血清维生素水平与肺癌患病风险及临床病理特征的相关性
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(1. 中国人民解放军总医院第一医学中心营养科,北京100853;2. 解放军医学院,北京100853)

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R734.2

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军队保健专项重点项目(22BJZ20)


Correlation of serum vitamin levels with risk and clinicopathological features of lung cancer
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(1.Department of Nutrition, First Medical Center, Chinese PLA General Hospital, Beijing 100853, China;2. Chinese PLA Medical School, Beijing 100853, China)

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    摘要:

    目的 探究血清维生素水平与肺癌临床病理及其他因素的相关性。方法 回顾性分析2020年9月至2022年5月于某大型综合三甲医院549例住院肺结节/肺占位患者的临床资料。比较良恶性肺结节患者及不同病理类型肺癌患者的血清维生素水平的差异,采用logistic回归分析评估血清维生素水平与不同病理类型肺癌发生风险的相关性。采用SPSS 26.0软件进行数据分析。根据数据类型,组间比较分别采用t检验、Wilcoxon检验及χ2检验。结果 本研究共纳入因体检发现肺结节或肺占位住院患者549例。其中由病理及临床诊断良性肺结节29例(5.3%),小细胞肺癌(SCLC)56例(10.2%),非小细胞肺癌(NSCLC)464例(84.5%)。与良性肺结节相比,肺癌患者血清维生素A、维生素B1、维生素C及维生素D水平显著降低(均P<0.01)。所有肺癌患者中,女性肺癌患者血清维生素A和维生素C水平显著降低(均P<0.01)。与NSCLC患者相比,SCLC患者血清维生素B2和维生素D水平显著降低(均P<0.05);在NSCLC中,相较于鳞癌患者,腺癌患者血清维生素C显著降低(P<0.05);相较于早期(Ⅰ期和Ⅱ期),NSCLC中晚期(Ⅲ期及Ⅳ期)患者血清维生素A、维生素B2及维生素D显著降低(均P<0.05)。Logistic回归分析得出,血清维生素A缺乏(OR=0.220,95%CI 0.126~0.385;P<0.001)、维生素B1缺乏(OR=0.963,95%CI 0.938~0.988;P=0.004)可作为肺癌发生的独立危险因素;血清维生素A缺乏(OR=2.433,95%CI 1.007~5.878;P=0.048)、维生素B2缺乏(OR=1.780,95%CI 1.115~2.843;P=0.016)可作为SCLC发生的独立危险因素;血清维生素C缺乏(OR=0.932,95%CI 0.889~0.977;P=0.004)、维生素D缺乏(OR=0.967,95%CI 0.948~0.986;P<0.001)可作为NSCLC中晚期发生的独立危险因素。结论 肺癌住院患者普遍存在维生素缺乏,血清维生素指标或可作为肺癌发生及进展的独立危险因素。

    Abstract:

    Objective To explore the correlation between serum vitamin levels and clinical pathology and other factors in lung cancer. Methods The clinical data of 549 inpatients with pulmonary nodules/lung occupation in a large-scale general hospital from September 2020 to May 2022 were retrospectively analyzed. The differences in serum vitamin levels were compared between patients with benign and malignant pulmonary nodules and among those with different pathological types of lung cancer. Logistic regression analysis was used to evaluate the correlation between serum vitamin levels and the risk of lung cancer of different pathological types. SPSS statistics 26.0 was used for statistical analysis. Data comparison between 2 groups was performed using student′s t test, Wilcoxon test or Chi-square test depending on data types. Results Among the 549 subjected patients, 29 cases (5.3%) were diagnosed as benign lung nodules by pathology and clinical diagnosis, 56 cases (10.2%) as small-cell lung cancer (SCLC), 464 cases (84.5%) of non-small-cell lung cancer (NSCLC). Compared with the patients with benign lung nodules, the serum levels of vitamin A, vitamin B1, vitamin C and vitamin D were significantly lower in lung cancer patients (all P<0.01). For the lung cancer patients, the serum vitamin A and vitamin C levels were obviously lower in the females (both P<0.01). The serum vitamin B2 and vitamin D levels were notably lower in the SCLC patients than the NSCLC patients (both P<0.05). In the NSCLC patients, the vitamin C level was notably lower in the adenocarcinoma patients than those with squamous cell carcinoma (P<0.05). The serum levels of vitamin A, vitamin B2, and vitamin D were remarkably lower in the patients with intermediate and advanced NSCLC (stage Ⅲ and Ⅳ) than those with early NSCLC (all P<0.05). Logistic regression analysis showed that serum vitamin A deficiency (OR=0.220,95%CI 0.126-0.385; P<0.001) and vitamin B1 deficiency (OR=0.963,95%CI 0.938-0.988; P=0.004) were independent risk factors for lung cancer. Serum vitamin A deficiency (OR=2.433,95%CI 1.007-5.878; P=0.048) and vitamin B2 deficiency (OR=1.780,95%CI 1.115-2.843; P=0.016) were independent risk factors for SCLC. Serum vitamin C deficiency (OR=0.932,95%CI 0.889-0.977; P=0.004) and vitamin D deficiency (OR=0.967,95%CI 0.948-0.986; P<0.001) can be used as an independent risk factor for advanced NSCLC. Conclusion Vitamin deficiency is quite common in patients hospitalized due to lung cancer. Some serum vitamin indicators may be independent risk factors for the development and progression of lung cancer.

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刘鹿,喻航,徐庆,张永,张新胜,刘英华.血清维生素水平与肺癌患病风险及临床病理特征的相关性[J].中华老年多器官疾病杂志,2022,21(10):749~754

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  • 收稿日期:2022-09-08
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  • 在线发布日期: 2022-11-02
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