Correlation between serum lipids before radical gastrectomy for gastric cancer and the prognosis

doi:10.3969/j.issn.1004-583X.2024.10.004

Abstract

Abstract:

Objective To evaluate the correlation of serum lipids before radical gastrectomy for gastric cancer (GC) with clinicopathological characteristics and prognosis. Methods A total of 307 GC patients underwent radical gastrectomy in the Second Hospital of Lanzhou University from October 2019 to May 2020 were retrospectively analyzed. The clinical data were compared to explore the correlation between serum lipids 2 weeks before radical gastrectomy and the prognosis. Results The follow-up time of 307 GC patients was 1-79 months, with a median follow-up time of 52 months. As of the final follow-up time, a total of 72 patients were lost to follow-up in this study, and 235 patients were finally included, of which 111 patients died. The preoperative increase in total cholesterol (TC) was significantly correlated with gender, pathological T stage(pT), pathological N stage(pN), carcinoembryonic antigen (CEA) and neurovascular invasion (P<0.05). High levels of triglyceride (TG) was significantly correlated with tumor maximum diameter, vascular invasion, pathological differentiation, pT, pN, and body mass index (BMI) (P<0.05). The increase in the low-density lipoprotein cholesterol (LDL-C) was significantly correlated with increased BMI, pT, pN,CEA and perineural invasion (P<0.05). Cox univariate risk analysis was performed on 235 GC patients treated with radical gastrectomy. Tumor maximum diameter, tumor location, vascular invasion, nerve invasion, CEA, carbohydrate antigen (CA) 125, CA199, pT, pN, TC, TG and LDL-C were all risk factors for the overall survival after radical gastrectomy (P<0.05). Multivariate analysis showed that after excluding other confounding factors, tumor size, CEA, CA125, CA199, pT, BMI and LDL-C were the independent risk factors for the prognosis of gastric cancer (P<0.05). Conclusion Preoperative LDL-C can be used as an independent factor to predict the prognosis of GC after radical gastrectomy.

Key words: stomach neoplasms, serum lipids, prognosis

CLC Number:

R735.2

Zhao Jinxia, Kang Huihui, Zhang Yao, Fu Shengjun, Sun Pengfei. Correlation between serum lipids before radical gastrectomy for gastric cancer and the prognosis[J]. Clinical Focus, 2024, 39(10): 889-895.

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URL: https://huicui.hebmu.edu.cn/EN/10.3969/j.issn.1004-583X.2024.10.004

https://huicui.hebmu.edu.cn/EN/Y2024/V39/I10/889

Figures/Tables 8

References 23

[1]	Smyth ES, Nilsson M, Grabsch, et al. Gastric cancer[J]. Lancet, 2020, 396(10251):635-648. doi: S0140-6736(20)31288-5 pmid: 32861308
[2]	Siegel RL, Giaquinto AN, Jemal A. Cancer statistics[J]. CA Cancer J Clin, 2024, 74(1):12-49.
[3]	Ulmer H, Borena W, Rapp K, et al. Serum triglyceride concentrations and cancer risk in a large cohort study in Austria[J]. Br J Cancer, 2009, 101(7):1202-1206.
[4]	Wettstein MS, Saba K, Umbehr MH, et al. Prognostic role of preoperative serum lipid levels in patients undergoing radical prostatectomy for clinically localized prostate cancer[J]. Prostate, 2017, 77(5):549-556. doi: 10.1002/pros.23296 pmid: 28093792
[5]	Hong TT, Shen D, Chen XP, et al. Preoperative serum lipid profile and outcome in nonmetastatic colorectal cancer[J]. Chronic Dis Transl Med, 2016, 2(4):241-249.
[6]	Cui YN, Gao Q, Zhu SS, et al. Effect of serum lipid level on prognosis of patients with small cell lung cancer at the initial treatment[J]. Zhonghua Zhong Liu Za Zhi, 2021, 43(3):318-323.
[7]	Munir R, Usman H, Hasnain S, et al. Atypical plasma lipid profile in cancer patients: Cause or consequence[J]. Biochimie, 2014 102(1):9-18.
[8]	Deng CF, Zhu N, Zhao TJ, et al. Involvement of LDL and ox-LDL in cancer development and its therapeutical potential[J]. Front Oncol, 2022, 22(3):803473-803473.
[9]	Bailwad SA, Singh N, Jani DR, et al. Alterations in serum lipid profile patterns in oral cancer: Correlation with histological grading and tobacco abuse[J]. Oral Health Dent Manag, 2014, 13(3):573-579. pmid: 25284514
[10]	Patel PS, Shah MH, Jha FP, et al. Alterations in plasma lipid profile patterns in head and neck cancer and oral precancerous conditions[J]. Indian J Cancer, 2004, 41(1):25-31. pmid: 15105576
[11]	Cheng C, Geng F, Cheng X, et al. Lipid metabolism reprogramming and its potential targets in cancer[J]. Cancer Commun (Lond), 2018, 38(1):27-27.
[12]	Kuzu OF, Noory MA. Robertson GP: The role of cholesterol in cancer[J]. Cancer Res, 2016, 76(8):2063-2070. doi: 10.1158/0008-5472.CAN-15-2613 pmid: 27197250
[13]	Lohe VK, Degwekar SS, Bhowate RR, et al. Evaluation of correlation of serum lipid profile in patients with oral cancer and precancer and its association with tobacco abuse[J]. J Oral Pathol Med, 2010, 39(2):141-148. doi: 10.1111/j.1600-0714.2009.00828.x pmid: 20002982
[14]	Srinivas GV, Namala S, Ananthaneni A, et al. Evaluation and correlation of serum lipid profile in oral and gastrointestinal cancer patients[J]. J Int Oral Health, 2013, 5(6):72-77.
[15]	Oka R, Utsumi T, Endo T, et al. Effect of androgen deprivation therapy on arterial stiffness and serum lipid profile changes in patients with prostate cancer: A prospective study of initial 6-month follow-up[J]. Int J Clin Oncol, 2016, 21(2):389-396. doi: 10.1007/s10147-015-0891-7 pmid: 26296528
[16]	Amerizadeh A, Vaseghi G, Farajzadegan Z, et al. An updated systematic review and meta-analysis on association of serum lipid profile with risk of breast cancer incidence[J]. Int J Prev Med, 2022, 12(1):92-92.
[17]	Garg D, Sunil MK, Singh PP, et al. Serum lipid profile in oral precancer and cancer: A diagnostic or prognostic marker[J]. J Int Oral Health, 2014, 6(2):33-39.
[18]	Li G, Da M, Zhang W, et al. Alteration of serum lipid profile and its prognostic value in head and neck squamous cell carcinoma[J]. J Oral Pathol Med, 2016, 45(3):167-172. doi: 10.1111/jop.12344 pmid: 26189546
[19]	Cui F, Zhou H, Lv D, et al. Preoperative serum low-density lipoprotein cholesterol is an independent prognostic factor in patients with renal cell carcinoma after nephrectomy[J]. Lipids Health Dis, 2023, 22(1):26-26. doi: 10.1186/s12944-023-01791-6 pmid: 36814277
[20]	Pih GY, Gong EJ, Choi JY, et al. Associations of serum lipid level with gastric cancer risk, pathology, and prognosis[J]. Cancer Res Treat, 2021, 53(2):445-456. doi: 10.4143/crt.2020.599 pmid: 33253515
[21]	Nam SY, Park BJ, Nam JH, et al. Effect of Helicobacter pylori eradication and high-density lipoprotein on the risk of de novo gastric cancer development[J]. Gastrointest Endosc, 2019, 90(3):448-456. doi: S0016-5107(19)31659-1 pmid: 31034810
[22]	Heravi G, Yazdanpanah O podgorski I, et al. Lipid metabolism reprogramming in renal cell carcinoma[J]. Cancer Metastasis Rev, 2022, 41(1):17-31.
[23]	Li B, Huang D, Zheng H, et al. Preoperative serum total cholesterol is a predictor of prognosis in patients with renal cell carcinoma: A meta-analysis of observational studies[J]. Int Braz J Urol, 2020, 46(2):158-168.

项目	TC<4.775 mmol/L组 (n=194)	TC≥4.775 mmol/L组 (n=41)	统计值	P值
年龄(岁)	56.51±0.25	58.10±9.10	t=0.92	0.36
性别[例(%)]
男性女性	169(87.1) 25(12.9)	25(60.9) 16(39.1)	χ²=2.02	0.04
肿瘤最大径(cm)	4.00(3.00,6.00)	3.50(2.50,5.00)	Z=1.40	0.16
分化程度[例(%)]
高中分化低分化	85(43.8) 109(56.2)	23(56.1) 18(43.9)	χ²=1.43	0.15
脉管侵犯[例(%)]
是否	156(80.4) 38(19.6)	28(68.3) 13(31.7)	χ²=1.71	0.09
神经侵犯[例(%)]
是否	133(68.6) 61(31.4)	19(46.3) 22(53.7)	χ²=2.70	0.01
BMI(kg/m²)	21.70±3.18	22.60±2.82	t=1.68	0.07
pT[例(%)]
T₁-T₂ T₃-T₄	47(24.2) 147(75.8)	19(46.3) 22(53.7)	χ²=2.86	0.00
pN[例(%)]
N₀-N₁ N₂-N₃	97(50.0) 97(50.0)	31(75.6) 10(24.4)	χ²=2.99	0.00
CEA(ng/ml)	2.37(1.42, 4.36)	1.73(1.11, 3.20)	Z=2.26	0.02
CA125(U/ml)	11.51(7.93, 17.48)	10.88(8.62, 15.68)	Z=0.33	0.74
CA199(U/ml)	11.59(6.14, 20.43)	8.93(5.79, 18.38)	Z=1.08	0.28

项目	TC<4.775 mmol/L组 (n=194)	TC≥4.775 mmol/L组 (n=41)	统计值	P值
年龄(岁)	56.51±0.25	58.10±9.10	t=0.92	0.36
性别[例(%)]
男性女性	169(87.1) 25(12.9)	25(60.9) 16(39.1)	χ²=2.02	0.04
肿瘤最大径(cm)	4.00(3.00,6.00)	3.50(2.50,5.00)	Z=1.40	0.16
分化程度[例(%)]
高中分化低分化	85(43.8) 109(56.2)	23(56.1) 18(43.9)	χ²=1.43	0.15
脉管侵犯[例(%)]
是否	156(80.4) 38(19.6)	28(68.3) 13(31.7)	χ²=1.71	0.09
神经侵犯[例(%)]
是否	133(68.6) 61(31.4)	19(46.3) 22(53.7)	χ²=2.70	0.01
BMI(kg/m²)	21.70±3.18	22.60±2.82	t=1.68	0.07
pT[例(%)]
T₁-T₂ T₃-T₄	47(24.2) 147(75.8)	19(46.3) 22(53.7)	χ²=2.86	0.00
pN[例(%)]
N₀-N₁ N₂-N₃	97(50.0) 97(50.0)	31(75.6) 10(24.4)	χ²=2.99	0.00
CEA(ng/ml)	2.37(1.42, 4.36)	1.73(1.11, 3.20)	Z=2.26	0.02
CA125(U/ml)	11.51(7.93, 17.48)	10.88(8.62, 15.68)	Z=0.33	0.74
CA199(U/ml)	11.59(6.14, 20.43)	8.93(5.79, 18.38)	Z=1.08	0.28

项目	TG<1.175 mmol/L组 (n=138)	TG≥1.175 mmol/L (n=97)	统计值	P值
年龄(岁)	56.57±10.48	57.09±9.47	t=0.40	0.69
性别[例(%)]
男性女性	101(73.2) 37(26.8)	72(74.2) 25(25.8)	χ²=0.18	0.86
肿瘤最大径(cm)	4.50(3.00,6.00)	3.00(2.15,5.00)	Z=3.69	0.00
分化程度[例(%)]
高中分化低分化	55(39.9) 83(60.1)	53(54.6) 44(45.4)	χ²=2.63	0.03
脉管侵犯[例(%)]
是否	117(84.8) 21(15.2)	67(69.1) 30(30.9)	χ²=2.87	0.00
神经侵犯[例(%)]
是否	104(75.4) 34(24.6)	48(49.5) 49(50.5)	χ²=4.08	0.00
BMI(kg/m²)	21.16±3.06	22.83±2.97	t=4.45	0.00
pT[例(%)]
T₁-T₂ T₃-T₄	25(18.1) 113(81.9)	41(42.3) 56(57.7)	χ²=4.05	0.00
pN[例(%)]
N₀-N₁ N₂-N₃	67(48.6) 71(51.4)	61(62.9) 36(37.1)	χ²=2.17	0.03
CEA(ng/ml)	50(25, 75)	2.35(1.32, 4.28)	Z=0.77	0.44
CA125(U/ml)	2.1(1.29, 3.79)	11.19(7.81, 17.95)	Z=0.44	0.66
CA199(U/ml)	11.69(8.80, 15.91)	10.68(6.02, 20.31)	Z=0.38	0.71

项目	TG<1.175 mmol/L组 (n=138)	TG≥1.175 mmol/L (n=97)	统计值	P值
年龄(岁)	56.57±10.48	57.09±9.47	t=0.40	0.69
性别[例(%)]
男性女性	101(73.2) 37(26.8)	72(74.2) 25(25.8)	χ²=0.18	0.86
肿瘤最大径(cm)	4.50(3.00,6.00)	3.00(2.15,5.00)	Z=3.69	0.00
分化程度[例(%)]
高中分化低分化	55(39.9) 83(60.1)	53(54.6) 44(45.4)	χ²=2.63	0.03
脉管侵犯[例(%)]
是否	117(84.8) 21(15.2)	67(69.1) 30(30.9)	χ²=2.87	0.00
神经侵犯[例(%)]
是否	104(75.4) 34(24.6)	48(49.5) 49(50.5)	χ²=4.08	0.00
BMI(kg/m²)	21.16±3.06	22.83±2.97	t=4.45	0.00
pT[例(%)]
T₁-T₂ T₃-T₄	25(18.1) 113(81.9)	41(42.3) 56(57.7)	χ²=4.05	0.00
pN[例(%)]
N₀-N₁ N₂-N₃	67(48.6) 71(51.4)	61(62.9) 36(37.1)	χ²=2.17	0.03
CEA(ng/ml)	50(25, 75)	2.35(1.32, 4.28)	Z=0.77	0.44
CA125(U/ml)	2.1(1.29, 3.79)	11.19(7.81, 17.95)	Z=0.44	0.66
CA199(U/ml)	11.69(8.80, 15.91)	10.68(6.02, 20.31)	Z=0.38	0.71

项目	LDL-C<2.975 mmol/L组 (n=180)	LDL-C≥2.975 mmol/L组 (n=55)	统计值	P值
年龄(岁)	56.41±10.20	58.02±0.56	t=0.33	0.74
性别[例(%)]
男性女性	139(77.2) 41(22.8)	34(61.8) 21(38.2)	χ²=2.26	0.27
肿瘤最大径(cm)	4.00(3.00,6.00)	3.50(2.50,5.00)	Z=1.45	0.15
分化程度[例(%)]
高中分化低分化	77(42.8) 103(57.2)	31(56.4) 24(43.6)	χ²=1.77	0.08
脉管侵犯[例(%)]
是否	147(81.7) 33(18.3)	37(67.3) 18(32.7)	χ²=2.26	0.24
神经侵犯[例(%)]
是否	126(70.0) 54(30.0)	26(47.3) 29(52.7)	χ²=3.08	0.00
BMI(kg/m²)	21.65±3.21	22.51±2.80	t=2.01	0.05
pT[例(%)]
T₁-T₂ T₃-T₄	42(23.3) 138(76.7)	24(43.6) 31(56.4)	χ²=2.93	0.00
pN[例(%)]
N₀-N₁ N₂-N₃	88(48.9) 92(51.1)	40(72.7) 15(27.3)	χ²=3.10	0.00
CEA(ng/ml)	2.38(1.347, 4.82)	1.80(1.26, 3.16)	Z=2.28	0.02
CA125(U/ml)	11.60(7.92, 17.81)	10.88(8.67, 15.16)	Z=0.58	0.56
CA199(U/ml)	10.88(5.96, 20.375)	10.59(6.12, 19.15)	Z=0.15	0.88