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全球乳腺癌发病率呈现逐年上升的趋势,我国尤为突出,乳腺癌成为女性发病率首位、死亡原因第二位的肿瘤。伴随着乳腺癌诊断及综合治疗手段的逐渐完善,乳腺癌的治疗和预后都有了长足的进步。但乳腺癌的发病原因一直是研究的重点,有关乳腺癌的确切发病机制仍然不很明确,现有证据表明雌激素水平与乳腺癌的发生密切相关,肥胖、血脂异常及代谢综合征与乳腺癌关系也一直被广泛关注。脂质是人体正常代谢的必需物质,过低或过高都会影响健康,血脂异常多无特异性症状,容易被人们忽视。脂质代谢异常与恶性肿瘤的相关性是近年来的研究热点,研究[1]表明血脂异常与乳腺癌的发生、发展及转移等密切相关,但各研究报道的结果不尽相同。本研究对浸润性乳腺癌病人和乳腺良性疾病病人进行分析比较,同时将激素受体(hormone receptor, HR)阳性和人类表皮生长因子受体2(human epidermal growth factor receptor-2, HER-2)阳性两种分子分型乳腺癌病人的血脂指标做对比分析,观察乳腺良恶性疾病血脂分布的异同,同时探讨性分析血脂代谢差异与不同亚型乳腺癌之间的关系。现作报道。
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观察组血清TC、TG、LDL-C水平显著高于对照组(P < 0.05~P < 0.01);而HDL-C水平则显著低于对照组(P < 0.01)(见表 1)。
分组 n TC TG HDL-C LDL-C 观察组 100 4.87±0.93 1.48±0.53 1.22±0.23 2.68±0.64 对照组 100 4.53±0.78 1.20±0.44 1.33±0.29 2.49±0.65 t — 2.80 4.06 2.97 2.08 P — < 0.01 < 0.01 < 0.01 < 0.05 表 1 2组血脂水平比较(x±s; mmol/L)
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观察组内未绝经病人TC、TG水平相比良性乳腺疾病病人群体更高(P < 0.05和P < 0.01);而HDL-C水平比对照组稍低(P < 0.05),LDL-C在2组的未绝经病人中水平差异无统计学意义(P>0.05)(见表 2)。
分组 n TC TG HDL-C LDL-C 观察组 50 4.60±0.88 1.41±0.52 1.27±0.20 2.51±0.67 对照组 50 4.24±0.50 1.09±0.35 1.36±0.20 2.33±0.53 t — 2.52 3.55 2.29 1.51 P — < 0.05 < 0.01 < 0.05 >0.05 表 2 2组未绝经群体血脂水平比较(x±s;mmol/L)
观察组内已绝经乳腺癌病人的血清TC、TG水平较对照组内的已绝经乳腺良性疾病病人相比普遍较高(P < 0.01和P < 0.05),而HDL-C水平正好相反,观察组已绝经病人要较对照组已绝经病人更低(P < 0.05),LDL-C在2组已绝经群体中差异无统计学意义(P>0.05)(见表 3)。
分组 n TC TG HDL-C LDL-C 观察组 50 5.24±0.82 1.55±0.54 1.18±0.26 2.85±0.58 对照组 50 4.79±0.88 1.30±0.51 1.31±0.36 2.65±0.71 t — 2.68 2.43 2.08 1.55 P — < 0.01 < 0.05 < 0.05 >0.05 表 3 2组已绝经群体血脂水平比较(x±s; mmol/L)
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在观察组内部,根据免疫组化所提示的分子分型不同进行比较,HER-2阳性病人的TC、TG、LDL-C明显高于HR阳性病人(P < 0.05);而HDL-C明显低于HR阳性病人(P < 0.05)(见表 4)。
分组 n TC TG HDL-C LDL-C HER-2阳性 50 5.12±0.94 1.59±0.53 1.17±0.22 2.83±0.58 HR阳性 50 4.72±0.83 1.37±0.51 1.28±0.23 2.53±0.67 t — 2.21 2.12 2.48 2.33 P — < 0.05 < 0.05 < 0.05 < 0.05 表 4 观察组内HER-2阳性与HR阳性病人血脂水平比较(x±s; mmol/L)
浸润性乳腺癌及不同分子分型病人的血脂水平分析
Analysis of the serum lipid levels in patients with invasive breast cancer and different molecular classifications
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摘要:
目的比较良性乳腺疾病病人和浸润性乳腺癌病人之间及激素受体(HR)阳性和人类表皮生长因子受体2(HER-2)阳性乳腺癌病人之间的血脂水平差异,分析血脂水平与乳腺癌发生发展的相关性。 方法选取初诊为浸润性乳腺癌的100例病人为观察组,其中HR阳性50例,HER-2阳性50例;另外选取同期住院治疗的与其一般资料相匹配的100例良性乳腺疾病病人作为对照组,检验所有对象血浆总胆固醇(TC)、三酰甘油(TG)、高密度脂蛋白胆固醇(HDL-C)及低密度脂蛋白胆固醇(LDL-C)水平,分析血脂代谢水平与浸润性乳腺癌之间的关系,同时进一步探讨HR阳性乳腺癌病人和HER-2阳性乳腺癌病人之间的血脂差异。 结果观察组病人血清TC、TG、LDL-C水平明显高于对照组(P < 0.05~P < 0.01),HDL-C水平明显低于对照组(P < 0.01)。按是否绝经分层分析发现,除LDL-C水平外,其他结果差异均有统计学意义。HER-2阳性乳腺癌病人TC、TG、LDL-C水平明显高于HR阳性乳腺癌病人(P < 0.05),HDL-C水平明显低于HR阳性乳腺癌(P < 0.05)。 结论女性血脂水平和乳腺癌患病风险之间存在一定的关联,高TC、TG、LDL-C和低HDL-C水平可能与乳腺癌发生、发展及分子分型存在着一定关系,提示脂质分析是乳腺癌分子分型研究的新方向。 Abstract:ObjectiveTo compare the serum lipid level between patients with benign breast disease and invasive breast cancer, and between positive hormone receptor (HR) and human epidermal growth factor receptor-2 (HER-2) -positive patients, and analyze the correlation between the level of lipid, and occurrence and development of breast cancer. MethodsOne hundred patients with invasive breast cancer (including 50 cases with HR-positive and 50 cases with HER-2-positive) and 100 patients with benign breast disease were divided into the observation group and control group, respectively.The levels of total cholesterol (TC), triglyceride (TG), high-density lipoprotein cholesterol (HDL-C), and low-density lipoprotein cholesterol (LDL-C) in two groups were detected, the relationship between the level of serum lipid and invasive breast cancer was analyzed, and the difference of the blood lipid level between HR-positive and HER-2-positive breast cancer patients was analyzed. ResultsThe serum levels of TC, TG and LDL-C in observation group were significantly higher than those in control group (P < 0.05 to P < 0.01), and the HDL-C level in observation group was significantly lower than that in control group (P < 0.01).According to the stratified analysis of pre-menopause and post-menopause, except for the LDL-C, the differences of other indicators were statistically significant (P < 0.05).The levels of TC, TG and LDL-C in HER-2-positive breast cancer patients were significantly higher than those in HR-positive patients (P < 0.05), and the level of HDL-C in HER-2-positive breast cancer patients was significantly lower than that in HR-positive patients (P < 0.05). ConclusionsThere is a certain correlation between serum lipid level and breast cancer risk for women.The high levels of TC, TG, LDL-C and low level of HDL-C may be related to the occurrence, development and molecular classifications of breast cancer, which suggests that the lipid analysis is a new direction of molecular classifications. -
Key words:
- breast neoplasms /
- lipid /
- molecular classification
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表 1 2组血脂水平比较(x±s; mmol/L)
分组 n TC TG HDL-C LDL-C 观察组 100 4.87±0.93 1.48±0.53 1.22±0.23 2.68±0.64 对照组 100 4.53±0.78 1.20±0.44 1.33±0.29 2.49±0.65 t — 2.80 4.06 2.97 2.08 P — < 0.01 < 0.01 < 0.01 < 0.05 表 2 2组未绝经群体血脂水平比较(x±s;mmol/L)
分组 n TC TG HDL-C LDL-C 观察组 50 4.60±0.88 1.41±0.52 1.27±0.20 2.51±0.67 对照组 50 4.24±0.50 1.09±0.35 1.36±0.20 2.33±0.53 t — 2.52 3.55 2.29 1.51 P — < 0.05 < 0.01 < 0.05 >0.05 表 3 2组已绝经群体血脂水平比较(x±s; mmol/L)
分组 n TC TG HDL-C LDL-C 观察组 50 5.24±0.82 1.55±0.54 1.18±0.26 2.85±0.58 对照组 50 4.79±0.88 1.30±0.51 1.31±0.36 2.65±0.71 t — 2.68 2.43 2.08 1.55 P — < 0.01 < 0.05 < 0.05 >0.05 表 4 观察组内HER-2阳性与HR阳性病人血脂水平比较(x±s; mmol/L)
分组 n TC TG HDL-C LDL-C HER-2阳性 50 5.12±0.94 1.59±0.53 1.17±0.22 2.83±0.58 HR阳性 50 4.72±0.83 1.37±0.51 1.28±0.23 2.53±0.67 t — 2.21 2.12 2.48 2.33 P — < 0.05 < 0.05 < 0.05 < 0.05 -
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