Effect Of Serum Lipid Levels On Prognosis In Patients With Small Cell Lung Cancer At The Initial Treatment

Objective:By exploring the blood lipid level of patients with small cell lung cancer at the initial treatment,the study aims to determining whether there was a correlation between lipid levels and prognosis of small cell lung cancer.Thus,providing a new direction for the diagnosis and treatment of SCLC.Methods:Retrospectively collected and analyzed the clinical characteristic of patients confirmed as small cell lung cancer by pathological and cytology in the Fist Hospital of Jilin University from Jan.2012 to Dec.2017.A total of 129 patients were included who were excluded from surgical treatment,combined with other tumors,combined with hypertension,diabetes,coronary heart disease and other abnormal lipid metabolism diseases,and who took lipid-lowering drugs and did not receive blood lipid examination at the first treatment.Through the medical record query system or telephone follow-up,compared age,gender,smoking status,body mass index(BMI),clinical stage,whether or not combined with radiotherapy,pretreated blood lipids with prognosis of SCLC.Clinical staging is classified by the Veterans Administration as limited and extensive disease,and lipids were grouped by NCEP ATPIII guidelines for dyslipidemia.The SPSS20.0 software was used to analyze the data,and chi-square test was used to analyze the correlation between blood lipid level and clinical characteristics of patients at the time of initial treatment.Kaplan-Meier survival curve was used for univariate analysis,and COX proportional risk model was used for multivariate analysis.Two-tailed P values < 0.05 were considered to be statistically significant.Results:1.A total of 129 patients with SCLC were included in this study.At the initial treatment,abnormal serum cholesterol was found in 39 cases(30.2%),abnormal triglycerides in 34 cases(26.4%),abnormal high-density lipoprotein cholesterol in 27 cases(20.9%),and abnormal low-density lipoprotein cholesterol in 39 cases(30.2%).2.In patients with small cell lung cancer,the median PFS was 10.5 months in the triglyceride normal group(TG<1.7 mmol/L)and the median OS was 20.2 months at the initial treatment.In the triglyceride abnormal group(TG?1.7 mmol/L)the median PFS was 8.8 months and the median OS was 15.6 months.Univariate and multivariate analyses suggested that hypertriglyceridemia was associated with shorter PFS(P=0.024,P=0.022),but not with OS.3.Triglyceride level is an independent risk factor for SCLC progression at the time of initial treatment(P=0.024),but were not significantly correlated with overall survival(P=0.097).There was no significant correlation between TC,HDL,LDL and SCLC prognosis(P > 0.05).Conclusions:1.The incidence of abnormal triglyceride was higher in small cell lung cancer patients than in non-tumor patients.2.Triglyceride level before treatment is significantly correlated with PFS of SCLC,but not with OS,and it is an independent risk factor for the progression of SCLC.3.The increase of triglyceride level at the initial treatment indicated rapid disease progression and poor prognosis,while there is no significant correlation between TC,HDL,LDL and SCLC prognosis at the initial treatment.