Deng Hongbin, Zhou Tao, Mo Xinkai, Liu Chengxin, Yin Yong
Department of Radiation Oncology, Shandong Cancer Hospital Affiliated to Shandong University, Shandong Academy of Medical Sciences, Jinan, Shandong 250117, P.R. China.
School of Medicine and Life Science, University of Jinan-Shandong Academy of Medical Science, Jinan, Shandong 25022, P.R. China.
Oncol Lett. 2019 Jan;17(1):1053-1061. doi: 10.3892/ol.2018.9683. Epub 2018 Nov 9.
The purpose of the current study was to investigate the prognostic role of preoperative serum lipid levels in patients with esophageal squamous cell carcinoma (ESCC) and to preliminarily explore the mechanism of serum lipids in this disease. Preoperative lipids, including total cholesterol, low-density lipoprotein (LDL) cholesterol, high-density lipoprotein (HDL) cholesterol and triglyceride levels, were assessed in 242 patients with ESCC. To eliminate the influence of nutritional status, all patients had previously undergone esophagectomy. Univariate and multivariate Cox regression analyses were performed to identify predictors of overall survival (OS). Associations between significant lipid targets and clinical features were then analyzed and the results were validated using TE-1 and ECa109 esophageal cancer cell lines. The cell proliferation was evaluated with a Cell Counting Kit-8 (CCK8) assay and the cell cycle was assessed with propidium iodide staining and flow cytometry. Univariate analysis revealed that HDL (P=0.048), LDL (P=0.020), Pathological T-staging status (pT status) (P=0.001), Pathological N-staging status (pN status) (P=0.001) and histological differentiation (P=0.002) were significantly associated with OS. Based on multivariate analysis, LDL [hazard ratio (HR)=2.164, P=0.005], pT status (HR=1.714, P=0.001), pN status (HR=1.966, P=0.001) and histological differentiation (HR=4.083, P=0.002) were risk factors in patients with ESCC. A high LDL level (>3.12 mmol/l) was associated with sex (P=0.001), tumor location (P=0.004) and a higher susceptibility to lymphatic metastasis (P=0.007). A CCK8 assay demonstrated that LDL promoted TE-1 and ECa109 cell proliferation, and flow cytometry analysis revealed that treatment with LDL at an appropriate concentration resulted in an accumulation of cells in G2 phase and decreased the number of cells in G1 phase. In summary, the current study identified that preoperative LDL serum level serves an important role in predicting ESCC outcome as LDL promotes lymphatic metastasis. Furthermore, a preliminary mechanism for this association has been validated .
本研究的目的是探讨术前血清脂质水平在食管鳞状细胞癌（ESCC）患者中的预后作用，并初步探究血清脂质在该疾病中的作用机制。对242例ESCC患者术前的脂质水平进行了评估，包括总胆固醇、低密度脂蛋白（LDL）胆固醇、高密度脂蛋白（HDL）胆固醇和甘油三酯水平。为消除营养状况的影响，所有患者均已接受过食管切除术。进行单因素和多因素Cox回归分析以确定总生存期（OS）的预测因素。然后分析显著脂质指标与临床特征之间的关联，并使用TE-1和ECa109食管癌细胞系对结果进行验证。用细胞计数试剂盒-8（CCK8）检测评估细胞增殖，并用碘化丙啶染色和流式细胞术评估细胞周期。单因素分析显示，HDL（P=0.048）、LDL（P=0.020）、病理T分期状态（pT状态）（P=0.001）、病理N分期状态（pN状态）（P=0.001）和组织学分化（P=0.002）与OS显著相关。基于多因素分析，LDL [风险比（HR）=2.164，P=0.005]、pT状态（HR=1.714，P=0.001）、pN状态（HR=1.966，P=0.001）和组织学分化（HR=4.083，P=0.002）是ESCC患者的危险因素。高LDL水平（>3.12 mmol/l）与性别（P=0.001）、肿瘤位置（P=0.004）及更高的淋巴转移易感性（P=0.007）相关。CCK8检测表明，LDL促进TE-1和ECa109细胞增殖，流式细胞术分析显示，适当浓度的LDL处理导致细胞在G2期积累，G1期细胞数量减少。总之，本研究发现术前血清LDL水平在预测ESCC预后中起重要作用，因为LDL促进淋巴转移。此外，已验证了这种关联的初步机制。
