Postoperative changes in serum lipid levels of breast cancer and adjuvant chemotherapy

摘要

Postoperative adjuvant drugs are usually given long-term for breast cancer to obtain various effects and their effects on serum lipid level changes were studied. Between June 1990 and May 2003, changes in serum levels of five serum lipids, cholesterol (CHO), triglyceride (TG), phospholipid (PL), free fatty acid (FFA), and high-density lipoprotein-cholesterol (HDL-C), were quantitated for 453 surgically-treated patients with breast cancer. Postoperative adjuvant settings were: 1. no drug; 2. Goserelin (G) of subcutaneous gradual release form; 3. tamoxifen; 4. oral fluoropyrimidines, i. e. tegafur, carmofur and doxyfluridine; and 5. oral alkylating agents, i. e. carboquone or cyclophosphamide. Preoperative levels of all five lipids correlated with age until 70, and postoperative levels of all five increased. The CHO level increased in patients treated with G, fluoropyrimidines and oral alkylating agents, decreased in patients treated with tamoxifen, and was stable in patients without adjuvant treatment. While the increase in the CHO level in G or decrease in tamoxifen was restored nearly to the preoperative level, the changes in patients with fluoropyrimidines or alkylating agents continued after five-year administration. Multiple regression analysis revealed significant effects of preoperative levels of all lipids, including T for CHO, G and oral fluoropyrimidines for TG, G for FFA, and oral fluoropyrimidines for PL. While postoperative adjuvant treatment for breast cancer affects changes in serum lipid levels as a function of preoperative level and age, it seems to be due to direct or indirect endocrine milieu.