The prognostic value of serum lipid-profile in renal cell cancer (RCC) remains unknown. The purpose of the study is to explore the association between the serum lipid-profile and RCC patients.The levels of preoperative serum lipid-profile (including cholesterol, triglycerides, high-density lipoprotein-cholesterol [HDL-C], low-density lipoprotein-cholesterol [LDL-C], apolipoprotein A-I [ApoA-I], and apolipoprotein B [ApoB]) were retrospectively performed in 786 patients with RCC.
The cutoff values of the lipids were determined by the receiver-operating characteristic (ROC) curve analysis. Univariate and multivariate Cox regression analyses were performed to investigate the prognostic value of serum lipids in RCC.Combined ROC analysis and univariate and multivariate Cox regression analyses, for overall survival (OS), revealed patients with low ApoA-I (<1.04) had significantly lower OS than the high ApoA-I (≥1.04) group (multivariate Cox regression analyses, hazard ratio [HR], 0.57; P = 0.003). Not only in the whole RCC cohort but also in the subgroups stratified according to the pT1-2 (P = 0.002), pN0 (P < 0.001), and pM0 (P = 0.001) status, respectively. Moreover, in the 755 patients with nonmetastasis, the low ApoA-I group was also associated with shortened disease-free survival (DFS) time compared to the high ApoA-I group (multivariate Cox regression analyses, HR, 0.65; P = 0.033). However, the other lipids were not independent prognostic factors for surgical RCC.An elevated level of preoperative ApoA-I was demonstrated to be related with better survival in patients with surgical RCC. Measuring the preoperative ApoA-I might be a simple way for finding the poor prognostic patients who should enrolled in further clinical trials and management.
Medicine. 2016 Mar [Epub]
Shengjie Guo, Xiaobo He, Qian Chen, Guangwei Yang, Kai Yao, Pei Dong, Yunlin Ye, Dong Chen, Zhiling Zhang, Zike Qin, Zhuowei Liu, Zaishang Li, Yunfei Xue, Meng Zhang, Ruiwu Liu, Fangjian Zhou, Hui Han
From the Department of Urology, Sun Yat-Sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou (SG, KY, PD, YY, DC, ZZ, ZQ, ZL, ZL, FZ, HH); Department of Medical Oncology, the Fifth Affiliated Hospital of Sun Yat-Sen University, Zhuhai (XH, GY); Xinhua College of Sun Yat-Sen University (QC); Medicine School of Sun Yat-Sen University, Guangzhou, China (YX, MZ); and Department of Biochemistry and Molecular Medicine, University of California Davis, Sacramento, CA, USA (RL).