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投稿时间：2020-03-31 网络发布日期：2021-01-20
投稿时间：2020-03-31 网络发布日期：2021-01-20
中文摘要: 目的 探讨血脂异常与乳腺癌患者术后疾病进展的关系,为乳腺癌的预防和治疗提供新的思路。
方法 采用回顾性研究方法,选取2014年1月至2016年10月徐州医科大学附属医院甲乳外科手术治疗的632例乳腺癌患者为研究对象,收集术前血脂资料和病理资料并随访病情至2019年11月。根据术后随访情况将患者分为疾病进展组(n=68)与疾病无进展组(n=564),比较两组患者血脂水平与临床病理资料的差异,分析不同血脂亚组与乳腺癌患者各临床病理特征的关联;采用Log-rank检验和Cox生存分析,分析影响乳腺癌术后疾病进展的独立危险因素。
结果 共有145例乳腺癌患者诊断为高脂血症,相较于非高脂血症487例患者,高脂血症乳腺癌患者肿瘤分期较高(P=0.014),非Luminal型分子分型(P=0.043)及细胞核增殖抗原Ki-67高表达的发生率较高(P=0.019)。Cox生存分析结果显示,高脂血症(HR=1.871,95%CI:1.153~3.309,P=0.011)、肿瘤Ⅲ期(HR=13.657,95%CI:5.797~32.175,P<0.01)、非Luminal型分子分型(HR=2.191,95%CI:1.335~3.596,P=0.002)、Ki-67高表达(HR=2.322,95%CI:1.138~4.735,P=0.021)是乳腺癌患者术后疾病进展的独立危险因素。与非高脂血症乳腺癌患者相比,高脂血症乳腺癌患者术后出现疾病进展的风险高（HR=1.871,95%CI:1.153~3.039）,预后差。
结论 血脂异常与乳腺癌患者术后疾病进展相关,乳腺癌患者术前高脂血症提示其术后出现疾病进展的可能性大,需定期随访,密切观察。
中文关键词: 乳腺癌 血脂异常 疾病进展 肿瘤分期 Luminal型分子分型 细胞核增殖抗原Ki-67
Abstract:Objective To investigate the relationship between dyslipidemia and disease progression in patients with breast cancer after operation,so as to provide new ideas for the prevention and treatment of breast cancer.
Methods The clinical data of 632 patients with breast cancer who received breast surgery in the Affiliated Hospital of Xuzhou Medical University from January 2014 to October 2016 were retrospectively analyzed.The preoperative blood lipid level and pathological data were collected,and all the patients were followed up until November 2019.According to the postoperative follow-up,the patients were divided into progression group (n=68) and non-progression group (n=564).The differences of blood lipid levels and pathological data between the two groups were compared,and the relationship between different blood lipid subgroups and pathological characteristics of breast cancer patients was analyzed.Log-rank test and Cox survival analysis were used to analyze the independent risk factors of disease progression after breast cancer surgery.
Results A total of 145 patients with breast cancer were diagnosed as hyperlipidemia.Compared with 487 patients without hyperlipidemia,patients with hyperlipidemia had higher tumor stage (P=0.014),higher incidence of non-Luminal molecular typing(P=0.043) and high expression of Ki-67 (P=0.019).Survival analysis showed that hyperlipidemia (HR=1.871,95% CI:1.153-3.309,P=0.011),tumor stage Ⅲ (HR=13.657,95% CI:5.797-32.175,P<0.01),non-Luminal molecular typing (HR=2.191,95% CI:1.335-3.596,P=0.002),and high expression of Ki-67 (HR=2.322,95% CI:1.138-4.735,P=0.021) were independent risk factors for postoperative disease progression of breast cancer patients.Compared with non-hyperlipidemic breast cancer patients,hyperlipidemic breast cancer patients had a higher risk of postoperative disease progression (HR=1.871,95% CI:1.153-3.039),and poor prognosis.
Conclusions Dyslipidemia is associated with disease progression after breast cancer surgery.Preoperative hyperlipidemia in breast cancer patients suggests that they have a high possibility of disease progression after surgery,which needs regular follow-up and close observation.
文章编号： 中图分类号：R737.9 文献标志码：A
基金项目:国家自然科学基金(81602321)
| 作者 | 单位 |
| 卜寒莉 1 | 1.徐州医科大学,江苏 徐州 221002； |
| 刘钊 2 | 2.徐州医科大学附属医院甲乳外科,江苏 徐州 221000； |
| 陆召军 1 | 1.徐州医科大学,江苏 徐州 221002； |
| 高修银 1 | 1.徐州医科大学,江苏 徐州 221002； |
| 孙燕茹 1 | 1.徐州医科大学,江苏 徐州 221002； |
| 谢翼 1 | 1.徐州医科大学,江苏 徐州 221002； |
| Author Name | Affiliation |
| BU Han-li*,LIU Zhao,LU Zhao-jun,GAO Xiu-yin,SUN Yan-ru,XIE Yi | *Xuzhou Medical University,Xuzhou,Jiangsu 221002,China |
引用文本：
卜寒莉 ,刘钊 ,陆召军 ,等.血脂异常与乳腺癌患者术后疾病进展的关系[J].中国临床研究,2021,34(1):43-47.
卜寒莉 ,刘钊 ,陆召军 ,等.血脂异常与乳腺癌患者术后疾病进展的关系[J].中国临床研究,2021,34(1):43-47.