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目的 :比较卵巢良性上皮肿瘤、早期及晚期恶性上皮肿瘤的血脂水平,探讨血脂变化在卵巢上皮肿瘤发生发展过程中可能的作用。方法:采用病例-对照研究,共纳入200例研究对象,按手术后病理结果分为良性组100例、早期恶性组和晚期恶性组各50例,收集各组血脂,主要观察总胆固醇(total cholesterol,TC)、甘油三酯(triglycerides,TG)、高密度脂蛋白胆固醇(highdensity lipoprotein cholesterol,HDL-c)、低密度脂蛋白胆固醇(low density lipoprotein cholesterol,LDL-c)、脂蛋白a[lipoprotein(a)]等血脂指标与卵巢上皮性肿瘤的相关关系。结果 :恶性组TC及HDL-c水平明显低于良性组,差异具有统计学意义(P<0.05),恶性组LP(a)水平也较良性组有升高的趋势(P=0.061)而LDL-c较良性组有降低趋势(P=0.061)。良性组、早期组及晚期组间TC、HDL-c、LDL-c及LP(a)水平方差分析结果均显示差异具有统计学意义(P值均<0.05)。其中良性组较早期组的HDL-c水平明显降低(P<0.001);晚期组较良性组TC、HDL-c、LDL-c明显下降(P值均<0.05),而晚期组LP(a)水平较良性组明显升高(P=0.013);晚期组与早期组相比,两组之间各项指标均无明显差异,而只有LP(a)呈升高趋势(P=0.052)。将TC、TG、HDL-c,LDL-c及LP(a)作为自变量,卵巢肿瘤的病变程度作为因变量,进行Logistic分析:HDL-c(P<0.01)及LP(a)(P=0.02)与卵巢肿瘤的发展程度有关,差异性具有统计学意义;根据指南标准分别对其进行赋值后,再次进行Logistic回归分析:HDL-c(P<0.01)及LDL-c(P=0.01)与肿瘤的病变程度有关,差异性具有统计学意义。结论 :HDL-c、LDL-c及LP(a)与卵巢肿瘤的发展程度有关,卵巢恶性肿瘤的期别越晚,HDL-c及LDL-c的值越低,而LP(a)值越高。
Objective: To compare the serum lipids in benign epithelial ovarian tumors, early and advanced malignant epithelial neoplasms, and to explore the possible role of the changes of serum lipids in the development of ovarian epithelial tumors. Methods: A total of 200 study subjects were enrolled in the case-control study. The patients were divided into benign group (100 cases), early malignant group (50 cases) and late malignant group (50 cases) TC), triglycerides (TG), high density lipoprotein cholesterol (HDL-c), low density lipoprotein cholesterol (LDL-c), lipoprotein a)] and other lipid indicators and ovarian epithelial tumor. Results: The levels of TC and HDL-c in malignant group were significantly lower than those in benign group (P <0.05). The level of LP (a) in malignant group was also higher than that in benign group (P = 0.061) -c than the benign group decreased (P = 0.061). The analysis of variance of the levels of TC, HDL-c, LDL-c and LP (a) in the benign group, the early group and the late group showed statistically significant differences (P <0.05). (P <0.001). The levels of TC, HDL-c and LDL-c in the benign group were significantly lower than those in the benign group (all P <0.05), while the levels of LP (a) (P = 0.013). Compared with the early group, there was no significant difference between the two groups in the late stage group, but only LP (a) increased (P = 0.052). The levels of TC, TG, HDL-c, LDL-c and LP (a) were used as independent variables and the degree of ovarian tumor was taken as the dependent variable. Logistic analysis was used to analyze the relationship between HDL-c and LP (a) 0.02) were related to the development of ovarian tumors. The differences were statistically significant. Logistic regression analysis was performed again after assigning values according to the guidelines: HDL-c (P <0.01) and LDL-c With the degree of tumor lesions, the difference was statistically significant. Conclusions: HDL-c, LDL-c and LP (a) are correlated with the development of ovarian tumors. The later the ovarian cancer, the lower the values of HDL-c and LDL-c, high.