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目的探讨结直肠癌患者术前血清低密度脂蛋白胆固醇(LDL-C)与高密度脂蛋白胆固醇(HDL-C)水平比值(简称L/H值)与结直肠癌病理分期的关系。方法回顾性分析2009年7月至2014年6月期间在解放军总医院接受手术治疗的187例结直肠癌患者的临床资料。结果不同TNM分期、N分期以及M分期患者的L/H值不同或不全相同(P<0.05),其中,TNMⅣ期高于Ⅰ、Ⅱ及Ⅲ期,N2期高于N1和N0期,M1期高于M0期;但不同T分期患者的L/H值比较差异无统计学意义(P>0.05)。logistic回归分析结果显示,在控制其他混杂因素的情况下,L/H值对结直肠癌TNM分期(OR=4.34,95%CI:2.837~6.644,P<0.000 1)、T分期(OR=1.72,95%CI:1.175~2.512,P=0.005 3)、N分期(OR=2.15,95%CI:1.422~3.254,P=0.000 3)及M分期(OR=3.04,95%CI:1.733~5.332,P=0.000 1)的影响均有统计学意义,L/H值越高者其TNM分期、T分期、N分期及M分期越高。结论术前血清L/H值的升高是结直肠癌TNM分期、T分期、N分期及M分期进展的独立危险因素。
Objective To investigate the relationship between preoperative serum LDL-C and HDL-C (L / H value) and the pathological stage of colorectal cancer in patients with colorectal cancer. Methods The clinical data of 187 patients with colorectal cancer who underwent surgical treatment at People’s Liberation Army General Hospital from July 2009 to June 2014 were retrospectively analyzed. Results The L / H values of patients with different stages of TNM, N stage and M stage were different or not (P <0.05). Among them, stage TNMⅣwas higher than stage Ⅰ, Ⅱ and Ⅲ, stage N2 was higher than stage N1 and stage N0, stage M1 Higher than the M0 period; however, there was no significant difference in L / H between different T stage patients (P> 0.05). The results of logistic regression analysis showed that the L / H value of TNM staging of colorectal cancer (OR = 4.34, 95% CI: 2.837-6.644, P <0.0001) and T stage , 95% CI: 1.175-2.512, P = 0.005 3), N staging (OR = 2.15,95% CI: 1.422-3.254, P = 0.0003) and M staging (OR = 3.04, 95% CI: 1.733-5.332 , P = 0.000 1) had statistical significance. The higher the L / H value, the higher the TNM staging, T staging, N staging and M staging. Conclusions The preoperative serum L / H value is an independent risk factor for the progression of TNM stage, T stage, N stage and M stage in colorectal cancer.