Xu Xin-Jian, Liu Shi-Wei, Li Jia-Qi, He Ming, Wang Hui, Meng Qing-Ju
Postdoctoral Research Station of Hebei Medical University, Department of Thoracic Surgery, The Fourth Hospital of Hebei Medical University, Shijiazhuang 050011, Hebei Province, China.
Department of Oncology, The First Affiliated Hospital of Xingtai Medical College, Xingtai 054001, Hebei Province, China.
World J Gastrointest Surg. 2025 Aug 27;17(8):106898. doi: 10.4240/wjgs.v17.i8.106898.
Esophageal cancer (EC) is one of the most common malignancies worldwide, and lymph node (LN) metastasis remains one of the leading causes of EC recurrence. Metabolic disorders critically affect cancer progression, and lipid levels are closely associated with the occurrence of EC and several other tumor types. This study analyzed pretreatment lipid levels to determine their association with LN metastasis.
To dissect the possible mechanisms underlying LN metastasis and clarify the prognostic role of lipid profiles in EC.
Serum lipid levels and clinicopathological information were retrospectively collected from 294 patients, and risk factors for LN metastasis were confirmed using a logistic regression model. Latent factors were explored using information from publicly accessible databases and immunofluorescence and immunohistochemical staining techniques.
High serum levels of low-density lipoprotein (LDL) cholesterol promote LN metastasis in EC, while high-density lipoprotein cholesterol has the opposite role. Information of a public database revealed that LDL receptors LRP5 and LRP6 are highly expressed in ECs, and LRP6 overexpression positively correlated with the infiltration of B lymphocytes and a poor prognosis. Immunofluorescence and immunohistochemical staining revealed that the expression of LRP6 and infiltrated B lymphocytes in patients with ≥ 1 regional LN metastasis, containing N1-3 (N+ group) were significantly higher than those in the N0 group. LRP6 was also highly expressed in the B lymphocytes of the N+ group. There was no difference in CXCL13 expression between the N+ and N0 groups. However, CXCR5 expression was significantly higher in the N0 group than in the N+ group.
High serum LDL levels can promote LN metastasis in EC, and the mechanisms may be related to LRP6 expression and the infiltration of B lymphocytes.
食管癌（EC）是全球最常见的恶性肿瘤之一，淋巴结（LN）转移仍然是EC复发的主要原因之一。代谢紊乱严重影响癌症进展，血脂水平与EC及其他几种肿瘤类型的发生密切相关。本研究分析了治疗前血脂水平，以确定其与LN转移的关系。
剖析LN转移的潜在机制，阐明血脂谱在EC中的预后作用。
回顾性收集294例患者的血脂水平和临床病理信息，并使用逻辑回归模型确定LN转移的危险因素。利用公开数据库的信息以及免疫荧光和免疫组织化学染色技术探索潜在因素。
血清低密度脂蛋白（LDL）胆固醇水平升高促进EC中的LN转移，而高密度脂蛋白胆固醇则起相反作用。一个公共数据库的信息显示，LDL受体LRP5和LRP6在EC中高表达，LRP6过表达与B淋巴细胞浸润及不良预后呈正相关。免疫荧光和免疫组织化学染色显示，≥1个区域LN转移（包含N1-3，N+组）患者中LRP6的表达和浸润的B淋巴细胞显著高于N0组。LRP6在N+组的B淋巴细胞中也高表达。N+组和N0组之间CXCL13表达无差异。然而，N0组中CXCR5表达显著高于N+组。
血清LDL水平升高可促进EC中的LN转移，其机制可能与LRP6表达和B淋巴细胞浸润有关。
