Adjuvant chemotherapy-associated lipid changes in breast cancer patients A real-word retrospective analysis
Adjuvant chemotherapy-associated lipid changes in breast cancer patients A real-word retrospective analysis
复制标题
乳腺癌患者辅助化疗相关血脂变化的真实回顾性分析
DOI：
10.1097/md.0000000000021498
复制
发表时间：
2020-08-14
期刊：
影响因子：
1.6
通讯作者：
Chen, Jie
中科院分区：
文献类型：
--
作者：
He, Tao;Wang, Chengshi;Chen, Jie
辅助化疗可能引起乳腺癌术后患者血脂的改变，但不同化疗方案引起的具体改变尚不清楚。本研究旨在探讨化疗前后的血脂状况，并比较不同化疗方案对血脂的副作用。我们回顾性分析了1934例连续接受以下化疗方案之一的BC术后患者的脂质谱：(1)阿霉素和环磷酰胺，然后是紫杉醇（AC-T）；(2)表柔比星和环磷酰胺，其次是紫杉醇（EC-T）；(3)环磷酰胺和紫杉醇（TC）；(4)氟尿嘧啶、环磷酰胺和表阿霉素（FEC）。在接受化疗方案的患者中，甘油三酯（TG）、总胆固醇（TC）和低密度脂蛋白（LDL-C）水平显著升高（P < 0.001）。在不同的化疗方案中，FEC对脂质谱（TG （P = 0.006）、高密度脂蛋白（HDL-C） （P < 0.001）和LDL-C (P < 0.001)）的副作用小于TC方案、AC-T和EC-T方案。FEC组化疗后新诊断的血脂异常发生率低于TC组和AC-T、EC-T组（P < 0.001）。此外，绝经前患者的脂质谱（TG、TC、HDL-C和LDL-C）的变化幅度大于绝经后患者（P = 0.004;P = 0.002;P = 0.003）。此外，在调整多个基线协变量后，与FEC方案相比，蒽环类药物加紫杉烷方案（AC-T和EC-T）仍与化疗后高TG水平（P = 0.004）和低HDL-C水平（P = 0.033）具有统计学相关性。此外，与BMI相比，体重指数（BMI） bbbb24与化疗后异常脂质谱（TG， TC, HDL-C, LDL-C）相关
Adjuvant chemotherapy may cause alterations in serum lipids in postoperative breast cancer (BC) patients, but the specific alterations caused by different chemotherapy regimens remain unclear. The aim of this study was to investigate the status of serum lipids pre- and post-chemotherapy and to compare the side effects of different chemotherapy regimens on serum lipid. We retrospectively analysed the lipid profiles of 1934 consecutive postoperative BC patients who received one of the following chemotherapy regimens: (1) doxorubicin and cyclophosphamide followed by paclitaxel (AC-T); (2) epirubicin and cyclophosphamide followed by paclitaxel (EC-T); (3) cyclophosphamide and paclitaxel (TC); and (4) fluorouracil, cyclophosphamide, and epirubicin (FEC). The levels of triglycerides (TG), total cholesterols (TC), and low-density lipoprotein (LDL-C) were significantly elevated in patients who received chemotherapy regimens above (P < .001). With respect to different chemotherapy regimens, FEC had less side effects on lipid profiles (TG (P = .006), high-density lipoprotein (HDL-C) (P < .001), and LDL-C (P < .001)) than TC regimen and AC-T and EC-T regimen. Also, the incidence of newly diagnosed dyslipidemia after chemotherapy was lower in FEC group than TC group and AC-T and EC-T group (P < .001). Additionally, the magnitude of the alterations in lipid profiles (TG, TC, HDL-C, and LDL-C) was greater in premenopausal patients than that of the postmenopausal patients (P = .004;P P = .002;P = .003, respectively). Moreover, after adjusting for multiple baseline covariates, anthracycline-plus-taxane-based regimens (AC-T and EC-T) were still statistically associated with a high level of TG (P = .004) and a low level of HDL-C (P = .033) after chemotherapy compared with FEC regimen. Also, body mass index (BMI) > 24 was associated with abnormal lipid profiles (TG, TC, HDL-C, LDL-C) post-chemotherapy compared with BMI