Serum low-density lipoprotein and low-density lipoprotein expression level at diagnosis are favorable prognostic factors in patients with small-cell lung cancer (SCLC)

Ting Zhou†,
Jianhua Zhan†,
Wenfeng Fang†,
Yuanyuan Zhao,
Yunpeng Yang,
Xue Hou,
Zhonghan Zhang,
Xiaobo He,
Yaxiong Zhang,
Yan Huang and
Li ZhangEmail author

†Contributed equally

BMC Cancer201717:269

DOI: 10.1186/s12885-017-3239-z

Received: 9 September 2016

Accepted: 28 March 2017

Published: 14 April 2017

Open Peer Review reports

Abstract

Background

Patients with small-cell lung cancer (SCLC) patients demonstrate varied survival outcomes. Previous studies have reported that lipoproteins are associated with prognosis in various cancers; however, the role of low-density lipoprotein (LDL) and low-density lipoprotein- cholesterol (LDLR) in patients with SCLC has not been studied.

Methods

In this study, the impact of LDL and LDLR on the prognosis of SCLC patients was evaluated. A total of 601 patients with SCLC were retrospectively evaluated, in which 198 patients had adequate tissues for immunohistochemistry, and serum LDL and LDLR expression levels at baseline were tested. X-tile tool, and univariate and multivariate Cox analysis were used to assess the association between LDL, LDLR and overall survival (OS).

Results

Univariate analysis demonstrated that a lower LDL level was significantly associated with superior OS (P = 0.037). Similarly, LDLR also significantly predicted OS (P = 0.003). Multivariate Cox analyses confirmed that lower LDL and LDLR expression was independent prognostic factors associated with longer OS (P = 0.019 and P = 0.027, respectively).

Conclusions

This study showed that both LDL and LDLR are prognostic indexes for survival in patients with SCLC. Patients with high LDL or LDLR expression level may benefit from treatment that modulates lipoprotein combined with platinum-based chemotherapy.