Abstract
Circulating lipoproteins as risk factors or prognostic indicators for various cancers have been investigated previously; however, no clear consensus has been reached. In this study, we aimed at evaluating the impact of serum lipoproteins on the prognosis of patients with squamous cell carcinoma of the head and neck (SCCHN). Levels of total cholesterol, low-density lipoproteins (LDL), high-density lipoproteins (HDL), triglycerides and lipoprotein(a) were measured in serum samples from 106 patients and 28 healthy controls. We found that HDL was the only lipoprotein exhibiting a significant difference in concentration between healthy controls and patients (p = 0.012). Kaplan–Meier survival curves indicated that patients with high levels of total cholesterol or LDL had better overall survival than patients with normal levels (p = 0.028 and p = 0.007, respectively). Looking at patients without lipid medication (n = 89) and adjusting for the effects of TNM stage and weight change, multivariate Cox regression models indicated that LDL was an independent prognostic factor for both overall (p = 0.005) and disease-free survival (p = 0.013). In summary, our study revealed that high LDL level is beneficial for survival outcome in patients with SCCHN. Use of cholesterol-lowering medicines for prevention or management of SCCHN needs to be evaluated carefully.
Highlights
Squamous cell carcinoma of the head and neck (SCCHN) is a common tumor type and a significant cause of death worldwide [1]
There was no significant difference between total cholesterol levels in SCCHN patients and controls (p = 0.208)
No significant difference in low-density lipoproteins (LDL) levels was found between patients and controls (p = 0.554), whereas high-density lipoproteins (HDL) levels were lower in patients (p = 0.012) (Figure 1A)
Summary
Squamous cell carcinoma of the head and neck (SCCHN) is a common tumor type and a significant cause of death worldwide [1]. The most common intraoral site for SCCHN is the tongue and squamous cell carcinoma of the oral tongue (SCCOT) is a serious public health problem with significant morbidity and mortality [2,3]. Several studies have shown that blood lipids are involved in the initiation and development of different types of cancer, including oral cancer [4]. Triglycerides (TGs) and cholesterol are the most abundant, with cholesterol being essential for cell membrane biogenesis, proliferation and differentiation [5] and being involved in the production of vitamin D and steroid hormones [6].
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