血清三酰甘油、胆固醇与绝经前女性乳腺癌的相关性
| 作者: |
1郭浩伟,
1陆澄,
1吕明明,
1王凤良
1 南京医科大学附属妇产医院(南京市妇幼保健院)乳腺外科，南京 210004 |
| 通讯: |
王凤良
Email: xianqu1981@126.com |
| DOI: | 10.3978/j.issn.2095-6959.2021.11.020 |
| 基金: | 江苏省自然科学基金(Bk20161120)；江苏省青年医学人才项目(QNRC2016102)；江苏省妇幼保健研究项目(201628)。 |
摘要
目的：回顾性研究血清三酰甘油(triglyceride，TG)、胆固醇(total cholesterol，TC)水平与绝经前女性乳腺癌的相关性。方法：比较2016年1月至2018年12月105例绝经前健康体检女性与105例绝经前乳腺癌患者的血清TG、TC差异。根据TC水平将研究对象由低到高排序，根据四分位数分为4组，采用logistic回归分析比较4组不同TC水平下乳腺癌发病率的风险比(odds ratio，OR)，分析血清TC水平与绝经前乳腺癌发病之间的相关性。绘制受试者工作特征(receiver operating characteristic，ROC)曲线，计算曲线下面积(area under curve，AUC)，评价血清TC水平预测绝经前乳腺癌发生风险的敏感性和特异性。结果：绝经前2组的TG水平相比，差异无统计学意义(P>0.05)，而绝经前乳腺癌组的TC水平低于健康对照组，差异有统计学意义(P<0.05)。血清TG、TC水平在绝经前与乳腺癌不同肿块大小、淋巴结状态、TNM分期、分子分型方面的差异均无统计学意义(均P>0.05)。随着TC水平的下降，绝经前女性乳腺癌的发病率逐渐升高(P=0.023)，其中低胆固醇组(2.89~<4.09 mmol/mL)相对于高胆固醇组(5.20~7.04 mmol/mL)乳腺癌发病率的OR值为2.087(95%CI：0.957~4.549，P=0.064)。ROC分析发现血清TC水平预测绝经前乳腺癌的敏感性为65.7%，特异性为61.4%，AUC为0.59(P=0.033)。结论：血清TC水平与绝经前女性乳腺癌的发生呈负相关，对乳腺癌的诊断价值处于中等水平。血清TC水平变化可以作为预测绝经前乳腺癌发病风险的标志物之一。
关键词：
胆固醇；三酰甘油；乳腺癌；绝经前
Correlation between serum triglyceride, cholesterol and breast cancer in premenopausal women
CorrespondingAuthor: WANG Fengliang Email: xianqu1981@126.com
DOI: 10.3978/j.issn.2095-6959.2021.11.020
Foundation: This work was supported by the Natural Science Foundation of Jiangsu Province (Bk20161120), the Young Medical Talents Project of Jiangsu Province (QNRC2016102), and the Maternal and Child Health Research Project of Jiangsu Province (201628), China.
Abstract
Objective: To study the correlation between serum triglyceride (TG), total cholesterol (TC) levels and the risk of breast cancer in premenopausal women. Methods: A total of 105 premenopausal breast cancer patients and 105 premenopausal healthy women were recruited (2016/1 to 2018/12). The differences of serum TG and TC were compared between the breast cancer patients and the healthy women. All research subjects were ranked from low to high according to TC level, and divided into 4 groups according to quartile. Logistic regression was used to compare the odds ratio (OR) of the incidence of breast cancer at different TC levels in the 4 groups, and to analyze the correlation between serum TC levels and the incidence of premenopausal breast cancer. ROC curve was drawn and the area under the curve was calculated to evaluate the sensitivity and specificity of TC levels in predicting the risk of pre-menopausal breast cancer. Results: There was no significant difference in TG between premenopausal breast cancer group and healthy control group, but the TC of breast cancer group was lower than that of healthy control group, the difference was statistically significant (P<0.05). There was no significant difference in the serum TG and TC among different tumor size, lymph node status, TNM stage, and molecular classification of breast cancer (P>0.05). The incidence of breast cancer increased with the decreasing of the serum TC levels in pre-menopausal women (P=0.023). The OR of the incidence of breast cancer in the lower cholesterol group (2.89–<4.09 mmol/mL) compared to the higher cholesterol group (5.20–7.04 mmol/mL) was 2.087 (95%CI: 0.957–4.549, P=0.064). ROC analysis showed that the sensitivity and specificity of serum TC level in predicting premenopausal breast cancer were 65.7% and 61.4%, and the AUC value of the area under ROC curve was 0.59 (P=0.033). Conclusion: Serum TC level is negatively correlated with the occurrence of breast cancer in pre-menopausal women, and its diagnostic value for breast cancer is at the medium level. TC level can be used as one of the markers to predict the risk of premenopausal breast cancer.
Keywords：
cholesterol; triglycerides; breast cancer; pre-menopause