Winawer S J, Flehinger B J, Buchalter J, Herbert E, Shike M
Memorial Sloan-Kettering Cancer Center, New York, NY 10021.
JAMA. 1990 Apr 18;263(15):2083-5.
We report the results of a 10-year, time-trend, case-control study in which serum cholesterol level was determined at several points in time preceding the diagnosis of colon cancer in a population of individuals who sought general checkups at an ambulatory care screening facility. Each of the 69 patients with colon cancer (32 men and 37 women) was matched with a control patient who was randomly selected. At the time of diagnosis, the patients with colon cancer had significantly lower serum cholesterol values than control patients (5.56 +/- 0.31 mmol/L [SEM] vs 6.47 +/- 0.34 mmol/L). This difference did not vary with sex or Dukes' stage of the cancer. The percent of matched pairs in which the cancer patient had a lower serum cholesterol level increased from 42% at 10 years prior to cancer diagnosis to 77% at diagnosis. The ratio of serum cholesterol at each period to the level at time of diagnosis demonstrated an average decline of 13% during the 10 years prior to diagnosis for case patients vs an average rise of 2% in the same period for control patients. We conclude that individuals in whom colorectal cancer develops share the same level of serum cholesterol as the general population initially, but during the 10 years preceding the cancer demonstrate a decline in serum cholesterol level that is opposite to the rising level seen with age in the general population.
我们报告了一项为期10年的时间趋势病例对照研究结果，该研究在一家门诊护理筛查机构进行一般体检的人群中，于结肠癌诊断前的多个时间点测定血清胆固醇水平。69例结肠癌患者（32例男性和37例女性）中的每一例都与一名随机选择的对照患者进行匹配。在诊断时，结肠癌患者的血清胆固醇值显著低于对照患者（5.56±0.31 mmol/L[标准误]对6.47±0.34 mmol/L）。这种差异不因性别或癌症的杜克分期而有所不同。癌症患者血清胆固醇水平较低的匹配对百分比从癌症诊断前10年的42%增加到诊断时的77%。病例患者在诊断前10年期间，各时期血清胆固醇与诊断时水平的比值平均下降了13%，而对照患者在同一时期平均上升了2%。我们得出结论，患结直肠癌的个体最初的血清胆固醇水平与普通人群相同，但在癌症发生前的10年中，血清胆固醇水平呈下降趋势，这与普通人群随年龄增长而上升的趋势相反。
