Yu Tiantian, Luo Dan, Luo Cancan, Xu-Monette Zijun Y, Yu Li
Department of Hematology, The Second Affiliated Hospital of Nanchang University Nanchang, Jiangxi, China.
Division of Hematopathology and Department of Pathology, Duke University Medical Center Durham, NC, USA.
Am J Cancer Res. 2023 Feb 15;13(2):475-484. eCollection 2023.
Lipid metabolism is associated with lymphomagenesis and functions as a new therapeutic target in patients with lymphoma. Several serum lipids and lipoproteins have prognostic value in solid tumors; however, their value in diffuse large B-cell lymphoma (DLBCL) has been poorly described. We retrospectively analyzed and compared pre-treatment serum lipid and lipoprotein levels, including triacylglycerol (TG), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), apolipoprotein A-I (ApoA-I), and apolipoprotein B (ApoB) between 105 DLBCL and 105 controls (no DLBCL). The prognostic significance of serum lipid and lipoprotein levels was determined using univariate and multivariate Cox proportional hazards models. The primary outcomes, overall survival (OS) and progression-free survival (PFS), were assessed by the Kaplan-Meier method. We combined the International Prognostic Index (IPI) with ApoA-I to build a nomogram model (IPI-A) to predict the OS and PFS of DLBCL. Serum TG, LDL-C, HDL-C, ApoA-I, and ApoB levels were significantly lower in the DLBCL patients than in controls and significantly increased after chemotherapy. Multivariate analyses showed that the ApoA-I level was an independent predictor of OS and PFS. In addition, our findings indicated that the prognostic index IPI-A significantly improves risk prediction over the traditional IPI score system. ApoA-I is an independent prognostic factor associated with poor OS and PFS in DLBCL patients. Our findings suggested that IPI-A is a prognostic index accurately used for risk assessment in patients with DLBCL.
脂质代谢与淋巴瘤发生相关，并作为淋巴瘤患者的一个新治疗靶点。几种血清脂质和脂蛋白在实体瘤中具有预后价值；然而，它们在弥漫性大B细胞淋巴瘤（DLBCL）中的价值鲜有描述。我们回顾性分析并比较了105例DLBCL患者与105例对照者（无DLBCL）治疗前的血清脂质和脂蛋白水平，包括三酰甘油（TG）、低密度脂蛋白胆固醇（LDL-C）、高密度脂蛋白胆固醇（HDL-C）、载脂蛋白A-I（ApoA-I）和载脂蛋白B（ApoB）。使用单因素和多因素Cox比例风险模型确定血清脂质和脂蛋白水平的预后意义。通过Kaplan-Meier法评估主要结局，即总生存期（OS）和无进展生存期（PFS）。我们将国际预后指数（IPI）与ApoA-I相结合构建了一个列线图模型（IPI-A），以预测DLBCL的OS和PFS。DLBCL患者的血清TG、LDL-C、HDL-C、ApoA-I和ApoB水平显著低于对照组，化疗后显著升高。多因素分析显示，ApoA-I水平是OS和PFS的独立预测因素。此外，我们的研究结果表明，预后指数IPI-A在风险预测方面显著优于传统的IPI评分系统。ApoA-I是与DLBCL患者OS和PFS不良相关的独立预后因素。我们的研究结果提示，IPI-A是一种可准确用于评估DLBCL患者风险的预后指数。
