本文選題：血脂　切入點：可切除非小細(xì)胞肺癌　出處：《山東大學(xué)》2016年碩士論文

【摘要】：背景：目前非小細(xì)胞肺癌(Non-small cell lung cancer,NSCLC)占主支氣管癌的85%,是世界上死亡率最高的惡性腫瘤之一。在腫瘤的發(fā)生和發(fā)展過程中,機體的代謝活動會產(chǎn)生相應(yīng)的變化。在機體內(nèi),脂質(zhì)的主要功能是儲存能量,作為主要的成分構(gòu)成細(xì)胞膜并且參與形成重要的信號分子。腫瘤發(fā)生后,機體內(nèi)的血脂含量也會產(chǎn)生相應(yīng)的改變。因此,關(guān)于肺癌患者血脂代謝的研究對疾病的診斷和預(yù)后具有十分重要的臨床意義。然而,脂質(zhì)代謝在腫瘤發(fā)展中的作用還沒有得到充分地研究,總膽固醇(TC,total cholesterol)、高密度脂蛋白膽固醇(HDL,high density lipoprotein cholesterol)、甘油三酯(TG,triglyceride)和低密度脂蛋白膽固醇(LDL, low density lipoprotein cholesterol)在肺癌預(yù)后中的作用也并不能夠完全明確。本研究旨在探討術(shù)前血脂水平與可切除非小細(xì)胞肺癌預(yù)后的關(guān)系。目的：本研究主要分析可切除非小細(xì)胞肺癌患者術(shù)前血脂水平與患者預(yù)后和病理特點的相關(guān)性,探討其對可切除非小細(xì)胞肺癌的預(yù)后有無影響,以期能為肺癌的治療提供新的方向。方法：回顧性收集2009年1月至2010年12月于山東大學(xué)齊魯醫(yī)院胸外科接受手術(shù)治療的非小細(xì)胞肺癌患者的臨床資料,排除接受術(shù)前新輔助放/化療者、腫瘤無法切除者、合并其他腫瘤者、合并糖尿病及高脂血癥等血脂代謝異常疾病者,服用任何影響脂質(zhì)代謝的藥物者、無血脂檢查者以及隨訪失訪者,共納入165例患者。隨訪并分析患者的年齡、性別、吸煙情況、術(shù)前血清TC水平、術(shù)前血清TG水平、術(shù)前血清HDL水平、術(shù)前血清LDL水平、病理學(xué)類型、分化程度、病灶部位、腫瘤直徑、pTNM分期等對可切除非小細(xì)胞肺癌患者的總生存時間(OS, overall survival)以及無進(jìn)展生存時間(PFS, progression-free survival)的影響。pTNM分期依據(jù)是2009年IASLC國際肺癌分期(第七版),TC、HDL、LDL分組標(biāo)準(zhǔn)依據(jù)NCEP ATPIII血脂異常指南。采用SPSS 17.0軟件進(jìn)行統(tǒng)計分析,運用卡方檢驗、Kaplan-Meier生存曲線、COX比例風(fēng)險模型等統(tǒng)計學(xué)方法處理相關(guān)數(shù)據(jù),P0.05時有統(tǒng)計學(xué)意義。結(jié)果：本研究共納入患者165例,其中,男性患者115例(69.3%),女性患者50例(30.3%),年齡在35-82歲(60.61±9.68)。術(shù)前血清TC水平是可切除非小細(xì)胞肺癌預(yù)后的獨立影響因素,術(shù)前血清TC水平≥200mg/dl組的患者總生存時間(P=0.005)以及無進(jìn)展生存時間(P=0.006)均優(yōu)于術(shù)前血清TC水平200mg/dl組,術(shù)前血清TG、HDL、LDL水平與可切除非小細(xì)胞肺癌的預(yù)后均不具有顯著相關(guān)性(P0.05)。結(jié)論：術(shù)前血清TC水平是影響可切除非小細(xì)胞肺癌患者預(yù)后的獨立影響因素,術(shù)前血清TC水平降低提示患者預(yù)后不良。血脂相關(guān)指標(biāo)的檢測可用于預(yù)測術(shù)后非小細(xì)胞肺癌患者的生存時間,是評價腫瘤患者預(yù)后的重要工具。
[Abstract]:Background: Non-small cell lung cancer (NSCLC) accounts for 85% of primary bronchial cancer and is one of the most fatal malignant tumors in the world. The main function of lipids is to store energy, as a major component of the cell membrane and participate in the formation of important signaling molecules. The study of lipid metabolism in patients with lung cancer is of great clinical significance in the diagnosis and prognosis of lung cancer. However, the role of lipid metabolism in tumor development has not been fully studied. The role of total cholesterol, high density lipoprotein cholesterol, triglyceride and low density lipoprotein cholesterol in the prognosis of lung cancer is not entirely clear. Objective: to study the relationship between preoperative blood lipid level and prognosis and pathological features of resectable non-small cell lung cancer (NSCLC). To investigate whether it has influence on the prognosis of resectable non-small cell lung cancer. Methods: from January 2009 to December 2010, the clinical data of patients with non-small cell lung cancer (NSCLC) undergoing surgical treatment in thoracic surgery of Qilu Hospital, Shandong University, were retrospectively collected. Those who received preoperative neoadjuvant radiotherapy / chemotherapy, patients with unresectable tumors, patients with other tumors, patients with dyslipidemia such as diabetes mellitus and hyperlipidemia, and those who took any drugs affecting lipid metabolism, The age, sex, smoking status, serum TC level, serum TG level, preoperative serum HDL level, preoperative serum LDL level of the patients were analyzed. Pathological type, degree of differentiation, location of lesion, Effects of tumor diameter and pTNM staging on Total Survival time (overall survival) and Progressive Survival of patients with resectable Non-small Cell Lung Cancer. PTNM staging is based on the IASLC International Lung Cancer staging 2009 (7th edition). NCEP ATPIII dyslipidemia guidelines. SPSS 17.0 software was used for statistical analysis. There was statistical significance when using Kaplan-Meier survival curve and Cox proportional risk model to process the relevant data (P0.05). Results: 165 patients were included in this study. 115 cases of male and 50 cases of female, aged 35-82 years, had 60.61 鹵9.68. The preoperative serum TC level was an independent factor influencing the prognosis of resectable non-small cell lung cancer (NSCLC). The total survival time of patients with preoperative serum TC level 鈮，

本文編號：1682074