Dong Ya, Wang Haocheng, Shan Dongfeng, Zhang Linwei, Yu Zhuang
Department of Oncology, The Affiliated Hospital of Qingdao University, Qingdao 266003, China.
Zhongguo Fei Ai Za Zhi. 2020 Oct 20;23(10):845-851. doi: 10.3779/j.issn.1009-3419.2020.104.21.
Lung cancer is the leading cause of cancer-related death, and small cell lung cancer (SCLC) has a poor prognosis in all types of lung cancer. This study evaluated the relationship between pretreatment serum apolipoprotein levels and prognosis in patients with SCLC, seeks a new index can guide diagnosis and treatment of SCLC.
This study retrospectively analyzed the clinical data of 122 patients with SCLC. The clinical results of patients with serum apolipoprotein levels within 2 weeks before treatment were collected, including apolipoprotein AI (ApoA-I), apolipoprotein B (ApoB), and the ratio of apolipoprotein B to apolipoprotein AI (ApoB/ApoA-I). Patients' progression-free survival (PFS) and overall survival (OS) are the main outcome indicators. The best critical to determine the index's value by X-tile tool. For survival analysis, Kaplan-Meier method was used for analysis, and Cox regression analysis method was used for single factor analysis and multifactor analysis.
Compared with patients with low ApoA-I levels, patients with high ApoA-I levels (ApoA-I>1.12 g/L) had better OS (21.5 mon vs 12.3 mon, P=0.007) and PFS (7.3 mon vs 5.5 mon, P=0.017). In contrast, patients with higher ApoB/ApoA-I levels had worse median OS than patients with lower ApoB/ApoA-I levels (13.4 mon vs 20.7 mon, P=0.012). Multivariate Cox regression analysis showed that ApoA-I was an independent prognostic factor affecting PFS in SCLC patients (HR=0.67, 95%CI: 0.45-0.99, P=0.043). ApoB/ApoA-I is an independent risk factor for OS in patients with SCLC (HR=1.98, 95%CI: 1.21-3.23, P=0.007).
Serum ApoA-I level and ApoB/ApoA-I level before treatment can be important prognostic factors for SCLC, which is helpful to judge the prognosis of patients.
肺癌是癌症相关死亡的主要原因，而小细胞肺癌（SCLC）在所有类型的肺癌中预后较差。本研究评估了SCLC患者治疗前血清载脂蛋白水平与预后的关系，旨在寻找一个可指导SCLC诊断和治疗的新指标。
本研究回顾性分析了122例SCLC患者的临床资料。收集患者治疗前2周内血清载脂蛋白水平的临床结果，包括载脂蛋白AI（ApoA-I）、载脂蛋白B（ApoB）以及载脂蛋白B与载脂蛋白AI的比值（ApoB/ApoA-I）。患者的无进展生存期（PFS）和总生存期（OS）为主要观察指标。通过X-tile工具确定指标价值的最佳临界值。生存分析采用Kaplan-Meier法进行分析，单因素分析和多因素分析采用Cox回归分析方法。
与ApoA-I水平低的患者相比，ApoA-I水平高（ApoA-I>1.12 g/L）的患者OS更好（21.5个月对12.3个月，P=0.007），PFS也更好（7.3个月对5.5个月，P=0.017）。相反，ApoB/ApoA-I水平较高的患者中位OS比ApoB/ApoA-I水平较低的患者更差（13.4个月对20.7个月，P=0.012）。多因素Cox回归分析显示，ApoA-I是影响SCLC患者PFS的独立预后因素（HR=0.67，95%CI：0.45-0.99，P=0.043）。ApoB/ApoA-I是SCLC患者OS的独立危险因素（HR=1.98，95%CI：1.21-3.23，P=0.007）。
治疗前血清ApoA-I水平和ApoB/ApoA-I水平可作为SCLC重要的预后因素，有助于判断患者的预后。
