目的研究新辅助化疗(NAC)对乳腺癌患者血脂水平的影响及相关因素,为降低乳腺癌患者心血管疾病相关死亡率和改善乳腺癌预后提供诊疗依据。方法收集整理青岛大学附属医院乳腺诊疗中心299例完成4～6周期化疗的乳腺癌患者临床病理资料及血...目的研究新辅助化疗(NAC)对乳腺癌患者血脂水平的影响及相关因素,为降低乳腺癌患者心血管疾病相关死亡率和改善乳腺癌预后提供诊疗依据。方法收集整理青岛大学附属医院乳腺诊疗中心299例完成4～6周期化疗的乳腺癌患者临床病理资料及血脂水平结果,分析患者接受NAC前后的血脂水平变化及相关影响因素。结果接受NAC后乳腺癌患者血清三酯甘油(TG)、总胆固醇(TC)及低密度脂蛋白胆固醇(LDL-C)水平均显著高于术前,而高密度脂蛋白胆固醇(HDL-C)水平低于术前,差异均有统计学意义[(2.26±1.77)mmol/L vs(1.47±1.13)mmol/L、(5.81±1.20)mmol/L vs (5.17±1.07)mmol/L、(3.42±0.89)mmol/L vs (2.87±0.77)mmol/L、(1.28±0.33)mmol/L vs (1.45±0.32)mmol/L,t=-10.02、-9.80、-9.36、9.28,均P<0.01]。单因素分析提示患者肿瘤病理类型(χ~2=7.676,P=0.022)及化疗方案(χ~2=10.747,P=0.005)是接受NAC后血清TG水平升高的相关因素;患者年龄(χ~2=4.065,P=0.044)及是否绝经(χ~2=5.134,P=0.023)与NAC后血清LDL-C水平升高相关;血清HDL-C的降低与患者年龄(χ~2=7.284,P=0.007)、分子分型(χ~2=8.626,P=0.003)及是否绝经(χ~2=9.608,P=0.002)有关,而体质量指数(BMI)和化疗疗效与各血脂水平变化无关。多因素分析显示病理类型为浸润性非特殊癌(OR=3.624,P=0.008)及蒽环类联合紫衫类化疗方案(OR=3.508,P=0.001)是影响TG水平升高的独立危险因素;未绝经(OR=2.237,P=0.017)、分子分型为三阴性(OR=3.184,P=0.001)是影响HDL-C水平降低的独立危险因素。结论NAC后乳腺癌患者各血脂水平的变化对心血管系统及肿瘤复发、转移等预后不利,临床医师应重视患者血脂代谢变化及相关危险因素,定期检测并及时给予指导干预,降低癌症患者心血管疾病的死亡率并改善预后。展开更多
Myostatin is a member of the transforming growth factor-β(TGF-β) super-family and functions as a negative regulator of muscle growth.Binding of the specific receptor,Activin receptor IIB(Act RIIB),with myostatin or ...Myostatin is a member of the transforming growth factor-β(TGF-β) super-family and functions as a negative regulator of muscle growth.Binding of the specific receptor,Activin receptor IIB(Act RIIB),with myostatin or other related TGF-β members,could be inhibited by the activin-binding protein follistatin(Fst) in mammals.Overexpressing Fst in mouse skeletal muscle leads to muscle hypertrophy and hyperplasia.To determine if Fst has similar roles in fish,we generated transgenic zebrafish expressing high levels of zebrafish Fst1 using the promoter of the zebrafish skeletal muscle-specific gene,myosin,light polypeptide 2,skeletal muscle(Mylz2).Independent transgenic zebrafish lines exhibited elevated expression levels of myogenic regulatory genes MyoD and Pax7 in muscle cells.Adult Fst1 overexpressing transgenic zebrafish exhibited a slight body weight increase.The high level of Fst1 expression dramatically increased myofiber numbers in skeletal muscle,without significantly changing the fiber size.Our findings suggest that Fst1 overexpression can promote zebrafish muscle growth by enhancing myofiber hyperplasia.展开更多
文摘目的研究新辅助化疗(NAC)对乳腺癌患者血脂水平的影响及相关因素,为降低乳腺癌患者心血管疾病相关死亡率和改善乳腺癌预后提供诊疗依据。方法收集整理青岛大学附属医院乳腺诊疗中心299例完成4～6周期化疗的乳腺癌患者临床病理资料及血脂水平结果,分析患者接受NAC前后的血脂水平变化及相关影响因素。结果接受NAC后乳腺癌患者血清三酯甘油(TG)、总胆固醇(TC)及低密度脂蛋白胆固醇(LDL-C)水平均显著高于术前,而高密度脂蛋白胆固醇(HDL-C)水平低于术前,差异均有统计学意义[(2.26±1.77)mmol/L vs(1.47±1.13)mmol/L、(5.81±1.20)mmol/L vs (5.17±1.07)mmol/L、(3.42±0.89)mmol/L vs (2.87±0.77)mmol/L、(1.28±0.33)mmol/L vs (1.45±0.32)mmol/L,t=-10.02、-9.80、-9.36、9.28,均P<0.01]。单因素分析提示患者肿瘤病理类型(χ~2=7.676,P=0.022)及化疗方案(χ~2=10.747,P=0.005)是接受NAC后血清TG水平升高的相关因素;患者年龄(χ~2=4.065,P=0.044)及是否绝经(χ~2=5.134,P=0.023)与NAC后血清LDL-C水平升高相关;血清HDL-C的降低与患者年龄(χ~2=7.284,P=0.007)、分子分型(χ~2=8.626,P=0.003)及是否绝经(χ~2=9.608,P=0.002)有关,而体质量指数(BMI)和化疗疗效与各血脂水平变化无关。多因素分析显示病理类型为浸润性非特殊癌(OR=3.624,P=0.008)及蒽环类联合紫衫类化疗方案(OR=3.508,P=0.001)是影响TG水平升高的独立危险因素;未绝经(OR=2.237,P=0.017)、分子分型为三阴性(OR=3.184,P=0.001)是影响HDL-C水平降低的独立危险因素。结论NAC后乳腺癌患者各血脂水平的变化对心血管系统及肿瘤复发、转移等预后不利,临床医师应重视患者血脂代谢变化及相关危险因素,定期检测并及时给予指导干预,降低癌症患者心血管疾病的死亡率并改善预后。
基金supported by the National Natural Science Foundation of China (Grant No. 30671600)the National Basic Research Program of China (Grant Nos. 2010CB126302,2009CB118701)
文摘Myostatin is a member of the transforming growth factor-β(TGF-β) super-family and functions as a negative regulator of muscle growth.Binding of the specific receptor,Activin receptor IIB(Act RIIB),with myostatin or other related TGF-β members,could be inhibited by the activin-binding protein follistatin(Fst) in mammals.Overexpressing Fst in mouse skeletal muscle leads to muscle hypertrophy and hyperplasia.To determine if Fst has similar roles in fish,we generated transgenic zebrafish expressing high levels of zebrafish Fst1 using the promoter of the zebrafish skeletal muscle-specific gene,myosin,light polypeptide 2,skeletal muscle(Mylz2).Independent transgenic zebrafish lines exhibited elevated expression levels of myogenic regulatory genes MyoD and Pax7 in muscle cells.Adult Fst1 overexpressing transgenic zebrafish exhibited a slight body weight increase.The high level of Fst1 expression dramatically increased myofiber numbers in skeletal muscle,without significantly changing the fiber size.Our findings suggest that Fst1 overexpression can promote zebrafish muscle growth by enhancing myofiber hyperplasia.
