摘要
目的探讨不同化疗方案对乳腺癌术后辅助化疗患者血脂水平的影响。方法选取1205例乳腺癌术后辅助化疗患者,其中绝经前682例,绝经后523例;表柔比星+环磷酰胺序贯紫杉醇(AC-T)方案606例,多西他赛+环磷酰胺(TC)方案347例,多西他赛+卡铂(TCb)方案252例。检测首次化疗前及最后1个周期化疗前患者总胆固醇、甘油三酯(TG)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)、小而密低密度脂蛋白胆固醇(sdLDL-C)水平。分析比较不同化疗方案对绝经前和绝经后乳腺癌术后患者血脂水平的影响。结果化疗后,不同化疗方案乳腺癌术后患者TG、sdLDL-C水平均高于本组化疗前(P﹤0.05),HDL-C水平均低于本组化疗前(P﹤0.05);AC-T方案患者总胆固醇、LDL-C水平均低于本组化疗前(P﹤0.05),而TC、TCb方案患者总胆固醇、LDL-C水平均高于本组化疗前(P﹤0.05)。化疗后,不同化疗方案绝经前乳腺癌术后患者TG、sdLDL-C水平均高于本组化疗前(P﹤0.05),AC-T、TC方案绝经前患者HDL-C水平均低于本组化疗前(P﹤0.05);AC-T方案绝经后乳腺癌术后患者总胆固醇、LDL-C水平均低于本组化疗前(P﹤0.05),TC、TCb方案绝经后患者sdLDL-C水平均高于本组化疗前(P﹤0.05)。1205例乳腺癌术后患者化疗前血脂正常507例,其中234例化疗后出现血脂异常,AC-T方案化疗后血脂异常发生率明显低于TC方案(P﹤0.01);在绝经前患者中,AC-T、TCb方案患者血脂异常发生率均低于TC方案患者(P﹤0.05)。结论术后辅助化疗可能对乳腺癌患者的血脂水平造成不良影响,与TC、TCb方案相比,AC-T方案对血脂的不良影响更小。除常规血脂指标外,化疗过程中监测sdLDL-C水平变化也有一定的临床意义。
Objective To explore the effect of different chemotherapy regimens on blood lipid levels in patients with breast cancer after adjuvant chemotherapy.Method A total of 1205 breast cancer patients with postoperative adjuvant chemotherapy were selected,including 682 premenopausal cases and 523 postmenopausal cases;epirubicin+cyclophos-phamide followed by paclitaxel(AC-T)regimen in 606 patients,docetaxel+cyclophosphamide(TC)regimen in 347 pa-tients,and docetaxel+carboplatin(TCb)regimen in 252 patients.The levels of total cholesterol,triglyceride(TG),high density lipoprotein cholesterol(HDL-C),low-density lipoprotein cholesterol(LDL-C),and small dense low-density lipo-protein cholesterol(sdLDL-C)were detected before the first chemotherapy and before the last cycle of chemotherapy.To analyze and compare the effects of different chemotherapy regimens on blood lipid levels in premenopausal and post-menopausal breast cancer patients.Result After chemotherapy,the levels of TG and sdLDL-C in breast cancer patients with different chemotherapy regimens were higher than those before chemotherapy(P<0.05),and the levels of HDL-C were lower than those before chemotherapy(P<0.05).The levels of total cholesterol and LDL-C in patients with AC-T regimen were lower than those before chemotherapy(P<0.05),while the levels of total cholesterol and LDL-C in patients with TC and TCb regimens were higher than those before chemotherapy(P<0.05).After chemotherapy,the levels of TG and sdLDL-C in premenopausal breast cancer patients with different chemotherapy regimens were higher than those be-fore chemotherapy(P<0.05),and the levels of HDL-C in premenopausal patients with AC-T and TC regimens were lower than those before chemotherapy(P<0.05).The levels of total cholesterol and LDL-C in postmenopausal breast cancer pa-tients with AC-T regimen were lower than those before chemotherapy(P<0.05),and the levels of sdLDL-C in postmeno-pausal patients with TC and TCb regimens were higher than those before chemotherapy(P<0.05).Among 1205 breast cancer
作者
李晓爽
马飞
孙晓莹
朱爱华
庞若
LI Xiaoshuang;MAFei;SUN Xiaoying;ZHU Aihua;PANG Ruo(Department of Medical Oncology,Cancer Hospital of Huanxing Chaoyang District Beijing,Beijing 100023,China;Department of Medical Oncology,National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital,Chinese Academy of Medical Sciences and Peking Union Medical College,Beijing 100021,China)
出处
《癌症进展》
2022年第11期1107-1111,1115,共6页
Oncology Progress
基金
北京市朝阳区科技计划项目(CYSF2047)。
关键词
乳腺癌
血脂
化疗
小而密低密度脂蛋白胆固醇
breast cancer
blood lipid
chemotherapy
small dense low-density lipoprotein cholesterol
