Objective:To analyze the characteristics of lipid metabolism in patients with lung cancer and the relationship between lipid levels and clinical characteristics of lung cancer.Methods:The clinical characteristics and blood lipid laboratory test results of 460 patients with lung cancer admitted to Jiangsu Provincial Hospital from January 2015 to June 2021 were collected, including total cholesterol(TC), triglyceride(TG), high density lipoprotein cholesterol(HDL-C), low density lipoprotein cholesterol(LDL-C), lipoprotein(a)[LP(a)], and 460 healthy subjects were selected as the control group.SPSS26.0 was used to compare serum lipid levels between the two groups and to analyze their correlation with clinical features.Results:Compared with the control group, the levels of TC, HDL-C and LDL-C in lung cancer patients were significantly decreased, and the level of LP(a)was increased( P<0.05 for all). There were some differences in the serum lipid levels in patients with different pathological types of lung cancer.The levels of serum TC, HDL-C and LDL-C in patients with adenocarcinoma were significantly higher than in those with squamous cell carcinoma( P<0.05 for all). Serum HDL-C in patients with small cell lung cancer was significantly higher than that in patients with squamous cell carcinoma( P<0.05 for all). Serum HDL-C in patients with small cell lung cancer was significantly higher than that in patients with squamous cell carcinoma( P<0.05). There was no significant difference in serum TC, TG, HDL-C and LDL-C levels between adenocarcinoma patients and small cell lung cancer patients( P>0.05 for all). When TC level increased, the risk of lung cancer decreased( OR=0.692, 95% CI: 0.509-0.941). However, the risk of lung cancer increased when LP(a)level increased( OR=1.394, 95% CI: 1.042-1.864). Conclusions:Patients with lung cancer have abnormal lipid metabolism.The risk of lung cancer was reduced in patients with high TC, while the risk of lung cancer was increased in patients with LP(a).