ApoB/ApoA-1 Ratio as a Novel Prognostic Predictor in Patients With Primary Small Cell Carcinoma of the Esophagus

Abstract

Background and Aim: Primary small cell carcinoma of the esophagus (SCCE) is a rarely aggressive disease characterized by rapid progression, widespread metastasis, and poor prognosis. This study was aimed to evaluate the prognostic significance of serum lipids for overall survival (OS) in SCCE patients. Methods: We retrospectively analyzed SCCE patients in a training cohort (61 patients) and validated them in a validation cohort (27 patients). These cases were collected from Sun Yat-sen University Cancer Center from 2006 to 2017. Univariate and multivariate Cox survival analyses were performed to determine serum lipids as prognostic factors associated with the patient's OS. Time-dependent receiver operating characteristics (ROC) were used to compare predictive power of independent prognostic factors. The predictive accuracy and discriminative ability of the prognostic factors were measured by the concordance index (C-index) and decision curve, and were compared with the TNM stage system. Results: On multivariate analysis of the training cohort, independent factors for survival were gender, BAR (ApoB/ApoA-1) and TNM stage. The area under the curve (AUC) of BAR+TNM stage in the training cohort was higher than that of TNM stage for OS, and similar result was observed in the validation cohort. The c-index of BAR+TNM stage for predicting the OS was 0.655 (95% CI = 0.571-0.740), which was higher than that of TNM stage [0.614 (95% CI = 0.530-0.698)] in the training cohort. In the validation cohort, the C-index of the BAR+TNM stage for predicting OS was also higher than that of the TNM stage [0.688 (95% CI: 0.570∼0.806) vs. (0.512; 95% CI: 0.392∼0.632)]. In addition, decision curve analysis also showed that the predictive accuracy of BAR+TNM stage for OS was higher than TNM stage both in the training and the validation cohorts. Conclusions: BAR represents a promising prognostic indicator that might complement TNM stage in the prognosis of SCCE, and that warrant further assessment in large SCCE patient cohort.

Potential biomarkers and immune characteristics of small bowel adenocarcinoma

“…As a metabolic gene, apolipoprotein B (APOB) is the most important apolipoprotein on chylomicrons and low-density lipoprotein 40 , 41 . APOB has been confirmed to be associated with the pathogenesis of a variety of gastrointestinal malignancies, including liver cancer, gallbladder cancer, esophageal cancer and pancreatic duct adenocarcinoma 42 – 45 . Abdominal obesity has been identified as a risk factor for SBA 46 .…”

Analysis of multiple databases identifies crucial genes correlated with prognosis of hepatocellular carcinoma

“…APOB , belongs to the apolipoprotein family, forms sub-microscopic spherical particles, which transports dietary lipids from the intestine to the liver via the bloodstream 67 . Interestingly, multiple studies have indicated that APOB is associated with non-small cell lung cancer 68 , gallbladder cancer 69 , low-grade glioma 70 and primary small cell carcinoma of the esophagus 71 . Study by Lee et al showed that APOB inactivation is associated with poor outcome in HCC patients 72 .…”

APOB is a potential prognostic biomarker in hepatocellular carcinoma

“…APOB primarily produces two isoforms of proteins, namely apoB-100 and apoB-48 [ 24 , 25 ], which are predominantly present in the serum. It is worth noting that previous research has shown a connection between APOB and diverse forms of cancer, such as gallbladder cancer [ 26 , 27 ], low-grade glioma [ 28 ], non-small cell lung cancer [ 29 , 30 ], and primary small cell carcinoma of the esophagus [ 31 ]. Furthermore, research conducted by Lee and colleagues indicated that individuals with HCC who have a deactivated APOB gene experience worse results [ 32 ].…”