The serum levels of total cholesterol and LDL-cholesterol in prognostic effect for breast tumor

doi:10.3969/j.issn.1009-976X.2015.01.004

Abstract

Abstract:

【Abstract】〓Objective〓To investigate the value of plasma level of lipoprotein at prognosis of breast tumor. Methods〓Clinical data of 244 patients with breast cancer under therapy in the Sun Yat-sen Memorial Hospital and 99 healthy donors during November 2003 to September 2008. First, the plasma metabolic indexes were compared between the healthy donors and breast cancer patients. Furthermore, Spearman association showed breast cancer patients with high TC or LDL-C had larger tumor size and ER/PR deficiency. Cox regression model was used to analyze the disease free survival (DFS) curve and evaluate the prognostic factors of DFS. Results〓The plasma level of total cholesterol, LDL-C, triglyceride, glucose were higher in breast cancer patients than those in healthy donors, while HDL-C was reverse. The high plasma level of total cholesterol, LDL-C were more inclined to present at Her-2 positive or triple negative breast cancer, than ER/PR positive substyle. There was positive correction between tumor size and TC or LDL-C. Moreover, Cox regression model showed poorer DFS in the group with TC≥5.2 mmol/L or LDL-C>3.08 mmol/L than that with TC<5.2 mmol/L or LDL-C≤3.08 mmol/L (TC 68% vs 77.7%, LDL-C 73.4% vs 86.3%, P<0.05), which revealed that TC or LDL-C was independent prognostic factors of breast cancer progression. Conclusion〓Plasma level of TC or LDL-C was an independent prognostic factor of breast cancer progression.

Key words: Total cholesterol, LDL-C, DFS, Breast cancer

摘要：

【摘要】〓目的〓探讨血清中脂蛋白水平对乳腺癌预后的影响。方法〓回顾分析2003年11月至2008年9月在中山大学孙逸仙纪念医院初诊的244例乳腺癌患者及同期99例健康体者的临床资料。比较两者血清代谢指标的变化,Spearman相关分析总胆固醇、LDL-C与乳腺癌的肿瘤大小的关系,Cox回归模型评估影响无病生存率(DFS)的预后因素。结果〓乳腺癌患者血清总胆固醇(TC)、甘油三酯、低密度脂蛋白(LDL-C)、血糖较正常人高,而高密度脂蛋白(HDL-C)较正常人低;血清总胆固醇、LDL-C水平在ER/PR阳性乳腺癌患者中较Her-2阳性及三阴型乳腺癌低。血清总胆固醇、LDL-C与肿瘤的大小呈正相关。TC≥5.2 mmol/L 组或LDL-C>3.08 mmol/L 组的DFS较TC<5.2 mmol/L 组或LDL-C≤3.08mmol/L 组明显降低(TC 68% vs 77.7%, LDL-C 73.4% vs 86.3%, P<0.05)。结论〓高胆固醇、高LDL-C血症是乳腺癌独立的预后因素。

关键词: 总胆固醇, 低密度脂蛋白, 无病生存率, 乳腺癌

CLC Number:

R737.9

Lin Xiaorong, Huang Di, Chen Jingqi, Wu Zhiyong. The serum levels of total cholesterol and LDL-cholesterol in prognostic effect for breast tumor[J]. Lingnan Modern Clinics in Surgery, 2015, 15(01): 17-21.

林晓榕黄迪陈静琦吴智勇. 血清总胆固醇及低密度脂蛋白水平对乳腺癌预后的影响[J]. 岭南现代临床外科, 2015, 15(01): 17-21.

References

[1] Yager JD, Davidson NE.Estrogen carcinogenesis in breast cancer[J]. The New England journal of medicine 2006; 354:270-82.[J]., 2006, (354):-
[2] Bray F, McCarron P, Parkin DM.The changing global patterns of female breast cancer incidence and mortality[J]. Breast cancer research : BCR 2004; 6:229-39.
[3] Steinhagen-Thiessen E, Bramlage P, Losch C, et al.Dyslipidemia in primary care--prevalence, recognition, treatment and control: data from the German Metabolic and Cardiovascular Risk Project (GEMCAS) [J]. Cardiovascular diabetology 2008; 7:31.
[4] Ha M, Sung J, Song YM.Serum total cholesterol and the risk of breast cancer in postmenopausal Korean women[J]. Cancer causes & control : CCC 2009; 20:1055-60.
[5] Hoyer AP, Engholm G.Serum lipids and breast cancer risk: a cohort study of 5, 207 Danish women[J]. Cancer causes & control : CCC 1992; 3:403-8.
[6] Vatten LJ, Foss OP.Total serum cholesterol and triglycerides and risk of breast cancer: a prospective study of 24, 329 Norwegian women[J]. Cancer research 1990; 50:2341-6.
[7] Berrino F, Villarini A, Traina A, et al.Metabolic syndrome and breast cancer prognosis[J]. Breast cancer research and treatment 2014; 147:159-65.
[8] Kabat GC, Kim M, Chlebowski RT, et al.A longitudinal study of the metabolic syndrome and risk of postmenopausal breast cancer[J]. Cancer epidemiology, biomarkers & prevention : a publication of the American Association for Cancer Research, cosponsored by the American Society of Preventive Oncology 2009; 18:2046-53.
[9] Kim Y, Park SK, Han W, et al.Serum high-density lipoprotein cholesterol and breast cancer risk by menopausal status, body mass index, and hormonal receptor in Korea[J]. Cancer epidemiology, biomarkers & prevention : a publication of the American Association for Cancer Research, cosponsored by the American Society of Preventive Oncology 2009; 18:508-15.
[10] Bevers TB, Anderson BO, Bonaccio E, et al.NCCN clinical practice guidelines in oncology: breast cancer screening and diagnosis[J]. Journal of the National Comprehensive Cancer Network : JNCCN 2009; 7:1060-96.
[11] Yang WT, Zhu XZ.The introduction of 2012 WHO classification of tumours of the breast[J]. Zhonghua bing li xue za zhi Chinese journal of pathology 2013; 42:78-80.
[12] Antalis CJ, Arnold T, Rasool T, et al.High ACAT1 expression in estrogen receptor negative basal-like breast cancer cells is associated with LDL-induced proliferation[J]. Breast cancer research and treatment 2010; 122:661-70.
[13] Antalis CJ, Uchida A, Buhman KK, Siddiqui RA.Migration of MDA-MB-231 breast cancer cells depends on the availability of exogenous lipids and cholesterol esterification[J]. Clinical & experimental metastasis 2011; 28:733-41.
[14] Pan B, Ren H, Lv X, et al.Hypochlorite-induced oxidative stress elevates the capability of HDL in promoting breast cancer metastasis[J]. Journal of translational medicine 2012; 10:65.
[15] Pan B, Ren H, Ma Y, et al.High-density lipoprotein of patients with type 2 diabetes mellitus elevates the capability of promoting migration and invasion of breast cancer cells[J]. International journal of cancer Journal international du cancer 2012; 131:70-82.
[16] Nelson ER, Wardell SE, Jasper JS, et al.27-Hydroxycholesterol links hypercholesterolemia and breast cancer pathophysiology[J].Science 2013; 342:1094-8.
[17] Llaverias G, Danilo C, Mercier I, et al.Role of cholesterol in the development and progression of breast cancer[J]. The American journal of pathology 2011; 178:402-12.
[18] Alikhani N, Ferguson RD, Novosyadlyy R, et al.Mammary tumor growth and pulmonary metastasis are enhanced in a hyperlipidemic mouse model[J]. Oncogene 2013; 32:961-7.
[19] Strohmaier S, Edlinger M, Manjer J, et al.Total serum cholesterol and cancer incidence in the Metabolic syndrome and Cancer Project (Me-Can) [J]. PloS one 2013; 8:e54242.
[20] Law MR, Thompson SG.Low serum cholesterol and the risk of cancer: an analysis of the published prospective studies[J]. Cancer causes & control : CCC 1991; 2:253-61.
[21] Dessi S, Batetta B, Pulisci D, et al.Altered pattern of lipid metabolism in patients with lung cancer[J]. Oncology 1992; 49:436-41.
[22] Fagherazzi G, Fabre A, Boutron-Ruault MC, Clavel-Chapelon F.Serum cholesterol level, use of a cholesterol-lowering drug, and breast cancer: results from the prospective E3N cohort[J]. European journal of cancer prevention : the official journal of the European Cancer Prevention Organisation 2010; 19:120-5.
[23] Ross R.Atherosclerosis--an inflammatory disease[J]. The New England journal of medicine 1999; 340:115-26.
[24] Hansson GK, Libby P.The immune response in atherosclerosis: a double-edged sword[J]. Nature reviews Immunology 2006; 6:508-19.
[25] Pires LA, Hegg R, Freitas FR, et al.Effect of neoadjuvant chemotherapy on low-density lipoprotein (LDL) receptor and LDL receptor-related protein 1 (LRP-1) receptor in locally advanced breast cancer[J]. Brazilian journal of medical and biological research 2012; 45:557-64.
[26] Kitahara CM, Berrington de Gonzalez A, Freedman ND, et al.Total cholesterol and cancer risk in a large prospective study in Korea[J]. Journal of clinical oncology : official journal of the American Society of Clinical Oncology 2011; 29:1592-8.