The value of plasma omega-3 polyunsaturated fatty acids in predicting the response and prognosis of cervical squamous cell carcinoma to concurrent chemoradiotherapy

Abstract

Background In recent years, abnormalities in plasma omega-3 polyunsaturated fatty acids (omega-3 PUFAs) have been proven to be related to the risk of cancer, but their prognostic value for cancer is not clear. The purpose of this study was to retrospectively evaluate the response and prognostic significance of plasma omega-3 PUFAs in patients with cervical squamous cell carcinoma (CSCC) treated with concurrent chemoradiotherapy (CCRT). Spearman rank correlation analysis was used to analyze the correlation between omega-3 PUFAs and squamous cell carcinoma antigen (SCC-Ag). Methods The 89 patients with CSCC who underwent CCRT were evaluated retrospectively. Binary logistic regression analysis was used to analyze the independent predictors related to complete response (CR) after CCRT. A Cox proportional hazard model and Kaplan-Meier analysis were utilized to perform survival analysis. Results After univariate and multivariate logistic regression analysis, a high level of plasma EPA was independently correlated with an increased incidence of CR after CCRT (odds ratio (OR), 0.980; 95% confidence interval (CI), 0.962–0.999, P = 0.038). With a median follow-up of 41.3 months, the CSCC patients in the high EPA (≥ 58.0 nmol/mL) group exhibited longer OS and PFS. In the multivariate analysis, pretreatment plasma EPA was an independent prognostic factor for PFS in patients with CSCC who underwent CCRT (hazard ratio (HR), 0.249; 95% CI, 0.079–0.780, P = 0.017). However, it was not an independent prognostic factor of OS. Spearman rank correlation analysis showed that there was a negative correlation between pretreatment SCC-Ag (pre SCC-Ag) and EPA (r =-0.305, P = 0.004), and a weak negative correlation between posttreatment SCC-Ag (post SCC-Ag) and EPA (r =-0.251, P = 0.018). Conclusion Plasma omega-3 PUFAs are related to the response and survival outcome of patients with CSCC who underwent CCRT. Pretreatment plasma EPA may be a promising biomarker to predict the response and prognosis of patients with CSCC who undergo CCRT. In addition, the pretreatment plasma EPA level presented a negative correlation with the SCC-Ag level.