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胃癌患者的血脂水平和胰岛素抵抗标志物:诊断和预后意义。

Lipid levels and insulin resistance markers in gastric cancer patients: diagnostic and prognostic significance.

机构信息

Department of Gastrointestinal Surgery, Shanghai East Hospital, School of Medicine, Tongji University, 200120, Shanghai, China.

出版信息

BMC Gastroenterol. 2024 Oct 21;24(1):373. doi: 10.1186/s12876-024-03463-w.

Abstract

Gastric cancer (GC) is a highly heterogeneous and aggressive malignant tumor that seriously affects the life safety of people all over the world. Its early manifestations are subtle. The present study aimed to investigate the clinical significance of serum lipid profiles, insulin resistance markers including the triglyceride-glucose (TyG) index and the atherosclerotic index (AI), in GC patients. A retrospective analysis encompassed 215 GC patients and 827 healthy individuals. The study results show that the total cholesterol, triglycerides, low-density lipoprotein, high-density lipoprotein levels, and the TyG index of GC patients were significantly lower than those of the control group before and after propensity score matching analysis. In the GC group, the levels of CEA, CA199, CA125, and CA724 tumor markers were higher than those in the healthy control group. Patients in advanced stages exhibited lower serum levels of serum lipids and TyG index compared to those in early stages. ROC analysis revealed that the TyG index, CA125, and CA199 combination yielded the highest positive prediction rate for GC at 98.6%. TyG index is significantly associated with the risk of adverse reactions after chemotherapy (OR = 1.104, 95% CI 1.028-1.186, P < 0.01). Multiple tumor markers and the TyG index combined detection showed correlations with five adverse reactions caused by chemotherapy (r < 0.6, P < 0.05). Preoperative lipid profiles in the serum show a strong correlation with patients diagnosed with GC. Evaluating a combination of various serum lipids and cancer markers significantly improves diagnostic precision for GC and the ability to predict chemotherapy side effects.

摘要

胃癌(GC)是一种高度异质性和侵袭性的恶性肿瘤,严重影响着全世界人民的生命安全。其早期表现较为隐匿。本研究旨在探讨血清脂质谱、胰岛素抵抗标志物(包括甘油三酯-葡萄糖(TyG)指数和动脉粥样硬化指数(AI))在 GC 患者中的临床意义。本研究回顾性分析了 215 例 GC 患者和 827 例健康对照者。研究结果表明,在倾向评分匹配分析前后,GC 患者的总胆固醇、甘油三酯、低密度脂蛋白、高密度脂蛋白水平和 TyG 指数均显著低于对照组。在 GC 组中,CEA、CA199、CA125 和 CA724 肿瘤标志物水平均高于健康对照组。晚期患者的血清脂质和 TyG 指数水平低于早期患者。ROC 分析显示,TyG 指数、CA125 和 CA199 联合对 GC 的阳性预测率最高,为 98.6%。TyG 指数与化疗后不良反应的风险显著相关(OR=1.104,95%CI 1.028-1.186,P<0.01)。多项肿瘤标志物与 TyG 指数联合检测与化疗引起的五种不良反应呈显著相关(r<0.6,P<0.05)。术前血清中脂质谱与 GC 患者的诊断密切相关。评估各种血清脂质和癌症标志物的联合检测显著提高了 GC 的诊断精度和预测化疗副作用的能力。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/534c/11495014/ae01fb00ca0b/12876_2024_3463_Fig1_HTML.jpg

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