Central Lab, First Affiliated Hospital, Fujian Medical University, No. 20 Chazhong Road, Taijiang District, Fuzhou, 350005, Fujian, China.
Central Laboratory, National Regional Medical Center, Binhai Campus of the First Affiliated Hospital, Fujian Medical University, Fuzhou, 350212, Fujian, China.
Cancer Causes Control. 2023 Sep;34(9):801-811. doi: 10.1007/s10552-023-01710-1. Epub 2023 Jun 1.
To investigate the effect of serum lipids concentration on the prognosis of high-grade glioma patients undergoing postoperative radiotherapy.
Retrospective analysis of the patients with high-grade glioma who received postoperative Intensity Modulated Radiotherapy between 13 May 2013 and 12 September 2018 was performed. The patients were grouped according to the average values of serum total cholesterol, LDL, and HDL concentration in peripheral blood (before surgery, 6 months after therapy). Cox proportional hazards model was performed to determine whether the total cholesterol concentration, LDL concentration, and HDL concentration in peripheral blood before therapy and their changes after therapy were factors influencing the prognosis.
The results of COX regression analysis showed that the independent prognostic factors of high-grade glioma patients were pathological grade, the extent of resection, serum cholesterol concentration pre-surgery, and the change of LDL concentration from pre-surgery to post-therapy. The prognosis of patients with high serum total cholesterol concentration before therapy was worse than those of patients with low total cholesterol concentration. The 5-year survival rate and the median survival time of patients with high serum total cholesterol concentration before therapy were 4.9% and 23.6 months, but the low cholesterol concentration group were 19.6% and 24.5 months, respectively. Besides, the average serum LDL concentration in high-grade glioma patients gradually increased after therapy. The 5-year survival rate of patients and the median survival time with elevated LDL concentration after therapy is 11.8% and 20.4 months, but the reduced LDL concentration group was 16.7% and 28.4 months, respectively. The total cholesterol and LDL concentration increased significantly after therapy in Grade IV patients while Grade III patients did not.
The cholesterol concentration before therapy and LDL concentration change from pre-surgery to post-therapy are the factors that affect the prognosis of high-grade glioma patients who have undergone postoperative radiotherapy. In the final analysis, the high serum cholesterol pre-surgery and the increased in serum LDL concentration from pre-surgery to post-therapy were associated with worse survival of patients.
探讨血清脂质浓度对行术后放疗的高级别脑胶质瘤患者预后的影响。
对 2013 年 5 月 13 日至 2018 年 9 月 12 日接受术后调强放疗的高级别脑胶质瘤患者进行回顾性分析。根据外周血（术前、治疗后 6 个月）中总胆固醇、LDL 和 HDL 浓度的平均值将患者分组。采用 Cox 比例风险模型确定治疗前外周血总胆固醇浓度、LDL 浓度和 HDL 浓度及其治疗后变化是否为影响预后的因素。
COX 回归分析结果显示，高级别脑胶质瘤患者的独立预后因素为病理分级、切除程度、术前血清胆固醇浓度以及术前至术后 LDL 浓度变化。治疗前血清总胆固醇浓度较高的患者预后较差，治疗前血清总胆固醇浓度较高的患者 5 年生存率和中位生存时间分别为 4.9%和 23.6 个月，而低胆固醇浓度组分别为 19.6%和 24.5 个月。此外，高级别脑胶质瘤患者治疗后平均血清 LDL 浓度逐渐升高。治疗后 LDL 浓度升高患者的 5 年生存率和中位生存时间为 11.8%和 20.4 个月，而 LDL 浓度降低组为 16.7%和 28.4 个月。IV 级患者治疗后总胆固醇和 LDL 浓度显著升高，而 III 级患者则没有。
治疗前胆固醇浓度和治疗前后 LDL 浓度变化是影响术后放疗的高级别脑胶质瘤患者预后的因素。归根结底，术前高血清胆固醇和术前至术后血清 LDL 浓度增加与患者生存不良相关。
