乳腺癌患者（新）辅助化疗后血脂的动态变化：一项回顾性观察研究。
Dynamic Changes of Blood Lipids in Breast Cancer Patients After (Neo)adjuvant Chemotherapy: A Retrospective Observational Study.
作者信息
Xu Liuyue, Dong Qian, Long Yaoying, Tang Xiaoqiong, Zhang Nan, Lu Kai
机构信息
Department of Hematology, The First Affiliated Hospital of Chongqing Medical University, Chongqing 400016, People's Republic of China.
Department of Cardiology, The First Affiliated Hospital of Chongqing Medical University, Chongqing 400016, People's Republic of China.
出版信息
Int J Gen Med. 2020 Oct 14;13:817-823. doi: 10.2147/IJGM.S273056. eCollection 2020.
BACKGROUND
Previous studies indicated that the (neo)adjuvant chemotherapy for breast cancer can cause significant dyslipidemia in patients, but how long this abnormality can persist is unclear so far. The purpose of this study is to investigate whether (neo)adjuvant chemotherapy has a long-term effect on blood lipids in breast cancer patients.
METHODS
A total of 159 newly diagnosed female breast cancer patients receiving the (neo)adjuvant chemotherapy subsequently and 159 female healthy controls were enrolled into the observational study. All participants' blood lipid profiles which included TC, TG, HDL-C, and LDL-C before and at the end of the 1st and 12th month after chemotherapy were retrieved from the electronic medical record system. The blood lipid profiles and the percentage of dyslipidemia before and after chemotherapy in breast cancer patients and controls were compared.
RESULTS
Compared with the baseline before chemotherapy, TC, LDL-C, and TG increased significantly at the end of the 1st month after chemotherapy, but only the abnormal increase in TG (2.98±0.71 mmol/L vs 2.82±0.63 mmol/L, <0.05) and LDL-C (1.82±0.42 mmol/L vs 1.59±0.42 mmol/L, <0.05) continued until the 12th month after chemotherapy. Levels of HDL-C in breast cancer patients and all the blood lipid parameters in controls remained stable during the observation period. The percentage of dyslipidemia in breast cancer patients rose from 41.5% at baseline to 54.1% at the 12th month after chemotherapy. Subgroup analysis demonstrated that the increase in dyslipidemia percentage was more pronounced in patients with low body mass index and aged over 50 years.
CONCLUSION
The (neo)adjuvant chemotherapy used for treating breast cancers can cause significant abnormalities in blood lipid profiles, and the abnormal increase in LDL-C and TG can last at least 12 months after chemotherapy, which indicates long-term management of blood lipid is necessary for those patients.
背景
既往研究表明，乳腺癌的（新）辅助化疗可导致患者出现显著的血脂异常，但这种异常会持续多久目前尚不清楚。本研究的目的是调查（新）辅助化疗对乳腺癌患者血脂是否有长期影响。
方法
共有159例新诊断的女性乳腺癌患者随后接受了（新）辅助化疗，并纳入159名女性健康对照者进行观察性研究。从电子病历系统中获取所有参与者化疗前、化疗第1个月末和第12个月末的血脂谱，包括总胆固醇（TC）、甘油三酯（TG）、高密度脂蛋白胆固醇（HDL-C）和低密度脂蛋白胆固醇（LDL-C）。比较乳腺癌患者和对照者化疗前后的血脂谱及血脂异常百分比。
结果
与化疗前的基线水平相比，化疗后第1个月末TC、LDL-C和TG显著升高，但只有TG（2.98±0.71 mmol/L比2.82±0.63 mmol/L，P<0.05）和LDL-C（1.82±0.42 mmol/L比1.59±0.42 mmol/L，P<0.05）的异常升高持续至化疗后第12个月末。在观察期内，乳腺癌患者的HDL-C水平以及对照者的所有血脂参数均保持稳定。乳腺癌患者血脂异常百分比从基线时的41.5%升至化疗后第12个月末的54.1%。亚组分析表明，体重指数较低且年龄超过50岁的患者血脂异常百分比增加更为明显。
结论
用于治疗乳腺癌的（新）辅助化疗可导致血脂谱显著异常，LDL-C和TG的异常升高在化疗后至少可持续12个月，这表明对这些患者进行血脂的长期管理是必要的。
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