血脂水平与中晚期鼻咽癌患者临床特征及生存预后的研究

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中文摘要：目的探讨中晚期鼻咽癌患者血清脂质水平与临床特征、生存预后的相关性.方法回顾性分析2008 年1 月至2018年1 月于江南大学附属医院 238 例初诊Ⅲ～Ⅳ期鼻咽癌患者,收集血清脂质相关指标高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)、载脂蛋白A1(ApoA1)、载脂蛋白B(ApoB)、载脂蛋白E(ApoE)、胆固醇和甘油三酯,采用单因素和多因素Cox回归模型分析、Kaplan-Meier生存曲线和受试者操作特征(ROC)曲线等进行统计分析和临床预后评价.结果年龄≥55 岁鼻咽癌患者的ApoA1 水平明显高于年龄<55 岁鼻咽癌患者(P=0.013).女性患者HDL-C水平明显高于男性患者(P=0.001).单因素Cox回归模型分析结果显示,胆固醇与鼻咽癌患者总生存(OS)期差异有统计学意义(HR=1.626,95%CI=1.065～2.482,P=0.024).进一步对P<0.1 的ApoB、ApoE和胆固醇纳入多因素 Cox回归模型分析,结果显示高胆固醇是鼻咽癌预后的危险因素(HR=1.613,95%CI=1.058～2.460,P=0.026).不同基线胆固醇水平下,HDL-C(P=0.024)、LDL-C(P=0.001)和ApoB(P=0.001)水平差异具有统计学意义.低胆固醇患者的生存期比高胆固醇患者长,低胆固醇患者具有更长的总生存期(P=0.025).ROC曲线分析显示,胆固醇预测鼻咽癌预后的曲线下面积差异具有统计学意义,提示胆固醇对中晚期鼻咽癌患者生存具有预测能力(AUC=0.581,95%CI=0.505～0.656,P=0.037).结论中晚期鼻咽癌患者不同临床特征间血脂存在明显差异;血清胆固醇是预测鼻咽癌患者预后的因素,且高胆固醇是鼻咽癌患者的危险因素,与患者不良预后相关.

外文标题：A study of blood lipid levels with clinical characteristics and survival prognosis of patients with middle-to late-stage nasopharyngeal carcinoma

外文摘要：Objective To explore the correlation between serum lipid levels and clinical characteristics and survival prognosis of patients with middle-to late-stage nasopharyngeal carcinoma(NPC).Method To retrospectively analyze 285 patients with NPC stageⅢ-Ⅳ in Affiliated Hospital of Jiangnan University,and collect serum lipid-related indexes of high-density lipoprotein cholesterol(HDL-C),low-density lipoprotein cholesterol(LDL-C),apolipoprotein A1(ApoA1),apolipoprotein B(ApoB),apolipoprotein E(ApoE),cholesterol(CHOL),and triglyceride(TG).Statistical analysis and clinical prognostic evaluation were performed using univariate and multivariate Cox regression,Kaplan-Meier survival curves and ROC curves.Result ApoA1 was significantly higher in NPC patients aged≥55 years than in NPC patients aged<55 years(P=0.013).Further grouped by gender,the results showed that HDL-C was significantly higher in the female group than in the male group(P=0.001).The results of Cox one-way analysis showed that the difference in OS between high CHOL level and NPC patients was statistically significant(HR=1.626,95%CI=1.065-2.482,P=0.024).Further ApoB,ApoE and CHOL with P<0.1 were included in a multifactorial Cox proportional risk analysis,which showed that CHOL was a risk factor for NPC prognosis(HR=1.613,95%CI=1.058-2.460,P=0.026).The differences in HDL-C(P=0.024),LDL-C(P=0.001)and ApoB(P=0.001)were statistically significant at different baseline CHOL levels.Survival time was longer in the low CHOL group than in the high CHOL group,and the low CHOL group had a higher overall survival time(P=0.025).ROC curve analysis showed that the area under the curve of CHOL predicting NPC prognosis(AUC=0.581,95%CI=0.505-0.656,P=0.037).Conclusion Significant differences in serum lipids were found between the different clinical features of patients with middle and advanced NPC;Serum CHOL emerged as an independent predictor of prognosis in patients with middle and advanced NPC,and High cholesterol level is a risk factor for nasopharyngeal carcinoma patients and is associated with poor prognosis.

外文关键词：

Nasopharyngeal carcinomaLipidsCholesterolPrognosisClinical featuresTumor stagingInfluencing factorsMetabolic abnormalities

作者：

寇立勇、吴平、孙静、陈炜、葛晓松

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作者单位：

江南大学附属医院全科医学科,江苏无锡 214122

江南大学附属医院营养科,江苏无锡 214122

江南大学附属医院肿瘤内科,江苏无锡 214122

关键词：

鼻咽癌血脂胆固醇预后临床特征肿瘤分期影响因素代谢异常

基金：

江苏省卫生健康委科研项目无锡市软科学研究项目无锡市江南大学附属医院临床研究与转化医学研究项目无锡市卫生健康委科研项目

项目编号：

Z2023020KX-24-B34LCYJ202347HB2023063

出版年：

2024

DOI：

10.16689/j.cnki.cn11-9349/r.2024.04.010

肿瘤代谢与营养电子杂志

CSTPCD

ISSN：

年,卷(期)：2024.11(4)

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