Prognostic value of serum apolipoprotein A-I in locally advanced cervical squamous cell carcinoma treated with radical chemoradiotherapy

Hui Chang, Kai Chen, Yan-Zhu Lin, Ya-Lan Tao, Yang Liu, Xin-Ping Cao, Wei-Jun Ye


Background: Distant metastasis (DM) remains the major cause of death from locally advanced cervical squamous cell carcinoma (CSCC). This study aimed to evaluate the predictive value of pretreatment serum lipids on DM and death, in patients with locally advanced CSCC.
Methods: In this study, a total of 331 consecutive patients with stages IIB–IVA CSCC and completed record of radical concurrent chemoradiotherapy (CCRT) were involved between January 2011 and June 2013. Pretreatment serum lipid indexes including total cholesterol (TC), triglyceride (TG), high-density lipoprotein cholesterol (HDL-c), low-density lipoprotein cholesterol (LDL-c), apolipoprotein A-I (apoAI) and apolipoprotein B (apoB) were analyzed for their association with the overall survival (OS), the local-recurrence-free survival (RFS), the distant-metastasis-free survival (MFS) and the disease-free survival (DFS), together with clinical features [age, stage, parametrial invasion, tumor diameter, lymph node metastasis, hemoglobin, squamous cell carcinoma (SCC) antigen and carbohydrate antigen 125 (CA125)].
Results: After univariate and multivariate analysis, serum apoAI level (≥1.2 vs. <1.2 g/L) emerged as an independent predictor of the OS [hazard ratio (HR) =0.500, 95% confidence interval (CI), 0.321–0.778], the MFS (HR =0.503, 95% CI, 0.323–0.784) and DFS (HR =0.521 95% CI, 0.338–0.803).
Conclusions: For locally advanced CSCC treated with CCRT, low pretreatment level of serum apoAI could predict high risk of DM and poor prognosis. This finding might help clinicians to direct therapy for eradicating DM and conduct clinical trials on apoAI-targeting anti-tumor therapies.