Wu Jiayuan, Zhang Chuanmeng, Zhang Gaohua, Wang Yufeng, Zhang Zhanhui, Su Wenmei, Lyu Jun
Clinical Research Center, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China.
Department of Clinical Research, The Affiliated Hospital of Guangdong Medical University, Zhanjiang, China.
Cell Physiol Biochem. 2018;51(2):575-588. doi: 10.1159/000495277. Epub 2018 Nov 22.
BACKGROUND/AIMS: Serum apolipoprotein A1 (apoA1) has been reported to be abnormally expressed in several malignancies. However, the prognostic role of apoA1 in solid tumors is still controversial. We conducted this meta-analysis to obtain a more accurate evaluation of prognostic significance of apoA1 in Chinese patients with solid tumors.
A comprehensive literature search of electronic databases was carried out up to August 2018. We included studies investigating the association between pretreatment serum apoA1 level and clinicopathological features, including survival outcomes, in solid tumors. Hazard ratios (HRs) and odds ratio (ORs) with 95% confidence intervals (CIs) were applied as effect size estimates.
A total of 13 studies and 8052 patients were included in our meta-analysis. Elevated level of pretreatment serum apoA1 was markedly associated with an improved OS (pooled HR = 0.608, 95% CI = 0.557 - 0.665, P < 0.001). The statistical significances were observed in all cancer types, including digestive system malignancies (pooled HR = 0.633; 95% CI = 0.550-0.727; P < 0.001), urinary system cancers (pooled HR = 0.471; 95% CI = 0.352-0.630; P < 0.001), nasopharyngeal cancer (pooled HR = 0.642; 95% CI = 0.538-0.766; P < 0.001) and non-small cell lung cancer (pooled HR = 0.526; 95% CI = 0.329-0.841; P = 0.007), but not in breast cancer (pooled HR = 0.573; 95% CI = 0.266-1.246; P = 0.155). Meanwhile, cancer patients with a low level of serum apoA1 suffered an unfavorable DFS (pooled HR = 0.714, 95% CI = 0.603 - 0.845, P < 0.001). Moreover, abnormal serum apoA1 was significantly correlated to tumor size (pooled OR = 0.640, 95% CI = 0.475 - 0.863, P = 0.003), tumor differentiation (pooled HR = 0.724, 95% CI = 0.565 - 0.929, P = 0.011), and tumor stage (pooled HR = 0.493, 95% CI = 0.384 - 0.633, P < 0.001).
Elevated level of pretreatment serum apoA1 was significantly associated with longer survival in patients with solid tumors. Pretreatment serum apoA1 could serve as a novel positive factor for malignant patient prognosis in Chinese population.
背景/目的：血清载脂蛋白A1（apoA1）在多种恶性肿瘤中被报道存在异常表达。然而，apoA1在实体瘤中的预后作用仍存在争议。我们进行这项荟萃分析，以更准确地评估apoA1在中国实体瘤患者中的预后意义。
截至2018年8月，对电子数据库进行了全面的文献检索。我们纳入了研究实体瘤患者治疗前血清apoA1水平与临床病理特征（包括生存结局）之间关联的研究。风险比（HRs）和比值比（ORs）及其95%置信区间（CIs）用作效应量估计。
我们的荟萃分析共纳入13项研究和8052例患者。治疗前血清apoA1水平升高与总生存期改善显著相关（合并HR = 0.608，95% CI = 0.557 - 0.665，P < 0.001）。在所有癌症类型中均观察到统计学意义，包括消化系统恶性肿瘤（合并HR = 0.633；95% CI = 0.550 - 0.727；P < 0.001）、泌尿系统癌症（合并HR = 0.471；95% CI = 0.352 - 0.630；P < 0.001）、鼻咽癌（合并HR = 0.642；95% CI = 0.538 - 0.766；P < 0.001）和非小细胞肺癌（合并HR = 0.526；95% CI = 0.329 - 0.841；P = 0.007），但在乳腺癌中未观察到（合并HR = 0.573；95% CI = 0.266 - 1.246；P = 0.155）。同时，血清apoA1水平低的癌症患者无病生存期较差（合并HR = 0.714，95% CI = 0.603 - 0.845，P < 0.001）。此外，血清apoA1异常与肿瘤大小（合并OR = 0.64
