血脂代谢与胃癌发病风险相关性的病例对照研究

  目的  探讨血脂代谢水平与胃癌发生发展的相关性。  方法  选取2016年3月至2017年6月天津医科大学肿瘤医院诊治的1 072例胃癌患者与同期1 084例健康人群进行病例-对照研究，检测血清总胆固醇（total cholesterol，TC）、甘油三酯（triglyceride，TG）、高密度脂蛋白（high-density lipoprotein，HDL）和低密度脂蛋白（low-density lipoprotein，LDL）水平，采用单因素及多因素分析探讨血脂代谢水平与胃癌发病风险及临床病理特征的关系。  结果  胃癌患者血清中的TG、LDL水平均高于对照组，HDL低于对照组；男性胃癌患者LDL高于对照组，HDL低于对照组；女性胃癌患者血清中的TG、LDL高于对照组，HDL低于对照组（均P < 0.05）。胃癌患者HDL、LDL水平与胃癌的发病风险显著相关；男性中HDL及LDL，女性中TG、HDL及LDL分别与胃癌的发病风险显著相关。胃癌患者中，TG及TC升高常见于远端胃癌及分期较早的患者；HDL降低多见于低、未分化胃癌。男性中，TG升高多见于分期较早的患者；HDL降低多见于低、未分化胃癌。女性中，TC增高更常见于分期较早的患者（均P < 0.05）。  结论  胃癌患者血脂水平高于健康对照组，与胃癌的发病风险显著相关。在胃癌患者中随着疾病的进展，患者肿瘤消耗增多、营养状态持续下降，血脂水平逐渐降低。 

A case-control study of the correlation between lipid metabolism and gastric cancer risk

Objective:To investigate the correlation between lipid metabolism and gastric cancer.Methods:In total,1,072 patients with gastric cancer treated at Tianjin Medical University Cancer Institute and Hospital from March 2016 to June 2017 were enrolled,and 1,084 healthy subjects were included as controls.Using univariate and multivariate analyses,the correlation between lipid metabolism and gastric cancer risk was examined;furthermore,clinicopathological characteristics,including serum total cholesterol(TC),triglyceride(TG),high-density lipoprotein(HDL),and low-density lipoprotein(LDL)levels,were assessed.Results:Serum TG and LDL levels were higher and HDL levels were lower in gastric cancer patients than in healthy controls.Furthermore,serum LDL levels were higher and HDL levels were lower in male gastric cancer patients than in healthy controls.Serum TG and LDL levels were higher and HDL levels were lower in female gastric cancer patients than in healthy controls(P<0.05).In all gastric cancer patients,HDL and LDL levels were significantly correlated with gastric cancer risk.Moreover,in male patients,HDL and LDL levels were significantly correlated with gastric cancer risk.In female patients,TG,HDL,and LDL levels were significantly associated with gastric cancer risk.Among gastric cancer patients,elevated TG and TC levels were more common in patients with distal gastric cancer and an early disease stage.Decreased HDL levels were more common in patients with little differentiated/undifferentiated gastric cancer.Among male patients,increased TG levels were more common in patients with an early disease stage.Decreased HDL levels were more common in patients with little differentiated/undifferentiated gastric cancer.Among female patients,elevated TC levels were more common in early-stage cancer patients.Conclusions:Serum lipid levels were higher in gastric cancer patients than in healthy controls,and they correlated with gastric cancer risk.However,as gastric cancer progresses owing to increased tumor nutrient uptake and patient's reduced nutritional status,serum lipid levels gradually decrease.