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Elevated apolipoprotein B predicts poor postsurgery prognosis in patients with hepatocellular carcinoma

Authors Yan X, Yao M, Wen X, Zhu Y, Zhao E, Qian X, Chen X, Lu W, Lv Q, Zhang L, Lu F

Received 29 October 2018

Accepted for publication 25 January 2019

Published 12 March 2019 Volume 2019:12 Pages 1957—1964


Checked for plagiarism Yes

Review by Single-blind

Peer reviewers approved by Ms Justinn Cochran

Peer reviewer comments 2

Editor who approved publication: Dr Federico Perche

Xiaotong Yan,1,* Mingjie Yao,2,* Xiajie Wen,2 Yiwei Zhu,3 Erjiang Zhao,4 Xiangjun Qian,2 Xiangmei Chen,2 Weiquan Lu,4 Quanjun Lv,3 Ling Zhang,5 Fengmin Lu1,2

1Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou 450001, China; 2Department of Microbiology and Infectious Disease Center, School of Basic Medical Sciences, Peking University Health Science Center, Beijing 100191, China; 3Department of Nutrition and Food Hygiene, College of Public Health, Zhengzhou University, Zhengzhou 450001, China; 4Department of Medical Records, Henan Cancer Hospital, Zhengzhou 450008, China; 5Department of Hepatobiliary Surgery, Henan Cancer Hospital, Zhengzhou 450008, China

*These authors contributed equally to this work

Aims: To date, curative resection remains to be the most optimal therapeutic choice of hepatocellular carcinoma (HCC), though the overall survival (OS) remains extremely unsatisfactory. To better manage the HCC patients, we evaluated the prognosis predicting values of apolipoprotein B (ApoB) and low-density lipoprotein cholesterol (LDL-C) on the long-time survival of patients who underwent surgical treatment in this study.
Methods: A subgroup of 164 patients from our previously described follow-up cohort were enrolled in this study, of whom the pre-surgery ApoB and LDL-C measurements were available. They had been followed until January 2017, with a 19.5 months median survival time. The prognosis predicting values of serum ApoB, LDL-C, and other clinical variables were evaluated through Cox univariate and multivariate analyses, meanwhile, Kaplan–Meier analysis was conducted to obtain the OS curves.
Results: Pre-surgery ApoB was an independent prognosis predicting factor with HR as 1.396 (P=0.033), elevated ApoB was associated with worse postsurgery prognosis in HCC patients. Concordantly, Spearman’s correlation analysis revealed that value of pre-surgery ApoB was to some extent correlated with tumor size (r=0.355, P<0.001). In line with this, further univariate and multivariate logistic regression analysis revealed that patients with higher ApoB value were more likely to have larger tumor size (≥5 cm), with the OR value as high as 2.221 (95% CI: 1.288–3.830, P=0.004). Additionally, level of ApoB was found to be highly correlated with the serum level of LDL-C (r=0.686, P<0.001).
Conclusion: ApoB could be a valuable novel prognosis predicting marker for HCC patients who underwent curative liver resection. Moreover, elevated ApoB level could indicate worse outcome in HCC patients, which could be explained by the relationship between ApoB and residual liver function.

Keywords: hepatocellular carcinoma, curative resection, survival, apolipoprotein B

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