Validation of Prognosis Value of Cumulative Prognostic Scores Based on Serum High-Density Lipoprotein Cholesterol and Albumin Levels in Patients with Colorectal Cancer

Abstract

Aims: Noninvasive tools for the prognosis of colorectal cancer (CRC) are in urgent need. Lipids and proteins have been studied in CRC several years, thus a prognostic indicator based on preoperative serum high-density lipoprotein cholesterol (HDL-C) and serum albumin (ALB) levels (HA score) in CRC patients and to compare the correlation with survival to that of the Glasgow prognostic score.Patient and methods: In the present study, the patient characteristics, clinicopathological factors, and the level of pre-treatment serum markers (HDL-C, ALB, CEA and CA19-9) were analyzed retrospectively in 248 patients with CRC.Results: In HA score, patients with reduced HDL-C and decreased ALB levels were allocated a score of 2, those with only one of these abnormalities were assign as score 1, and those with neither of these abnormalities were allocated a score of 0. The cut-off value of HDL-C and ALB were defined as median. Among these, the distribution of the HA score were 66 patients of score 2 (26.61%), 112 patients of score 1 (45.16%), and 70 patients of score 0(28.23%). The prognostic significance of the HA score was then determined by Univariate and multivariate cox hazards in CRC. Univariate analysis revealed that tumor invasion depth, lymph node metastasis, metastasis, TNM stage, CEA, CA19-9, HA score and GPS had a significant association with the OS and DFS of CRC, furthermore HA score (P<0.001, P<0.001) TNM stage(P<0.001, P<0.001) were retained as the prognostic factors that were associated with OS and DFS according to multivariate analyses.Conclusions: These results suggest that the overall survival (OS) and disease-free survival (DFS) were shorter in CRC patients with a high level of HA score. Thus, our study has proposed that the evaluation of preoperative serum HA score may be used to predict OS and DFS of CRC.

Prognostic value of pre-treatment Naples prognostic score (NPS) in patients with osteosarcoma

“…Hypocholesterolemia has been reported to correlate with worse outcomes and prognosis in a variety of tumors, such as renal cell carcinoma (RCC), CRC, breast cancer, etc. [51][52][53]. Low levels of cholesterol can influence cell membrane fluidity, inhibiting the mobility of cell surface receptors and finally interfering their ability for transmembrane signals transmission [54].…”

Association of preoperative systemic Immune-inflammation Index and Prognostic Nutritional Index with survival in patients with Upper Tract Urothelial Carcinoma

“…Accumulating evidence indicates that increased systemic inflammatory response and a low nutritional status play important roles in the tumor progression and metastasis, which influence treatment outcomes, prognosis, and survival [12,13]. In recent years, the role of inflammation or nutrition-related factors, including NLR, PLR, albumin levels, and sarcopenia, in malignant tumors have attracted increased attention as significant predictors for various cancers that can reflect tumor' progression [7,8,[14][15][16]. In the current study, high SII and low PNI were correlated with old age, larger tumor size, LVI, pathologic T stage, N stage, and other clinical parameters indicative of an aggressive phenotype, which were consistent with the findings of a previous study.…”

“…Preoperative malnutritional status is also closely related to postoperative survival outcomes in cancer patients 12 . Recently, several studies reported the potential role of novel indicators based on inflammatory and nutritional variables in patients with cancer 13 - 15 . The prognostic nutritional index (PNI), which is calculated from serum albumin level and lymphocyte counts, is one parameters that reflects preoperative nutritional status and has also been validated as an effective prognostic factor in various cancers, including UTUC 12 , 13 .…”

Revealing the Role of High-Density Lipoprotein in Colorectal Cancer

“…Of note, in the Irish Longitudinal Study on Ageing (TILDA), HDL-C was a unique lipid parameter that was not related to the poor prognosis of patients with CRC after two years of follow-up [ 32 ]. In line with the expanding knowledge on the role of HDL in CRC, Huang et al [ 33 ] recently developed a simple prognostic score based on the HDL-C and albumin ratio (HA score). The authors demonstrated a shorter OS and DFS in CRC patients with a high HA score, representing reduced HDL-C and albumin levels [ 33 ].…”