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目的 探讨胃癌患者糖脂代谢水平与临床病理学特征的相关性.方法 收集443例入住湖州师范学院附属第一医院的胃癌患者临床病理参数,统计胃癌患者初入院空腹糖脂代谢指标水平及所占百分比,分析糖脂代谢指标水平与临床病理参数的相关性.结果 与糖脂代谢指标正常水平的胃癌患者相比,血清低水平总胆固醇(x2 =7.676)男性胃癌患者显著较少(P＜0.05),低水平高密度脂蛋白(x2 =7.520)、低水平载脂蛋白A1(x2=6.253)男性胃癌患者均显著较多(P＜0.05).血清总胆固醇水平与患者年龄(r=-0.116)、肿瘤直径(r=-0.117)及TNM分期(r=-0.111)均呈负相关(P ＜0.05);HDL与肿瘤直径(r=-0.094)、转移淋巴结数量(r=-0.106)、原发灶浸润深度(r=-0.112)、淋巴结转移分级(r=-0.102)及TNM分期(r=-0.107)均呈负相关(P＜0.05);低密度脂蛋白水平与患者年龄(r=-0.116)呈负相关(P＜0.05);血清脂蛋白a与肿瘤直径(r=0.170)、转移淋巴结数量(r=0.151)、原发灶浸润深度(r=0.160)、淋巴结转移分级(r=0.153)及TNM分期(r =0.115)均呈正相关(P＜0.05);载脂蛋白A1与远处转移(r=-0.168)、TNM分期(r=-0.120)均呈负相关(P＜0.05);载脂蛋白B与远处转移(r=-0.132)呈负相关(P＜0.05).血糖及三酰甘油水平与胃癌患者临床病理特征无明显关联(P＞0.05).结论 低脂代谢水平、高脂蛋白A血症可能是胃癌恶性程度及进展的代谢特征,监测血脂指标变化可能对胃癌患者病程评估有一定参考价值.

Objective To analyze the correlation between glycolipids metabolism and clinicopathologic features in patients with gastric cancer.Methods Glycolipids metabolism and clinicopathologic features of 443 gastric cancer patients were collected,and their correlation was analyzed.Results Compared to gastric cancer patients with normal levels of glycolipids metabolism,there were less male patients who were with low level of total cholesterol (TCH) (x2 =7.676,P ＜ 0.05),and the number of male patients with low levd of high-density lipoprotein (HDL) (x2 =7.520) and apoA1 (x2 =6.253) was higher (both P ＜ 0.05).Serum TCH level showed a negative correlation with age of patients (r =-0.116),tumor size (r =-0.117) and TNM stage (r =-0.111) (P ＜ 0.05);serum HDL level was negatively correlated with tumor diameter (r =-0.094),the number of metastatic lymph nodes (r =-0.106),primary tumor invasion depth (r=-0.112),metastatic lymph nodes stage (r=-0.102) and TNM stage (r =-0.107) (P ＜ 0.05);serum LDL was negatively correlated with age of patients (r =-0.116) (P ＜0.05);serun LPa was positively correlated with tumor size (r=0.170),the number of metastatic lymph nodes (r =0.151),primary tumor invasion depth (r =0.160),metastatic lymph nodes stage (r =0.153) and TNM stage (r =0.115) (P ＜0.05);apoA1 was negatively correlated with distant metastasis (r =-0.168) and TNM stage (r =-0.120) (P ＜0.05);and apoB was negatively correlated with distant metastases (r =-0.132,P ＜0.05).Levels of blood glucose and TG had no significant association with clinicopathological features of gastric cancer patients (P ＞ 0.05).Conclusions Low lipid metabolism but high level of LPa may be the metabolic characteristics of gastric cancer progression.Monitoring the changes of serum lipids levels could be valuable for the prognosis of patients with gastric cancer.