The Effect of Preoperative Apolipoprotein A-I on the Prognosis of Surgical Renal Cell Carcinoma: A Retrospective Large Sample Study.
The Effect of Preoperative Apolipoprotein A-I on the Prognosis of Surgical Renal Cell Carcinoma: A Retrospective Large Sample Study.
复制标题
DOI：
10.1097/md.0000000000003147
复制
发表时间：
2016-03
期刊：
影响因子：
1.6
通讯作者：
Han H
中科院分区：
文献类型：
--
作者：
Guo S;He X;Chen Q;Yang G;Yao K;Dong P;Ye Y;Chen D;Zhang Z;Qin Z;Liu Z;Li Z;Xue Y;Zhang M;Liu R;Zhou F;Han H
肾细胞癌 (RCC) 中血清脂质谱的预后价值仍不清楚。该研究的目的是探讨血清脂质谱与肾细胞癌患者之间的关联。回顾性分析 786 例肾细胞癌患者的术前血脂水平（包括胆固醇、甘油三酯、高密度脂蛋白胆固醇 [HDL-C]、低密度脂蛋白胆固醇 [LDL-C]、载脂蛋白 A-I [ApoA-I] 和载脂蛋白 B [ApoB]）。通过接受者操作特征（ROC）曲线分析确定脂质的截止值。采用单变量和多变量 Cox 回归分析来研究血清脂质在 RCC 中的预后价值。结合 ROC 分析以及单变量和多变量 Cox 回归分析，对于总生存 (OS)，显示低 ApoA-I (<1.04) 患者的 OS 显着低于高 ApoA-I (≥1.04) 组（多变量 Cox 回归分析，风险比 [HR]，0.57；P = 0.003）。不仅在整个 RCC 队列中，而且在根据 pT1-2 (P = 0.002)、pN0 (P < 0.001) 和 pM0 (P = 0.001) 状态分层的亚组中，分别。此外，在 755 名非转移患者中，与高 ApoA-I 组相比，低 ApoA-I 组还与缩短的无病生存 (DFS) 时间相关（多变量 Cox 回归分析，HR，0.65；P = 0.033）。然而，其他脂质并不是手术肾细胞癌的独立预后因素。术前 ApoA-I 水平升高被证明与手术肾细胞癌患者的更好生存相关。测量术前 ApoA-I 可能是发现应参加进一步临床试验和管理的预后不良患者的简单方法。
The prognostic value of serum lipid-profile in renal cell cancer (RCC) remains unknown. The purpose of the study is to explore the association between the serum lipid-profile and RCC patients. The levels of preoperative serum lipid-profile (including cholesterol, triglycerides, high-density lipoprotein-cholesterol [HDL-C], low-density lipoprotein-cholesterol [LDL-C], apolipoprotein A-I [ApoA-I], and apolipoprotein B [ApoB]) were retrospectively performed in 786 patients with RCC. The cutoff values of the lipids were determined by the receiver-operating characteristic (ROC) curve analysis. Univariate and multivariate Cox regression analyses were performed to investigate the prognostic value of serum lipids in RCC. Combined ROC analysis and univariate and multivariate Cox regression analyses, for overall survival (OS), revealed patients with low ApoA-I (<1.04) had significantly lower OS than the high ApoA-I (≥1.04) group (multivariate Cox regression analyses, hazard ratio [HR], 0.57; P = 0.003). Not only in the whole RCC cohort but also in the subgroups stratified according to the pT1-2 (P = 0.002), pN0 (P < 0.001), and pM0 (P = 0.001) status, respectively. Moreover, in the 755 patients with nonmetastasis, the low ApoA-I group was also associated with shortened disease-free survival (DFS) time compared to the high ApoA-I group (multivariate Cox regression analyses, HR, 0.65; P = 0.033). However, the other lipids were not independent prognostic factors for surgical RCC. An elevated level of preoperative ApoA-I was demonstrated to be related with better survival in patients with surgical RCC. Measuring the preoperative ApoA-I might be a simple way for finding the poor prognostic patients who should enrolled in further clinical trials and management.