Role of Lipids and Apolipoproteins in Predicting the Prognosis of Hepatocellular Carcinoma After Resection

Xiao-Chun Ni,1 Yong Yi,2 Yi-Peng Fu,3 Xiao-Yan Cai,4 Gao Liu,2 Jin-Long Huang,2 Wei Gan,2 Jie Xu,5 Shuang-Jian Qiu6 1Shanghai Ninth People’s Hospital, General Surgery, Shanghai, People’s Republic of China; 2Liver Cancer Institute, Hepatic Surgery, Shanghai, People’s Republic of China; 3Obstetrics & Gynecology Hospital of Fudan University, Shanghai, People’s Republic of China; 4Shanghai Pudong Gongli Hospital, General Surgery, Shanghai, People’s Republic of China; 5Shanghai Ninth People’s Hospital, Infection Disease, Shanghai, People’s Republic of China; 6Liver Cancer Institute, Zhongshan Hospital, Fudan University, Shanghai 200032, People’s Republic of ChinaCorrespondence: Jie XuShanghai Ninth People’s Hospital, Infection Disease, 280 Mohe Road, Shanghai, People’s Republic of ChinaEmail dr.xu@aliyun.comShuang-Jian QiuLiver Cancer Institute, Zhongshan Hospital, Fudan University, 180 Fenglin Road, Shanghai 200032, People’s Republic of ChinaTel/Fax +86-21-64037181Email qiushuangjianzs@163.comPurpose: To further clarify the association between abnormal levels of serum lipid components as the main features of dyslipidaemia and hepatocellular carcinoma, which remains unclear.Patients and Methods: We examined the serum level of lipids and apolipoproteins pattern in 471 patients undergoing curative resection for HCC, 193 patients with chronic liver disease, and 104 patients with benign liver diseases. We performed uni- and multivariate analyses to evaluate the predictive roles of lipids and apolipoproteins for recurrence and survival of HCC in a training cohort of 242 patients and then validated in a cohort of 229 patients.Results: The majority circulating lipid and apolipoprotein levels such as ApoA1, HDL, and LDL in chronic liver disease and HCC were slightly significantly decreased as compared to those in benign lesion. But no significant differential expression patterns of lipids and apolipoproteins were observed between chronic liver hepatitis and HCC. Multivariable analysis identified ApoA1 as a key parameter related to recurrence and survival in both training and validation cohorts. Moreover, we further demonstrated that low ApoA1 was an independent prognostic factor of poor early recurrence in two cohorts.Conclusion: Although the alterations of circulating lipids and apolipoproteins were observed in HCC, none of lipids or apolipoproteins could serve as a diagnostic marker. Serum ApoA1 merits consideration as a novel prognostic marker for patients with HCC undergoing surgery since it predicts early recurrence and survival, especially for early stage patients and may improve the prognostic stratification of patients for clinical management and promote HCC clinic outcomes.Keywords: apolipoprotein, prognosis, hepatocellular carcinoma, surgery