Novel parameter based on lipid indicators ratio improves prognostic value of plasma lipid levels in resectable colorectal cancer patients

World J Gastrointest Surg. 2021 Jul 27;13(7):689-701. doi: 10.4240/wjgs.v13.i7.689.


Background: At present, the value of lipid indicators in evaluating the prognosis of colorectal cancer is still relatively limited.

Aim: To evaluate the value of a novel parameter for colorectal cancer (CRC) prognosis scoring based on preoperative serum lipid levels.

Methods: Four key serum lipid factors, namely, high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), apolipoprotein A1 (ApoA1), and apolipoprotein B (ApoB), were detected. Two representative ratios, HDL-C-LDL-C ratio (HLR) and ApoA1-ApoB ratio (ABR) were calculated. The relationship of these parameters with the prognosis of CRC patients including progression-free survival (PFS) and overall survival (OS) was analyzed by Kaplan-Meier plot and Cox proportional hazards regression. A novel lipoprotein cholesterol-apolipoprotein (LA) score based on HLR and ABR was established and its value in prognosis evaluation for CRC patients was explored.

Results: Multivariate Cox proportional hazards regression analysis of PFS and OS showed that HDL-C, ApoA1, HLR, and ABR were positively associated with the prognosis of CRC patients. LA score was independently associated with a good prognosis in resectable CRC patients. Data processing of a dummy variable showed that the prognosis of patients with higher LA scores is better than that with lower LA scores.

Conclusion: The newly established LA score might serve as a better predictor of the prognosis of resectable CRC patients.

Keywords: Apolipoprotein A1-apolipoprotein B ratio; Colorectal cancer; High-density lipoprotein cholesterol-low-density lipoprotein cholesterol ratio; Liptein cholesterol-apolipoprotein score; Prognosis.