血脂与激素受体阴性乳腺癌远处转移及疗效的关系

目的 测定激素受体阴性乳腺癌患者的血脂水平,探讨血脂异常与远处转移的关系,及化疗后血脂水平变化与近期疗效的关系。方法 收集154例激素受体阴性乳腺癌患者的临床病理资料和空腹血脂水平,远处转移组患者化疗2周期后第14天再次测定血脂水平。χ²检验分析临床病理特征及基线血脂水平与远处转移的关系,Logistic回归分析远处转移的独立危险因素,配对t检验分析远处转移组患者化疗后血脂各指标变化与疗效关系。结果 乳腺癌远处转移与肿块大小、区域淋巴结转移、组织学分级、高TC、高TG及高LDL-C血症有关(P＜0.05)。Logistic回归分析显示,肿块大小(OR=1.563)、区域淋巴结转移(OR=1.983)、高TC血症(OR=1.502)、高TG血症(OR=1.877)是远处转移的独立危险因素。远处转移组中化疗有效组(PR+SD),TC、TG及LDL-C水平有降低趋势,HDL-C水平有升高趋势,疗效PR组TG水平降低有统计学意义。结论 高脂血症与激素受体阴性乳腺癌远处转移相关,有效的抗肿瘤治疗可降低血脂水平。动态监测血脂水平可作为激素受体阴性乳腺癌远处转移及疗效评价的辅助参考指标。

Association of blood lipid with distant metastases and clinical response in patients with hormone receptor negative breast cancer

Objective To investigate the relationship between dyslipidemia and distant metastases in patients with hormone receptor(HR)negative breast cancer,and to explore the impact of blood lipid change during chemotherapy on clinical response.Methods We collected the complete clinicopathological data and fasting blood lipid in 154 patients with HR negative breast cancer.The secondary blood lipid level were measured on day14 after two cycles of chemotherapy in patients with distant metastases.Single factor chi-square test was choosen to analyze the relationship between clinicopathological characteristics,including baseline lipid level,and distant metastases,then independent risk factor for distant metastases were evaluated by logistic regression model.Data about altered blood lipid and clinical response analysis were performed using paired t-test pre-or post-chemotherapy.Results Our Results from single chi-square test showed that distant metastasis from breast cancer was significantly associated with tumor size,local lymph node metastases,grade,higher total cholesterol(TC),higher triglycerides(TG)and higher low-density lipoprotein(LDL)(P＜0.05).For distant metastases,independent risk factors were tumor size(OR=1.563),local lymph node metastases(OR=1.983),higher TC(OR=1.502),higher TG(OR=1.877).Decreased trend of TC,TG and LDL and increased trend of HDL were showed in disease control(PR+SD)group,and TG had significantly tend in Objective response(PR)group.Conclusion Hyperlipidmia is significantly associated with distant metastases in patients with HR negative breast cancer,and blood lipid levels decrease with effective anti-tumor chemotherapy.Dynamic monitoring of blood lipid levels could be a candidate surrogate biomarker for outcome prediction and distant metastases in patients with HR negative breast cancer.