摘要
目的 探讨鼻咽癌患者治疗前血脂水平的变化,并探索是否可以作为预测鼻咽癌的指标.方法 选取广西壮族自治区人民医院2013-2022年病理确诊并资料齐全的131例鼻咽癌患者作为鼻咽癌组,对照组为随机选取的119名健康体检人员,检测鼻咽癌患者治疗前的血脂参数总胆固醇(TC)、甘油三酯(TG)、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)、载脂蛋白A1(ApoA1)、载脂蛋白B(ApoB)及脂蛋白a[Lp(a)]值并进行统计学分析.结果 鼻咽癌组所有血脂参数与对照组比较,差异均有统计学意义(P＜0.000 1).M分期组间比较,其中TC、LDL-C、ApoB差异有统计学意义(P＜0.01).受试者操作特征(ROC)曲线的结果显示,TC、HDL-C、ApoA1、Lp(a)、TC/HDL-C、LDL-C/HDL-C 及 ApoA1/ApoB 的曲线下面积(AUC)＞0.7,其中 TC/HDL-C、LDL-C/HDL-C 及 ApoA1/ApoB 3 个指标的 AUC 最大,分别为 0.82、0.77、0.75,灵敏度分别为 0.70、0.70、0.65,特异度分别为 0.88、0.82、0.78,cut-off 值分别为＞3.97、＞2.50、＜1.24.结论 鼻咽癌患者治疗前的TC、TG、LDL-C、HDL-C、ApoA1、ApoB及Lp(a)水平即发生异常.在M分期中发现鼻咽癌有远处转移组的TC、LDL-C、ApoB相比无远处转移组明显升高.TC/HDL-C、LDL-C/HDL-C和ApoA1/ApoB血脂比值参数可以作为预测鼻咽癌发生的指标,灵敏度和特异度均较好.
Abstract
Objective To investigate changes in pre-treatment lipid levels in patients with nasopharyn-geal carcinoma and to explore whether they can be used as predictors of nasopharyngeal carcinoma.Methods A total of 131 nasopharyngeal cancer patients with pathologically confirmed diagnosis and complete data from 2013-2022 in the People's Hospital of Guangxi Zhuang Autonomous Region were selected as the nasopharyngeal cancer group,and the control group consisted of 119 randomly selected health checkups,and the lipid parameters of nasopharyngeal cancer patients prior to treatment were detected,including total choles-terol(TC),triglycerides(TG),low-density lipoprotein cholesterol(LDL-C),high-density lipoprotein choles-terol(HDL-C),apolipoprotein A1(Apo A1),apolipoprotein B(ApoB)and lipoprotein a[Lp(a)]values were measured and statistically analyzed.Results All lipid parameters in the nasopharyngeal cancer group were statistically significant when compared to the control group(P＜0.000 1).Comparison between M staging groups,in which the differences in TC,LDL-C,and ApoB were statistically significant(P＜0.01).The results of the subjects'operating characteristic(ROC)curves showed that the area under the curve(AUC)of TC,HDL-C,ApoA1,Lp(a),TC/HDL-C,LDL-C/HDL-C and ApoA1/ApoB were＞0.7.Among them,the AUC of TC/HDL-C,LDL-C/HDL-C,and ApoA1/ApoB were the highest,at 0.82,0.77,0.75,with sensitivity of 0.70,0.70,0.65,specificity of 0.88,0.82,0.78,and cut-off values of＞3.97,＞2.50,＜1.24,respectively.Conclusion Abnormalities in TC,TG,LDL-C,HDL-C,ApoA1,ApoB,and Lp(a)levels are found in nasopha-ryngeal cancer patients before treatment.TC,LDL-C and ApoB are found to be significantly higher in the group with distant metastases compare with the group without distant metastases in M staging.TC/HDL-C,LDL-C/HDL-C and ApoA1/ApoB lipid ratio parameters can be used as predictors of nasopharyngeal carcino-ma development with good sensitivity and specificity.
维普
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