Predictive value of a reduction in the level of high-density lipoprotein-cholesterol in patients with non-small-cell lung cancer undergoing radical resection and adjuvant chemotherapy: a retrospective observational study

• Published in: Lipids in health and disease Vol. 20; no. 1; pp. 109 - 14
• Main Authors: Luo, Fan, Zeng, Kang-mei, Cao, Jia-xin, Zhou, Ting, Lin, Su-xia, Ma, Wen-juan, Yang, Yun-peng, Zhang, Zhong-han, Lu, Fei-teng, Huang, Yan, Zhao, Hong-yun, Zhang, Li
• Format: Journal Article
• Language: English
• Published: England BioMed Central Ltd 20.09.2021; BioMed Central; BMC
• Subjects: Adjuvant chemotherapy; Adjuvant treatment; Adult; Aged; Apolipoprotein A-I - blood; Apolipoprotein B-100 - blood; Apolipoproteins; Cancer; Cancer therapies; Carcinoma, Non-Small-Cell Lung - blood; Carcinoma, Non-Small-Cell Lung - diagnosis; Carcinoma, Non-Small-Cell Lung - mortality; Carcinoma, Non-Small-Cell Lung - surgery; Care and treatment; Cell survival; Chemotherapy; Chemotherapy, Adjuvant; Cholesterol; Cholesterol, HDL; Cholesterol, HDL - blood; Cholesterol, LDL - blood; Diabetes; Disease; Disease-Free Survival; Drugs; Fasting; Female; Health aspects; Hepatic lobectomy; High density lipoprotein; High-density lipoprotein-cholesterol; Histology; Humans; Hypertension; Lipids; Lipoproteins; Low density lipoprotein; Lung cancer; Lung cancer, Non-small cell; Lung Neoplasms - blood; Lung Neoplasms - diagnosis; Lung Neoplasms - mortality; Lung Neoplasms - surgery; Male; Measurement; Medical prognosis; Medical screening; Metabolic syndrome; Middle Aged; Neoplasm Staging - methods; Non-small cell lung carcinoma; Non-small-cell lung cancer; Observational studies; Patient outcomes; Patients; Pneumonectomy; Prognosis; Retrospective Studies; Small cell lung carcinoma; Surgery; Triglycerides - blood; Tumors; China; United States > US; Non-small-cell lung cancer; Adjuvant chemotherapy; Prognosis; High-density lipoprotein-cholesterol; Disease-free survival
• ISSN: 1476-511X; 1476-511X
• DOI: 10.1186/s12944-021-01538-1

Cancer patients often exhibit chemotherapy-associated changes in serum lipid profiles, however, their prognostic value before and after adjuvant chemotherapy on survival among non-small-cell lung cancer (NSCLC) patients is unknown. NSCLC patients undergoing radical resection and subsequent adjuvant chemotherapy from 2013 to 2017 at Sun Yat-sen University Cancer Center were retrospectively reviewed. Fasted serum lipid levels were measured before and after chemotherapy. The optimal lipid cut-off values at baseline and fluctuation were determined using X-tile™. The fluctuations in serum lipid levels and disease-free survival (DFS) were assessed. Serum cholesterol, low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein-cholesterol (HDL-C), triglyceride, apolipoprotein (Apo) A-I, and ApoB all significantly increased after adjuvant chemotherapy. X-tile determined 1.52 mmol/L of HDL-C and 0.74 g/L of ApoB as the optimal cut-off values before chemotherapy. Patients with HDL-C ≥ 1.52 mmol/L (median DFS: not reached vs. 26.30 months, P = 0.0005) and a decreased HDL-C level after adjuvant chemotherapy (median DFS: 80.43 vs. 26.12 months, P = 0.0204) had a longer DFS. An HDL-C level that increased by ≥ 0.32 mmol/L after chemotherapy indicated a worse DFS. A high baseline ApoB level were associated with a superior DFS. In the univariate analysis and the multivariate Cox analyses, a high baseline HDL-C level and a HDL-C reduction after adjuvant chemotherapy were independent indicators for superior DFS. High baseline HDL-C was related to N0-1 stage (χ  = 6.413, P = 0.011), and HDL-C fluctuation was significantly correlated with specific chemotherapy regimens (χ  = 5.002, P = 0.025). Adjuvant chemotherapy increased various lipid levels in resected NSCLC patients. A higher HDL-C level before chemotherapy and a reduced HDL-C level after adjuvant chemotherapy were independent predictors of longer DFS in patients with curable NSCLC.