本文選題：血脂　切入點：結(jié)直腸癌　出處：《廣西醫(yī)科大學(xué)》2017年碩士論文

【摘要】：目的:探討術(shù)前血脂水平與結(jié)直腸癌病理分期及其預(yù)后的關(guān)系。方法:回顧性分析2012年9月至2014年9月于廣西醫(yī)科大學(xué)第一附屬醫(yī)院病理診斷為結(jié)直腸癌并接受手術(shù)治療的460例患者。比較術(shù)前血脂水平在不同T分期、N分期、M分期、TNM分期、部位、有無神經(jīng)浸潤、有無脈管侵犯之間的差異以及與預(yù)后的關(guān)系,所得數(shù)據(jù)采用SPSS 17.0軟件進(jìn)行統(tǒng)計學(xué)分析。結(jié)果:1.結(jié)直腸癌患者不同T分期之間比較,術(shù)前TC、HDL-C、apoAⅠ、apoB水平差異有統(tǒng)計學(xué)意義(P0.05);logistic回歸分析顯示TC(OR=0.775,95%CI:0.635~0.945)、HDL-C(OR=0.470,95%CI:0.306~0.723)、apoAⅠ(OR=0.384,95%CI:0.162~0.910)、apoB(OR=0.310,95%CI:0.113~0.854)與T分期呈負(fù)相關(guān)。2.結(jié)直腸癌患者不同N分期之間比較,術(shù)前各血脂水平無顯著差異(P0.05);logistic回歸分析顯示LP(a)(OR=0.606,95%CI:0.386~0.950)與N分期呈負(fù)相關(guān)。3.結(jié)直腸癌患者不同M分期、TNM分期之間比較,術(shù)前HDL-C、apoAⅠ、LP(a)差異有統(tǒng)計學(xué)意義(P0.05);logistic回歸分析顯示HDL-C(OR=0.228,95%CI:0.121~0.684)、apoAⅠ(OR=0.037,95%CI:0.008~0.180)與M分期呈負(fù)相關(guān),HDL-C(OR=0.228,95%CI:0.087~0.624)、apoAⅠ(OR=0.036,95%CI:0.006~0.225)與TNM分期呈負(fù)相關(guān)。4.結(jié)直腸癌患者有無神經(jīng)浸潤及有無脈管侵犯之間比較,術(shù)前血脂各水平差異均無統(tǒng)計學(xué)意義(P0.05)。5.直腸癌患者的術(shù)前TC、HDL-C、LDL-C、apoAⅠ水平明顯高于結(jié)腸癌患者(P0.05),左半結(jié)腸癌患者術(shù)前TC、TG、apoB水平明顯高于右半結(jié)腸癌患者(P0.05)。6.單因素分析顯示T分期(x~2=8.219,P=0.042)、N分期(x~2=29.038,P=0.000)、M分期(x~2=100.738,P=0.000)、脈管侵犯(x~2=4.717,P=0.030)、術(shù)前TG水平(x~2=5.106,P=0.024)與結(jié)直腸患者預(yù)后有關(guān)(P0.05),Cox比例風(fēng)險模型分析顯示N分期、M分期是結(jié)直腸癌患者生存的獨立危險因素(P0.05),而術(shù)前TG水平不是結(jié)直腸癌患者生存的獨立影響因素(P0.05)。結(jié)論:術(shù)前HDL-C、apoAⅠ水平與結(jié)直腸癌患者T分期、M分期、TNM分期有一定的關(guān)聯(lián),但與結(jié)直腸癌患者預(yù)后無相關(guān)性。
[Abstract]:Objective: to investigate the relationship between preoperative blood lipid level and pathological stage and prognosis of colorectal cancer.Methods: from September 2012 to September 2014, 460 patients with colorectal cancer diagnosed pathologically and treated surgically in the first affiliated Hospital of Guangxi Medical University were retrospectively analyzed.The blood lipid levels in different T / N stages and M / M staging were compared before and after operation. The difference of blood lipid levels between different T staging and N / M staging, including nerve infiltration, vascular invasion and prognosis was compared. The data were analyzed statistically by SPSS 17.0 software.The result is 1: 1.There was no significant difference in serum lipid levels between different N stages of colorectal cancer patients. Logistic regression analysis showed that there was a negative correlation between the serum lipid levels and N staging. The logistic regression analysis showed that there was a negative correlation between the serum lipid levels and the N staging in patients with colorectal cancer. The logistic regression analysis showed that there was a negative correlation between the serum lipid levels and the N staging in patients with colorectal cancer.There was no significant difference in blood lipid levels before operation between patients with colorectal cancer with or without nerve invasion and with or without vascular invasion (P0.05. 5).The preoperative level of TCnHDL-CnLDL-CapoA 鈪，

本文編號：1723662