Pan Yangxun, Ye Zhiwei, Ling Yihong, Kong Lingheng, Wang Chenwei, Chen Gong, Wan Desen, Chen Minshan, Hu Dandan
Department of Liver Surgery, Sun Yat-Sen University Cancer Center, Guangzhou, China.
Department of Oncology-Pathology, Karolinska Institutet, Solna, Sweden.
Front Oncol. 2023 Jan 13;12:1089688. doi: 10.3389/fonc.2022.1089688. eCollection 2022.
The lipid metabolism status of patients with colorectal cancer (CRC) has not been understood comprehensively. The present study investigated the characteristics of lipid metabolism parameters in CRC patients with or without metastases and identified the independent prognostic factors of long-term prognosis.
The clinicopathological data of 231 CRC patients along with 259 formalin-fixed paraffin-embedded samples with or without liver or lung metastasis were retrieved and stained for apolipoprotein B (apoB) immunohistochemistry (IHC) in our center. The correlation and multivariable analysis between blood circulating apolipoprotein A-I (apoA1), apoB and overall survival (OS) were analyzed.
In the multivariable analysis, apoA1, apoB and apolipoprotein B and apolipoprotein A-I (apoB/A) ratio, were identified as independent prognostic factors for OS. Moreover, the apoB/A ratio showed a significantly negative association with OS time (R=-0.187, =0.004). CRC patients with low apoB/A ratio had better 1-, 3- and 5-year OS rates than those who had high apoB/A ratio (87.1%, 54.3%, and 37.1% vs. 92.5%, 72.0%, and 59.5%, respectively, =0.001). On histological level, similar expression intensity of apoB between primary CRC and liver metastases indicated better prognostic outcomes than those with different expression levels (100%, 83.3%, and 77.8% vs. 100%, 66.7%, and 33.3%, respectively; =0.033). Higher level of apoB in the primary CRC interprets into increased incidence of liver metastases. However, the apoB expression levels in the CRC tumor were not parallel to the circulating lipid metabolism parameters.
The apoB/A ratio was a reliable independent prognostic factor for predicting the long-term OS of CRC patients. Moreover, the IHC of the primary CRC and metastatic lesions verified the metastatic potential of apoB through a different aspect. Lipid metabolism status for cancer progression reported in the present study possessed potentially prognostic value, but bench-scale studies are needed for their future clinical applications.
结直肠癌（CRC）患者的脂质代谢状况尚未得到全面了解。本研究调查了有或无转移的CRC患者脂质代谢参数的特征，并确定了长期预后的独立预测因素。
检索了231例CRC患者以及259份有或无肝或肺转移的福尔马林固定石蜡包埋样本的临床病理数据，并在本中心进行载脂蛋白B（apoB）免疫组织化学（IHC）染色。分析了血液循环中载脂蛋白A-I（apoA1）、apoB与总生存期（OS）之间的相关性及多变量分析。
在多变量分析中，apoA1、apoB以及载脂蛋白B与载脂蛋白A-I（apoB/A）比值被确定为OS的独立预测因素。此外，apoB/A比值与OS时间呈显著负相关（R=-0.187，P=0.004）。apoB/A比值低的CRC患者1年、3年和5年总生存率高于apoB/A比值高的患者（分别为87.1%、54.3%和37.1% 对比 92.5%、72.0%和59.5%，P=0.001）。在组织学水平上，原发性CRC与肝转移灶之间apoB表达强度相似的患者预后好于表达水平不同的患者（分别为100%、83.3%和77.8% 对比 100%、66.7%和33.3%；P=0.033）。原发性CRC中较高水平的apoB意味着肝转移发生率增加。然而，CRC肿瘤中的apoB表达水平与循环脂质代谢参数并不平行。
apoB/A比值是预测CRC患者长期OS的可靠独立预测因素。此外，原发性CRC和转移灶的IHC从不同方面证实了apoB的转移潜能。本研究报道的癌症进展过程中的脂质代谢状况具有潜在的预后价值，但未来临床应用还需要基础研究。
