-C、Lp(a)、TC/HDL-C和LDL-C/HDL-C水平升高(P<0.05)。胰腺癌晚期组的HDL-C水平低于早期组(P<0.05)。结论血脂代谢水平与胰腺癌的发生、发展密切相关。

Objective To study the changes and clinical significance of serum lipids in the patients with pancreatic cancer.Methods Serum levels of fasting lipids were compared among the patients with pancreatic cancer(group A,157 cases),the patients with benign pancreatic disease(group B,115 cases) and healthy people(group C,150 cases).ROC curve was drawn to compare the diagnostic efficiency of the indicators for pancreatic cancer.Group A was further divided into two groups of A1(early stage, 65 cases) and A2(advanced stage, 92 cases).Serum levels of fasting lipids were compared among groups of A1,A2 and B.Results The levels of TC and HDL-C were lower(P<0.01),while the levels of lipoprotein(a)[Lp(a)],TC/HDL-C and LDL-C/HDL-C in group A were higher than those in group C(P<0.05).The levels of TC,LDL-C,Lp(a),TC/HDL-C and LDL-C/HDL-C in group A were higher than those in group B(P<0.05).The sensitivity and specificity of Lp(a) combined with LDL-C/HDL-C in diagnosing pancreatic cancer was 58.0% and 83.8%,respectively.The area under curve was 0.722 [95%CI(0.669-0.775)].Compared with group B,the levels of LDL-C and Lp(a) were increased in group A1(P<0.05),and the level of HDL-C was decreased, while the levels of LDL-C,Lp(a),TC/HDL-C and LDL-C/HDL-C were increased in group A2(P<0.05).The level of HDL-C in group A2 was lower than that in group A1(P<0.05).Conclusion The metabolism level of serum lipids is closely related to the occurrence and development of pancreatic cancer.