Preoperative serum lipid profile and outcome in nonmetastatic colorectal cancer

作     者：Ting-Ting Hong Di Shen Xiao-Ping Chen Xiao-Hong Wu Dong Hua 

作者机构：Department of Medical 0ncology Affiliated Hospital of Jiangnan University and Wuxi 4th People's Hospital Wuxi Jiangsu 214062 China 

出 版 物：《Chronic Diseases and Translational Medicine》 (慢性疾病与转化医学（英文版）)

年 卷 期：2016年第2卷第4期

页      面：-页

学科分类：1002[医学-临床医学] 100214[医学-肿瘤学] 10[医学] 

主　　题：Serum lipids Colorectal cancer Overall survival Prognostic model 

摘      要：Objective: A large portion of non-metastatic colorectal cancers (non-mCRCs) recur after curative surgery. In addition to the traditional tumor-related factors, host-related factors are also required to accurately predict prognosis. A few studies have shown an association between the serum lipid profile and the survival and treatment response of patients with colorectal cancer. Methods: We retrospectively evaluated the prognostic significance of the preoperative serum lipid profile [total cholesterol (TC), triglyceride (TG), low-density lipoprotein cholesterol (LDL-C), and high-density lipoprotein cholesterol (HDL-C)] in patients with non-mCRC treated with curative surgery. The Spearman rank correlation test was used to analyze associations between lipid levels and categorical variables. Lipid levels were modeled as four equal-sized quartiles based on the distribution among the whole cohort. Kaplan-Meier curves were used to estimate survival probabilities, and the log-rank test was used to detect differences between them. Multivariate fractional polynomial (MFP) analysis was used to model any non-linear effects and avoid categorization. To evaluate the added prognostic value of lipids, the predictive power of two models (with and without lipids as covariates) was compared by using Harrell s C-statistic and the Akaike information criterion (AIC). Results: A total of 266 patients with non-mCRC were enrolled in the present study. Spearman rank correlation test showed that TG levels inversely correlated with N stage (r ? ?0.20, P ? 0.00) and Tumor-Node-Metastasis (TNM) stage (r ? ?0.19, P ? 0.00). HDL-C levels positively correlated with perineural invasion (PNI) (r ? 0.15, P ? 0.02), and LDL-C levels inversely correlated with lymphovascular invasion (LVI) (r ? ?0.12, P ? 0.04). None of the four lipids predicted overall survival (OS) in univariate or multivariate analyses adjusted for age, gender, T stage, N stage, TNM stage, histological grade, tumor deposits,