术前血脂水平与结直肠癌病理分期及预后的相关性分析

发布时间：2018-04-08 22:31

  本文选题：血脂　切入点：结直肠癌　出处：《广西医科大学》2017年硕士论文

【摘要】：目的:探讨术前血脂水平与结直肠癌病理分期及其预后的关系。方法:回顾性分析2012年9月至2014年9月于广西医科大学第一附属医院病理诊断为结直肠癌并接受手术治疗的460例患者。比较术前血脂水平在不同T分期、N分期、M分期、TNM分期、部位、有无神经浸润、有无脉管侵犯之间的差异以及与预后的关系,所得数据采用SPSS 17.0软件进行统计学分析。结果:1.结直肠癌患者不同T分期之间比较,术前TC、HDL-C、apoAⅠ、apoB水平差异有统计学意义(P0.05);logistic回归分析显示TC(OR=0.775,95%CI:0.635~0.945)、HDL-C(OR=0.470,95%CI:0.306~0.723)、apoAⅠ(OR=0.384,95%CI:0.162~0.910)、apoB(OR=0.310,95%CI:0.113~0.854)与T分期呈负相关。2.结直肠癌患者不同N分期之间比较,术前各血脂水平无显著差异(P0.05);logistic回归分析显示LP(a)(OR=0.606,95%CI:0.386~0.950)与N分期呈负相关。3.结直肠癌患者不同M分期、TNM分期之间比较,术前HDL-C、apoAⅠ、LP(a)差异有统计学意义(P0.05);logistic回归分析显示HDL-C(OR=0.228,95%CI:0.121~0.684)、apoAⅠ(OR=0.037,95%CI:0.008~0.180)与M分期呈负相关,HDL-C(OR=0.228,95%CI:0.087~0.624)、apoAⅠ(OR=0.036,95%CI:0.006~0.225)与TNM分期呈负相关。4.结直肠癌患者有无神经浸润及有无脉管侵犯之间比较,术前血脂各水平差异均无统计学意义(P0.05)。5.直肠癌患者的术前TC、HDL-C、LDL-C、apoAⅠ水平明显高于结肠癌患者(P0.05),左半结肠癌患者术前TC、TG、apoB水平明显高于右半结肠癌患者(P0.05)。6.单因素分析显示T分期(x~2=8.219,P=0.042)、N分期(x~2=29.038,P=0.000)、M分期(x~2=100.738,P=0.000)、脉管侵犯(x~2=4.717,P=0.030)、术前TG水平(x~2=5.106,P=0.024)与结直肠患者预后有关(P0.05),Cox比例风险模型分析显示N分期、M分期是结直肠癌患者生存的独立危险因素(P0.05),而术前TG水平不是结直肠癌患者生存的独立影响因素(P0.05)。结论:术前HDL-C、apoAⅠ水平与结直肠癌患者T分期、M分期、TNM分期有一定的关联,但与结直肠癌患者预后无相关性。
[Abstract]:Objective: to investigate the relationship between preoperative blood lipid level and pathological stage and prognosis of colorectal cancer.Methods: from September 2012 to September 2014, 460 patients with colorectal cancer diagnosed pathologically and treated surgically in the first affiliated Hospital of Guangxi Medical University were retrospectively analyzed.The blood lipid levels in different T / N stages and M / M staging were compared before and after operation. The difference of blood lipid levels between different T staging and N / M staging, including nerve infiltration, vascular invasion and prognosis was compared. The data were analyzed statistically by SPSS 17.0 software.The result is 1: 1.There was no significant difference in serum lipid levels between different N stages of colorectal cancer patients. Logistic regression analysis showed that there was a negative correlation between the serum lipid levels and N staging. The logistic regression analysis showed that there was a negative correlation between the serum lipid levels and the N staging in patients with colorectal cancer. The logistic regression analysis showed that there was a negative correlation between the serum lipid levels and the N staging in patients with colorectal cancer.There was no significant difference in blood lipid levels before operation between patients with colorectal cancer with or without nerve invasion and with or without vascular invasion (P0.05. 5).The preoperative level of TCnHDL-CnLDL-CapoA 鈪，

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