Saarto T, Blomqvist C, Ehnholm C, Taskinen M R, Elomaa I
Department of Oncology, Helsinki University Central Hospital, Finland.
J Clin Endocrinol Metab. 1996 Dec;81(12):4453-7. doi: 10.1210/jcem.81.12.8954058.
The purpose of this study was to determine the effect of adjuvant chemotherapy on serum lipids and lipoproteins in premenopausal nonmetastatic breast cancer patients. Fifty-nine premenopausal breast cancer patients were treated with adjuvant chemotherapy comprising cyclophosphamide, methotrexate, and 5-fluorouracil. Levels of serum FSH, LH, and estradiol; fasting plasma levels of total cholesterol, high density lipoprotein cholesterol (HDL), low density lipoprotein cholesterol (LDL), triglyceride, and apolipoprotein A-I, A-II, and B levels; and lipoprotein(a) [Lp(a)] were measured before treatment and 12 months after the beginning of chemotherapy. The changes in serum lipids after chemotherapy correlated significantly to changes in menstruation. Total cholesterol, LDL, and HDL cholesterol levels increased significantly only in patients with chemotherapy-induced ovarian dysfunction. Changes in apo B paralleled those in LDL and apo A-I and A-II HDL cholesterol. The serum concentration of Lp(a) increased significantly only in patients who developed permanent amenorrhea. There were no significant changes in triglyceride levels. Chemotherapy per se has no effect on serum lipids unless associated with induction of ovarian dysfunction. Ovarian failure after chemotherapy has an unfavorable effect on serum total and LDL cholesterol, apo B, and Lp(a) levels, but a favorable effect on HDL cholesterol.
本研究的目的是确定辅助化疗对绝经前非转移性乳腺癌患者血清脂质和脂蛋白的影响。59例绝经前乳腺癌患者接受了包含环磷酰胺、甲氨蝶呤和5-氟尿嘧啶的辅助化疗。在治疗前和化疗开始后12个月测量血清促卵泡激素（FSH）、促黄体生成素（LH）和雌二醇水平；空腹血浆总胆固醇、高密度脂蛋白胆固醇（HDL）、低密度脂蛋白胆固醇（LDL）、甘油三酯以及载脂蛋白A-I、A-II和B水平；以及脂蛋白(a)[Lp(a)]。化疗后血清脂质的变化与月经变化显著相关。仅在化疗引起卵巢功能障碍的患者中，总胆固醇、LDL和HDL胆固醇水平显著升高。载脂蛋白B的变化与LDL以及载脂蛋白A-I和A-II HDL胆固醇的变化平行。仅在出现永久性闭经的患者中，血清Lp(a)浓度显著升高。甘油三酯水平无显著变化。化疗本身对血清脂质无影响，除非伴有卵巢功能障碍的诱导。化疗后卵巢功能衰竭对血清总胆固醇和LDL胆固醇、载脂蛋白B以及Lp(a)水平有不利影响，但对HDL胆固醇有有利影响。
