Gao Wendong, Yao Yilin, Gao Qilong, Zhao Tiancheng, Li Hegen
Department of Oncology, Longhua Hospital, Shanghai University of Traditional Chinese Medicine, 725 Wanping South Road, Xuhui District, Shanghai, 200032, China.
Department of Integrated Traditional Chinese and Western Medicine, The Affiliated Cancer Hospital of Zhengzhou University, Henan Cancer Hospital, Zhengzhou, 450008, China.
World J Surg Oncol. 2025 Jun 13;23(1):234. doi: 10.1186/s12957-025-03875-2.
Whether serum lipids have an impact on breast cancer(BC) prognosis remains controversial and unstudied. We conducted this systematic review (SR) and meta-analysis (MA) to explore the impact of levels of various components of the lipid profile on multiple survival outcomes (OSs) of BC.
We searched Pubmed, Embase, Cochrane Library, and Web of Science for relevant cohort studies to assess the impact of multiple lipids on the prognosis of BC patients. Included studies were subjected to quality assessment using the Newcastle-Ottawa scale (NOS). MA of extracted data was performed using StataSE 15.1.
17 studies in total were included, involving a sample size of 24,026. MA showed that high levels of low-density lipoprotein cholesterol (LDL-C ) (HR (hazard ratios) = 1.96, 95% confidence interva (CI): 1.03-3.73), apolipoprotein E (ApoE) (HR = 3.68, 95% CI: 1.71-7.94), and apolipoprotein B (ApoB) (HR = 1.93, 95% CI: 1.44-2.59) were associated with poorer OS, while high levels of low-density lipoprotein (LDL) (HR = 0.81, 95% CI. 0.74-0.88) and apolipoprotein D (ApoD) (HR = 0.44, 95% CI: 0.24-0.81) were associated with better OS. Both a high level of total cholesterol (TC) (HR = 1.60, 95% CI:1.08-2.37) and dyslipidemia (HR = 1.71, 95% CI:1.12-2.62) had a negative impact on disease-free survival (DFS) in BC patients.
This MA showed that the levels of LDL-C, ApoE, and ApoB in serum were associated with OS, and the TC level in serum and dyslipidemia were associated with DFS. However, the levels of blood lipids were less associated with other prognostic outcomes. Other high-quality studies are needed to further elucidate this issue.
PROSPERO CRD42024541755.
血清脂质是否会影响乳腺癌（BC）的预后仍存在争议且尚未得到研究。我们进行了这项系统评价（SR）和荟萃分析（MA），以探讨脂质谱各成分水平对BC多种生存结局（OS）的影响。
我们在PubMed、Embase、Cochrane图书馆和Web of Science中检索相关队列研究，以评估多种脂质对BC患者预后的影响。纳入的研究使用纽卡斯尔-渥太华量表（NOS）进行质量评估。使用StataSE 15.1对提取的数据进行MA。
总共纳入了17项研究，样本量为24,026。MA显示，高水平的低密度脂蛋白胆固醇（LDL-C）（风险比（HR）=1.96，95%置信区间（CI）：1.03 - 3.73）、载脂蛋白E（ApoE）（HR = 3.68，95% CI：1 .71 - 7.94）和载脂蛋白B（ApoB）（HR = 1.93，95% CI：1.44 - 2.59）与较差的OS相关，而高水平的低密度脂蛋白（LDL）（HR = 0.81，95% CI：0.74 - 0.88）和载脂蛋白D（ApoD）（HR = 0.44，95% CI：0.24 - 0.81）与较好的OS相关。高水平的总胆固醇（TC）（HR = 1.60，95% CI：1.08 - 2.37）和血脂异常（HR = 1.71，95% CI：1.12 - 2.62）均对BC患者的无病生存期（DFS）有负面影响。
这项MA表明，血清中LDL-C、ApoE和ApoB的水平与OS相关，血清TC水平和血脂异常与DFS相关。然而，血脂水平与其他预后结局的关联较小。需要其他高质量研究来进一步阐明这个问题。
PROSPERO CRD42024541755
