血清脂联素与子宫内膜癌发生及发展相关性的临床研究

发布时间：2018-01-31 02:48

本文关键词： 子宫内膜癌脂联素血清胰岛素胰岛素抵抗指数　出处：《广西医科大学》2017年硕士论文　论文类型：学位论文

【摘要】：目的:通过病例-对照研究,分析子宫内膜癌患者中血清脂联素的表达水平,探讨血清脂联素与子宫内膜癌发生发展之间的关系及其与胰岛素抵抗指数(HOMA-IR)的相关性。方法:选取2015年10月至2016年12月在广西医科大学附属肿瘤医院妇瘤科住院患者89例:新发子宫内膜癌患者59例为病例组,正常子宫内膜患者30例为对照组。分别采用酶联免疫法(ELISA)检测血清脂联素(adiponectin,ADP)表达情况,葡萄糖氧化酶法测定空腹血葡萄糖(fasting blood gloucse,FBG)水平,直接化学发光法测定空腹血清胰岛素(fasting serum insulin,FINS)水平。通过检测正常子宫内膜和子宫内膜癌患者血清脂联素、FBG和FINS水平,计算稳态模型胰岛素抵抗指数(HOMA-IR),进而比较HOMA-IR及血清脂联素在两组患者中表达情况、两者间的相关关系及血清脂联素在子宫内膜癌发生发展中的作用。应用SPSS19.0进行统计分析。结果:1、血清脂联素水平在病例组中为(9.13±8.79)μg/ml显著低于对照组(16.95±15.74)μg/ml(P0.01);FINS水平在病例组中为(8.02±3.33)μU/ml显著高于对照组(6.13±2.94)μU/ml(P0.01);HOMA-IR在病例组中为(1.74±0.97)明显高于对照组(1.29±0.77)(P0.05);FBG在两组中比较差别无统计学意义(P0.05)。2、在非肥胖患者中,血清脂联素在子宫内膜癌患者中含量明显低于对照组(P0.05)。3、单因素分析结果显示:血清脂联素、FINS、HOMA-IR可能为子宫内膜癌的影响因素。调整可能与子宫内膜癌发生有关的危险因素后,低血清脂联素水平是不依赖胰岛素抵抗的影响子宫内膜癌发生的独立危险因素(OR=0.869,95%CI:0.807-0.936)。且其对子宫内膜癌发生危险的影响呈剂量-反应关系。4、血清脂联素水平分别在子宫内膜癌患者不同的手术-病理分期、组织学分级、病理分型、肌层浸润深度、宫颈受累、淋巴结转移中比较,差异均无统计学意义(均P0.05)。5、Spearman相关分析显示血清脂联素水平与HOMA-IR无明显相关性(r=-0.134,P0.05)。结论:1、子宫内膜癌患者的血清脂联素水平下降;非肥胖的子宫内膜癌患者血清脂联素水平降低。2、低血清脂联素水平是子宫内膜癌发生的独立危险因素,其对子宫内膜癌发生危险的影响呈剂量-反应关系。3、血清脂联素水平与子宫内膜癌的手术-病理分期、组织学分级、病理分型、宫颈受累、淋巴结转移、肌层浸润深度无相关性。4、本研究尚未发现子宫内膜癌患者中低血清脂联素水平与HOMA-IR之间的相关性。
[Abstract]:Objective: through case-control study, analysis of the expression levels of serum adiponectin in patients with endometrial cancer, serum adiponectin and endometrial carcinogenesis and the relationship between the development of insulin resistance index (HOMA-IR) correlation. Methods: from October 2015 to December 2016 in the Department of gynecology oncology Affiliated Hospital of Guangxi Medical University, 89 patients with newly diagnosed in patients with endometrial carcinoma in 59 cases as the case group, with 30 cases of normal endometrium were used as control group. Enzyme linked immunosorbent assay (ELISA) detection of serum adiponectin (adiponectin, ADP) expression, determination of fasting blood glucose by glucose oxidase method (fasting blood gloucse, FBG) level, fasting serum insulin determination of direct chemiluminescence method (fasting serum insulin, FINS) level. Through the detection of normal endometrium and endometrial carcinoma, serum adiponectin, FBG and FINS levels, calculation of stability Insulin resistance index model (HOMA-IR), and then compare the expression of HOMA-IR and serum adiponectin in two groups of patients, the relationship between the serum adiponectin and in endometrial carcinoma. The application of SPSS19.0 for statistical analysis. Results: 1, the serum adiponectin levels in case group (9.13 + 8.79) g/ml was significantly lower than the control group (16.95 + 15.74) g/ml (P0.01); the level of FINS in case group (8.02 + 3.33) U/ml was significantly higher than the control group (6.13 + 2.94) U/ml (P0.01); HOMA-IR in case group (1.74 + 0.97) was significantly higher than the control group (1.29. 0.77) (P0.05; FBG) showed no significant difference in the two groups (.2, P0.05) in non obese patients, serum adiponectin levels in patients with endometrial cancer was significantly lower than the control group (P0.05.3), the results of univariate analysis showed that serum adiponectin, FINS, HOMA-IR for endometrial cancer The factors affecting the adjustment may occur. The risk factors associated with endometrial cancer, low serum adiponectin levels are independent risk factors of the occurrence of endometrial cancer does not depend on insulin resistance (OR=0.869,95%CI:0.807-0.936). And the endometrial cancer risk were.4 dose-response relationship, the serum adiponectin level in different patients endometrial cancer pathological stage, histological grade, histological type, depth of myometrial invasion, cervical involvement, lymph node metastasis, there were no significant differences (P0.05).5, Spearman correlation analysis showed that serum adiponectin levels and HOMA-IR no significant correlation (r=-0.134, P0.05). Conclusion: 1. The serum adiponectin level in patients with endometrial cancer decreased; reduce the non obese patients with endometrial cancer serum adiponectin.2, low serum adiponectin level is the occurrence of endometrial carcinoma The independent risk factors of endometrial cancer risk were.3 dose-response relationship, the serum adiponectin level in endometrial carcinoma with pathological stage, histological grade, pathological type, cervical involvement, lymph node metastasis, depth of myometrial invasion had no correlation with.4, this research has not found a correlation between low serum adiponectin and HOMA-IR in patients with endometrial cancer.

【学位授予单位】：广西医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R737.33

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