Department of Medical Oncology, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, Guangdong, People's Republic of China.
Department of Clinical Laboratory, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, Guangdong, People's Republic of China.
Cancer Control. 2021 Jan-Dec;28:10732748211028257. doi: 10.1177/10732748211028257.
To investigate the clinical significance of dynamic alteration of serum lipids in limited stage small cell lung cancer (LS-SCLC) patients and the risk that different lipid profiles poses to patients' health.
We retrospectively analyzed the variation trends and prognostic values of serum lipids in 310 LS-SCLC patients who had received standard chemotherapy between 2002 and 2017. In addition to serum lipid level, which were measured at the time of pretreatment, after-chemotherapy and during disease progression and later analyzed, the dynamic lipid alteration trend and its correlation to progression-free survival (PFS) and overall survival (OS) were also statistically analyzed using Log-rank test and COX regression analyses.
A significant decrease in HDL-C level was observed after standard chemotherapy (Post-CT baseline = -0.08 ± 0.34, < 0.001), and this trend of reduction was further enhanced by thoracic radiotherapy ( = 0.046). Increase in LDL-C level was also observed to be associated with higher likelihood of disease progression ( = 0.003). Moreover, the extent of the increase in LDL-C was also associated with the number of progression sites, as patients with higher increase in LDL-C in exhibiting a progression at more than 2 sites outside thorax ( = 0.037). The patients' median PFS and OS were 14.04 months (95%CI: 25.12-33.81) and 22.40 months (95%CI: 33.19-42.13), respectively. For both PFS and OS, LDL-C elevation remained an independent prognostic factor in the multivariate model ( = 0.007 and = 0.022, respectively).
Overall, for LS-SCLC patients, standard chemotherapy decreases the level of HDL-C, the level of increase in LDL-C could predict disease progression and even the number of progression sites, and LDL-C elevation could be an independent prognostic factor for poor OS and PFS.
探讨局限期小细胞肺癌（LS-SCLC）患者血清脂质动态变化的临床意义，以及不同血脂谱对患者健康的风险。
我们回顾性分析了 2002 年至 2017 年间接受标准化疗的 310 例 LS-SCLC 患者的血脂变化趋势和预后价值。除了在治疗前、化疗后和疾病进展时测量的血清脂质水平外，还使用 Log-rank 检验和 COX 回归分析对动态脂质变化趋势及其与无进展生存期（PFS）和总生存期（OS）的相关性进行了统计学分析。
标准化疗后观察到 HDL-C 水平显著降低（Post-CT 基线=-0.08±0.34，<0.001），且胸部放疗进一步增强了这种降低趋势（=0.046）。LDL-C 水平的升高也与疾病进展的可能性增加相关（=0.003）。此外，LDL-C 的升高程度也与进展部位的数量有关，因为 LDL-C 升高程度较高的患者在胸部以外有超过 2 个部位进展（=0.037）。患者的中位 PFS 和 OS 分别为 14.04 个月（95%CI：25.12-33.81）和 22.40 个月（95%CI：33.19-42.13）。对于 PFS 和 OS，LDL-C 升高在多变量模型中仍然是一个独立的预后因素（=0.007 和=0.022）。
总的来说，对于 LS-SCLC 患者，标准化疗会降低 HDL-C 水平，LDL-C 水平的升高可预测疾病进展，甚至进展部位的数量，LDL-C 升高可能是 OS 和 PFS 不良的独立预后因素。
