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The Effect of Preoperative Apolipoprotein A-I on the Prognosis of Surgical Renal Cell Carcinoma

View Article: PubMed Central - PubMed

ABSTRACT

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.

No MeSH data available.


Related in: MedlinePlus

Kaplan–Meier curves depicting OS according to preoperative ApoA-I levels in 786 patients with renal cell cancer. Patients were stratified according to the pT-status, pN-status, and pM-status. (A) Kaplan–Meier analysis of OS in T1-2 subgroup. (B) Kaplan–Meier analysis of OS in T3-4 subgroup. (C) Kaplan–Meier analysis of OS in N0 subgroup. (D) Kaplan–Meier analysis of OS in N1 subgroup. (E) Kaplan–Meier analysis of OS inM0 subgroup. (F) Kaplan–Meier analysis of OS in M1 subgroup. ApoA-I = apolipoprotein A-I, OS = overall survival.
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Figure 2: Kaplan–Meier curves depicting OS according to preoperative ApoA-I levels in 786 patients with renal cell cancer. Patients were stratified according to the pT-status, pN-status, and pM-status. (A) Kaplan–Meier analysis of OS in T1-2 subgroup. (B) Kaplan–Meier analysis of OS in T3-4 subgroup. (C) Kaplan–Meier analysis of OS in N0 subgroup. (D) Kaplan–Meier analysis of OS in N1 subgroup. (E) Kaplan–Meier analysis of OS inM0 subgroup. (F) Kaplan–Meier analysis of OS in M1 subgroup. ApoA-I = apolipoprotein A-I, OS = overall survival.

Mentions: To further investigate the prognostic significance of ApoA-I level in surgical RCC patients, the whole cohort was compared by the Kaplan–Meier method and the log-rank test. Patients with ApoA-I < 1.04 (n = 207) showed a significantly worse OS than the ApoA-I ≥ 1.04 group (n = 579) (ApoA-I < 1.04 vs ≥1.04, mean OS: 126.13 vs 141.78 months, respectively, P < 0.001, Figure 1A). We also evaluated the prognostic influence of the ApoA-I level in the subgroups based on the pT-status, pN-status, pM-status, respectively. Patients with a low ApoA-I level had a significantly shorter OS compared with those patients with a high ApoA-I level in the T1–2 subgroup (n = 676, ApoA-I < 1.04 vs ≥1.04, mean OS: 143.26 vs 149.91 months, respectively, P = 0.002, Figure 2A), N0 subgroup (n = 729, ApoA-I < 1.04 vs ≥1.04, mean OS: 134.03 vs 147.43 months, respectively, P < 0.001, Figure 2C), and M0 subgroup (n = 755, ApoA-I < 1.04 vs ≥1.04, mean OS: 134.68 vs 144.45 months, respectively, P = 0.001, Figure 2E). There was not statistical significance in the T3–4 subgroup (n = 110, ApoA-I < 1.04 vs ≥1.04, mean OS: 60.59 vs 88.33 months, respectively, P = 0.051, Figure 2B), N1 subgroup (n = 57, ApoA-I < 1.04 vs ≥1.04, mean OS: 51.89 vs 52.49 months, respectively, P = 0.254, Figure 2D), or M1 subgroup (n = 31, ApoA-I < 1.04 vs ≥1.04, mean OS: 30.29 vs 38.61 months, respectively, P = 0.384, Figure 2F).


The Effect of Preoperative Apolipoprotein A-I on the Prognosis of Surgical Renal Cell Carcinoma
Kaplan–Meier curves depicting OS according to preoperative ApoA-I levels in 786 patients with renal cell cancer. Patients were stratified according to the pT-status, pN-status, and pM-status. (A) Kaplan–Meier analysis of OS in T1-2 subgroup. (B) Kaplan–Meier analysis of OS in T3-4 subgroup. (C) Kaplan–Meier analysis of OS in N0 subgroup. (D) Kaplan–Meier analysis of OS in N1 subgroup. (E) Kaplan–Meier analysis of OS inM0 subgroup. (F) Kaplan–Meier analysis of OS in M1 subgroup. ApoA-I = apolipoprotein A-I, OS = overall survival.
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Figure 2: Kaplan–Meier curves depicting OS according to preoperative ApoA-I levels in 786 patients with renal cell cancer. Patients were stratified according to the pT-status, pN-status, and pM-status. (A) Kaplan–Meier analysis of OS in T1-2 subgroup. (B) Kaplan–Meier analysis of OS in T3-4 subgroup. (C) Kaplan–Meier analysis of OS in N0 subgroup. (D) Kaplan–Meier analysis of OS in N1 subgroup. (E) Kaplan–Meier analysis of OS inM0 subgroup. (F) Kaplan–Meier analysis of OS in M1 subgroup. ApoA-I = apolipoprotein A-I, OS = overall survival.
Mentions: To further investigate the prognostic significance of ApoA-I level in surgical RCC patients, the whole cohort was compared by the Kaplan–Meier method and the log-rank test. Patients with ApoA-I < 1.04 (n = 207) showed a significantly worse OS than the ApoA-I ≥ 1.04 group (n = 579) (ApoA-I < 1.04 vs ≥1.04, mean OS: 126.13 vs 141.78 months, respectively, P < 0.001, Figure 1A). We also evaluated the prognostic influence of the ApoA-I level in the subgroups based on the pT-status, pN-status, pM-status, respectively. Patients with a low ApoA-I level had a significantly shorter OS compared with those patients with a high ApoA-I level in the T1–2 subgroup (n = 676, ApoA-I < 1.04 vs ≥1.04, mean OS: 143.26 vs 149.91 months, respectively, P = 0.002, Figure 2A), N0 subgroup (n = 729, ApoA-I < 1.04 vs ≥1.04, mean OS: 134.03 vs 147.43 months, respectively, P < 0.001, Figure 2C), and M0 subgroup (n = 755, ApoA-I < 1.04 vs ≥1.04, mean OS: 134.68 vs 144.45 months, respectively, P = 0.001, Figure 2E). There was not statistical significance in the T3–4 subgroup (n = 110, ApoA-I < 1.04 vs ≥1.04, mean OS: 60.59 vs 88.33 months, respectively, P = 0.051, Figure 2B), N1 subgroup (n = 57, ApoA-I < 1.04 vs ≥1.04, mean OS: 51.89 vs 52.49 months, respectively, P = 0.254, Figure 2D), or M1 subgroup (n = 31, ApoA-I < 1.04 vs ≥1.04, mean OS: 30.29 vs 38.61 months, respectively, P = 0.384, Figure 2F).

View Article: PubMed Central - PubMed

ABSTRACT

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 (&lt;1.04) had significantly lower OS than the high ApoA-I (&ge;1.04) group (multivariate Cox regression analyses, hazard ratio [HR], 0.57; P&#8202;=&#8202;0.003). Not only in the whole RCC cohort but also in the subgroups stratified according to the pT1-2 (P&#8202;=&#8202;0.002), pN0 (P&#8202;&lt;&#8202;0.001), and pM0 (P&#8202;=&#8202;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&#8202;=&#8202;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.

No MeSH data available.


Related in: MedlinePlus