title: A high LDL-C to HDL-C ratio predicts poor prognosis for initially metastatic colorectal cancer patients with elevations in LDL-C.
abstract: Although lipid disequilibrium has been documented for several types of cancer including colorectal cancer (CRC), it remains unknown whether lipid parameters are associated with the outcome of metastatic CRC (mCRC) patients. Here, we retrospectively examined the lipid profiles of 453 mCRC patients and investigated whether any of the lipid parameters correlated with the outcome of mCRC patients. Pretreatment serum lipids, including triglyceride, cholesterol, high-density lipoprotein cholesterol (HDL-C), and low-density lipoprotein cholesterol (LDL-C), were collected in 453 initially mCRC patients. The LDL-C to HDL-C ratio (LHR) was calculated and divided into the first, second, and third tertiles. Univariate and multivariate analyses were performed to evaluate the impact of lipids on overall survival (OS) and progression-free survival (PFS). Nearly two-fifths of the patients (41.3%) exhibited elevations in LDL-C while most patients (88.3%) showed normal HDL-C levels. Decreased HDL-C (P=0.542) and increased LDL-C (P=0.023) were prognostic factors for poor OS, while triglyceride (P=0.542) and cholesterol (P=0.215) were not. Multivariate analysis revealed that LDL-C (P=0.031) was an independent prognostic factor. Triglyceride, cholesterol, HDL-C, and LDL-C did not correlate with PFS. Among patients with elevations in LDL-C levels, patients in the third tertile of the LHR had a markedly shorter median OS compared to those in the first or second tertile (P=0.012). Thus, increased LDL-C level is an independent prognostic factor for poor prognosis in mCRC patients, and a high LHR predicts poor prognosis for initially mCRC patients with elevations in LDL-C.
authors.affiliation: State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou, People's Republic of China ; VIP Region, Sun Yat-sen University Cancer Center, Guangzhou, People's Republic of China.
authors.forename: Fangxin
authors.initials: F
authors.lastname: Liao
authors.affiliation: State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou, People's Republic of China ; VIP Region, Sun Yat-sen University Cancer Center, Guangzhou, People's Republic of China.
authors.forename: Wenzhuo
authors.initials: W
authors.lastname: He
authors.affiliation: State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou, People's Republic of China ; VIP Region, Sun Yat-sen University Cancer Center, Guangzhou, People's Republic of China.
authors.forename: Chang
authors.initials: C
authors.lastname: Jiang
authors.affiliation: State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou, People's Republic of China ; VIP Region, Sun Yat-sen University Cancer Center, Guangzhou, People's Republic of China.
authors.forename: Chenxi
authors.initials: C
authors.lastname: Yin
authors.affiliation: State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou, People's Republic of China ; VIP Region, Sun Yat-sen University Cancer Center, Guangzhou, People's Republic of China.
authors.forename: Guifang
authors.initials: G
authors.lastname: Guo
authors.affiliation: State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou, People's Republic of China ; VIP Region, Sun Yat-sen University Cancer Center, Guangzhou, People's Republic of China.
authors.forename: Xuxian
authors.initials: X
authors.lastname: Chen
authors.affiliation: State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou, People's Republic of China ; VIP Region, Sun Yat-sen University Cancer Center, Guangzhou, People's Republic of China.
authors.forename: Huijuan
authors.initials: H
authors.lastname: Qiu
authors.affiliation: State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou, People's Republic of China ; VIP Region, Sun Yat-sen University Cancer Center, Guangzhou, People's Republic of China.
authors.forename: Yuming
authors.initials: Y
authors.lastname: Rong
authors.affiliation: State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou, People's Republic of China ; VIP Region, Sun Yat-sen University Cancer Center, Guangzhou, People's Republic of China.
authors.forename: Bei
authors.initials: B
authors.lastname: Zhang
authors.affiliation: State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou, People's Republic of China ; Gastric and Pancreatic Surgery, Sun Yat-sen University Cancer Center, Guangzhou, People's Republic of China.
authors.forename: Dazhi
authors.initials: D
authors.lastname: Xu
authors.affiliation: State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou, People's Republic of China ; VIP Region, Sun Yat-sen University Cancer Center, Guangzhou, People's Republic of China.
authors.forename: Liangping
authors.initials: L
authors.lastname: Xia
keywords: high low-density lipoprotein cholesterol; high-density lipoprotein cholesterol; metastatic colorectal cancer