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目的：流行病学研究发现血清胆固醇水平与一些癌症的发生和死亡率呈负相关。本文旨在评价大肠癌（ＣＲＣ）患者血脂及脂蛋白水平与ＣＲＣ分化程度、Ｄｕｋｅ氏分期和预后的关系。方法：应用自动生化分析仪，测定了进展期ＣＲＣ患者（ｎ＝７６），良性大肠疾病患者（ｎ＝４０）和正常对照者（ｎ＝６０）的血脂和脂蛋白水平，分别用ｔ检验、方差分析或Ｋａｐｌａｎ－Ｍｅｉｅｒ曲线Ｌｏｇ－ｒａｎｋ检验等对结果进行统计分析。结果：ＣＲＣ患者血清总胆固醇（ＴＣ）和高密度脂蛋白胆固醇（ＨＤＬ－Ｃ）水平明显低于良性大肠疾病组和正常对照组（Ｐ＜００２或Ｐ＜００１）。分化不良的ＣＲＣ患者的血清ＴＣ和ＨＤＬ－Ｃ水平显著低于分化良好者（Ｐ＜００５）。根据Ｄｕｋｅ氏分期，随着ＣＲＣ的进展，患者的血清ＴＣ和ＨＤＬ－Ｃ水平逐渐下降。血清ＴＣ和ＨＤＬ－Ｃ水平正常的ＣＲＣ患者的６个月生存率明显高于血清ＴＣ和ＨＤＬ－Ｃ水平下降者（Ｐ＜００５）。结论：大肠癌患者血清ＴＣ和ＨＤＬ－Ｃ水平下降，并可能与大肠癌的分化程度、Ｄｕｋｅ氏分期和患者的预后有关。
Purpose: Epidemiological studies have found that serum cholesterol levels are negatively correlated with the occurrence and mortality of some cancers. This article aims to evaluate the relationship between serum lipids and lipoprotein levels and the degree of CRC differentiation, Duke stage, and prognosis in patients with colorectal cancer (CRC). METHODS: Serum lipid and lipoprotein levels were measured in patients with advanced CRC (n=76), benign colorectal disease (n=40), and normal controls (n=60) using an automated biochemical analyzer. Analysis of variance or Kaplan-Meier curve Log-rank test, etc. Statistical analysis of the results. RESULTS: Serum total cholesterol (TC) and high-density lipoprotein cholesterol (HDL-C) levels were significantly lower in CRC patients than in benign large bowel disease and normal controls (P<002 or P<001). Serum TC and HDL-C levels were significantly lower in poorly differentiated CRC patients than in well-differentiated patients (P < 0.05). According to the Duke’s stage, as the CRC progresses, the patient’s serum TC and HDL-C levels gradually decrease. The 6-month survival rate of CRC patients with normal serum TC and HDL-C levels was significantly higher than that of serum TC and HDL-C levels (P < 0.05). Conclusions: Serum TC and HDL-C levels are decreased in patients with colorectal cancer, and may be related to the degree of differentiation of colorectal cancer, Dukes stage, and the prognosis of patients.