Silva Ana, Pereira Sofia S, Monteiro Mariana P, Araújo António, Faria Gil
Pharmacy Department, Centro Hospitalar Universitário do Porto, Porto, Portugal.
School of Health, Polytechnic Institute of Porto, Polytechnic of Porto, Porto, Portugal.
Front Oncol. 2021 Mar 4;11:631257. doi: 10.3389/fonc.2021.631257. eCollection 2021.
Metabolic syndrome (MS) is recognized as a risk factor for colon cancer (CC). However, whether the cluster of metabolic changes that define MS also influence CC prognosis remains unclear. Thus, our aim was to investigate whether the presence of MS or any of the MS individual components could provide prognostic information on tumor phenotype and survival outcomes. Clinical and pathological data from patients with CC (n = 300) who underwent surgical resection at a single tertiary hospital were retrospectively collected to evaluate presence of MS components and diagnostic criteria, CC phenotype and disease outcomes. Patients were allocated into two groups according to the presence or absence of MS (n = 85 MS vs n = 83 non-MS). The overall prevalence of MS individual components was 82.7% for increased waist-circumference (WC), 61.3% for high blood pressure (BP), 48.8% for low HDL-cholesterol, 39.9% for high fasting glucose, and 33.9% for hypertriglyceridemia. Patients in the MS group presented smaller tumors (p = 0.006) with lower T-stage (p = 0.002). High BP (p = 0.029) and hypertriglyceridemia (p = 0.044) were associated with a smaller tumor size, while low-HDL (p = 0.008) was associated with lower T-stage. After propensity score matching using age, tumor size and staging as covariates high-BP (p = 0.020) and WC (p = 0.003) were found to influence disease-free survival, but not overall survival. In conclusion, despite MS being an established risk factor for CC, our data does not support the hypothesis that MS components have a negative impact on disease extension or prognosis. Nevertheless, a protective role of BP and lipid lowering drugs cannot be excluded.
代谢综合征（MS）被认为是结肠癌（CC）的一个危险因素。然而，定义MS的代谢变化集群是否也会影响CC的预后仍不清楚。因此，我们的目的是研究MS的存在或MS的任何单个组成部分是否能提供有关肿瘤表型和生存结果的预后信息。回顾性收集了在一家三级医院接受手术切除的CC患者（n = 300）的临床和病理数据，以评估MS组成部分的存在情况和诊断标准、CC表型及疾病结局。根据是否存在MS将患者分为两组（n = 85例MS患者 vs n = 83例非MS患者）。MS单个组成部分的总体患病率为：腰围增加（WC）82.7%，高血压（BP）61.3%，低高密度脂蛋白胆固醇48.8%，空腹血糖升高39.9%，高甘油三酯血症33.9%。MS组患者的肿瘤较小（p = 0.006），T分期较低（p = 0.002）。高血压（p = 0.029）和高甘油三酯血症（p = 0.044）与较小的肿瘤大小相关，而低高密度脂蛋白（p = 0.008）与较低的T分期相关。在以年龄、肿瘤大小和分期作为协变量进行倾向评分匹配后，发现高血压（p = 0.020）和腰围（p = 0.003）会影响无病生存期，但不影响总生存期。总之，尽管MS是CC的既定危险因素，但我们的数据不支持MS组成部分对疾病进展或预后有负面影响这一假设。然而，不能排除BP和降脂药物的保护作用。
