脂蛋白胆固醇和载脂蛋白水平对乳腺癌发生及预后的预测价值

目的 探讨脂蛋白胆固醇和载脂蛋白水平对乳腺癌发病风险及预后的预测价值。方法 收集病例组418例首诊乳腺癌女性患者初次入院时和对照组418例正常女性健康体检时的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）和载脂蛋白B（ApoB）等资料，并对所有乳腺癌病例进行76个月的随访。采用logistic和cox回归模型分析脂蛋白胆固醇和载脂蛋白与乳腺癌风险和预后的相关性。结果 HDL - C（OR = 3.70， 95%CI:2.29～5.96）的增加与乳腺癌发生的风险相关，而LDL - C（OR = 0.47， 95%CI:0.39～0.58）则可降低风险。ROC曲线显示HDL - C与LDL - C联合时，AUC为0.702，对罹患乳腺癌的预测能力优于单一指标。50岁以下乳腺癌患者ApoA1水平与乳腺癌的预后有关，高ApoA1（≥1.32 g/L）可降低50岁以下乳腺癌患者的死亡风险。结论 脂蛋白胆固醇和载脂蛋白的水平变化在乳腺癌发生发展中具有重要作用，与乳腺癌的发病风险和预后有关。

Value of lipoprotein cholesterol and apolipoprotein levels for predicting the occurrence and prognosis of breast cancer

Objective To investigate the predictive value of lipoprotein cholesterol and apolipoprotein levels on the risk and prognosis of breast cancer. Methods Data of 418 cases of women with first diagnosed breast cancer at the first admission and 418 normal women in the control group at the time of physical examination were collected, including high density lipoprotein cholesterol (HDL-C), low density lipoprotein cholesterol (LDL-C), apolipoprotein A1 (ApoA1) and apolipoprotein B (ApoB). Then, all the breast cancer cases were followed up for 76 months. Logistic and Cox regression models were used to analyze the correlation of lipoprotein cholesterol and apolipoprotein with risk and prognosis of breast cancer. Results The level of HDL-C (OR=3.70, 95%CI: 2.29-5.96) increased the risk of breast cancer, while LDL-C (OR=0.47, 95%CI: 0.39-0.58) reduced the risk. The ROC analysis showed that the AUC of the combination was 0.702 and the prediction ability was better at predicting the risk of breast cancer than a single indicator. It was also confirmed that ApoA1 level in breast cancer patients under 50 years old was associated with the prognosis, with high ApoA1 (≥1.32g/L) decreased the risk of death in breast cancer patients under 50 years old. Conclusion The changes of lipoprotein cholesterol and apolipoprotein levels play important roles in breast cancer and are associated with the risk and prognosis of breast cancer.