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©The Author(s) 2021. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastrointest Surg. Jul 27, 2021; 13(7): 689-701
Published online Jul 27, 2021. doi: 10.4240/wjgs.v13.i7.689
Novel parameter based on lipid indicators ratio improves prognostic value of plasma lipid levels in resectable colorectal cancer patients
Jun-Nan Gu, Shuang Yao, Ying-Hao Cao, Sheng-He Deng, Fu-Wei Mao, Hong-Yu Jiang, Yang-Ting He, Xin-Ying Li, Song-Qing Ke, Hui-Li Li, Hang Li, Xing-Hua Liu, Hong-Li Liu, Ji-Liang Wang, Ke Wu, Li Liu, Kai-Lin Cai
Jun-Nan Gu, Ying-Hao Cao, Sheng-He Deng, Fu-Wei Mao, Hui-Li Li, Hang Li, Xing-Hua Liu, Ji-Liang Wang, Ke Wu, Kai-Lin Cai, Department of Gastrointestinal Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, Hubei Province, China
Shuang Yao, Hong-Yu Jiang, Yang-Ting He, Xin-Ying Li, Song-Qing Ke, Department of Epidemiology and Biostatistics, The Ministry of Education Key Lab of Environment and Health, School of Public Health, Huazhong University of Science and Technology, Wuhan 430022, Hubei Province, China
Hong-Li Liu, Cancer Center, Huazhong University of Science and Technology, Wuhan 430022, Hubei Province, China
Li Liu, Department of Epidemiology and Biostatistics, School of Public Health, Huazhong University of Science and Technology, Wuhan 430022, Hubei Province, China
Author contributions: Gu JN was responsible for conceptualization, methodology, validation, and writing of the original draft; Yao S was responsible for conceptualization, methodology, software, and formal analysis; Cao YH, Deng SH, and Mao FW were responsible for investigation and resources; Jiang HY, He YT, Li XY, and Ke SQ were responsible for resources and data curation; Li HL was responsible for visualization, supervision, and manuscript writing, review, and editing; Li H and Liu XH were responsible for visualization and supervision; Liu HL, Wu K, and Wang JL were responsible for supervision and project administration; Liu L and Cai KL were responsible for manuscript writing, review, and editing, supervision, project administration, and funding acquisition, and should be regarded as co-corresponding authors.
Supported by the Graduates’ Innovation Fund, Huazhong University of Science and Technology, No. 2020yjsCXCY080; and the Free Innovation Pre-research Fund and Platform Scientific Research Fund in 2019, No. 02.03.2019-111.
Institutional review board statement: This study was reviewed and approved by the Ethics Committee of the Wuhan Union Hospital.
Informed consent statement: The analysis used clinical data that were obtained after each patient agreed to treatment by written consent.
Conflict-of-interest statement: The authors declare no conflicts of interest related to this manuscript.
Data sharing statement: The data that support the findings of this study are available from the corresponding author upon reasonable request.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See:
http://creativecommons.org/Licenses/by-nc/4.0/ Corresponding author: Kai-Lin Cai, PhD, Doctor, Professor, Department of Gastrointestinal Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Union Hospital, No. 1277 Jiefang Avenue, Jianghan District, Wuhan 430022, Hubei Province, China. caikailin@hust.edu.cn
Received: December 28, 2020
Peer-review started: December 28, 2020
First decision: February 23, 2021
Revised: March 11, 2021
Accepted: June 28, 2021
Article in press: June 28, 2021
Published online: July 27, 2021
BACKGROUND
At present, the value of lipid indicators in evaluating the prognosis of colorectal cancer is still relatively limited.
AIM
To evaluate the value of a novel parameter for colorectal cancer (CRC) prognosis scoring based on preoperative serum lipid levels.
METHODS
Four key serum lipid factors, namely, high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), apolipoprotein A1 (ApoA1), and apolipoprotein B (ApoB), were detected. Two representative ratios, HDL-C-LDL-C ratio (HLR) and ApoA1-ApoB ratio (ABR) were calculated. The relationship of these parameters with the prognosis of CRC patients including progression-free survival (PFS) and overall survival (OS) was analyzed by Kaplan-Meier plot and Cox proportional hazards regression. A novel lipoprotein cholesterol-apolipoprotein (LA) score based on HLR and ABR was established and its value in prognosis evaluation for CRC patients was explored.
RESULTS
Multivariate Cox proportional hazards regression analysis of PFS and OS showed that HDL-C, ApoA1, HLR, and ABR were positively associated with the prognosis of CRC patients. LA score was independently associated with a good prognosis in resectable CRC patients. Data processing of a dummy variable showed that the prognosis of patients with higher LA scores is better than that with lower LA scores.
CONCLUSION
The newly established LA score might serve as a better predictor of the prognosis of resectable CRC patients.
Core Tip: Although the diagnosis and treatment of colorectal cancer are constantly improving, the prognosis of colorectal cancer still needs to be further improved. At present, the methods to evaluate the prognosis of colorectal cancer, whether imaging examination or endoscopic examination, are based on the judgment of tumor stage. Under the background that the relationship between lipid metabolism and cancer has been gradually explored, our research has further studied the relationship between some key lipid indicators and the prognosis of colorectal cancer, and has established a novel prognosis scoring system, namely, lipoprotein cholesterol-apolipoprotein score, based on lipid indicators, which is expected to have more application value in the future clinical work.
