The correlation between serum apolipoprotein B/apolipoprotein A1 ratio and brain necrosis in patients underwent radiotherapy for nasopharyngeal carcinoma.

Honghong Li,Xiaohuang Zhuo,Yi Li,Xiaolong Huang,Yamei Tang,Fukang Xie,Dong Zheng,Jinpeng Lin

doi:10.1002/brb3.1554

Abstract

IntroductionThe apolipoprotein B/apolipoprotein A1 (ApoB/ApoA1) ratio is recognized as a clinical indicator of cardiovascular disease and ischemic cerebral disease. Cerebrovascular dysfunction is also involved in head and neck radiotherapy. The aim of this study was to investigate the correlation between ApoB/ApoA1 ratio and the severity of radiation‐induced brain necrosis (RN) in patients who underwent radiotherapy after nasopharyngeal carcinoma (NPC).MethodsIn this retrospective study, 191 NPC patients diagnosed with RN were evaluated. Clinical characteristics, serum lipid, apolipoproteins, and brain magnetic resonance imaging findings were collected. Serum lipid and apolipoproteins were quantified using standard diagnostic assays, and the quality of life (QOL) was assessed by the World Health Organization quality of life abbreviated instrument (WHOQOL‐BREF).ResultsApoB/ApoA1 ratio was positively correlated with lesion volume (r = .18, p = .03) and negatively correlated with WHOQOL‐BREF scores (r = −.28, p < .01). The ApoB/ApoA1 ratio and intensity‐modulated radiation therapy (IMRT) were independent risk factor of RN volume. Moreover, ApoB/ApoA1 ratio was significantly negatively correlated with physical health (r = −.29, p < .01), psychological (r = −.27, p < .01), social relationships (r = −.17, p = .02), and environment (r = −.27, p < .01) domains of WHOQOL‐BREF.ConclusionsSerum ApoB/ApoA1 ratio is positively correlated with RN volume, which indicated serum ApoB/ApoA1 ratio as an independent risk factor for lesion volume in patients with RN after radiotherapy for NPC, suggesting a bright intervention target in RN treatment.

Highlights

The apolipoprotein B/apolipoprotein A1 (ApoB/Apolipoprotein A1 (ApoA1)) ratio is recognized as a clinical indicator of cardiovascular disease and ischemic cerebral disease
Serum ApoB/ApoA1 ratio is positively correlated with radiation-induced brain necrosis (RN) volume, which indicated serum ApoB/ApoA1 ratio as an independent risk factor for lesion volume in patients with RN after radiotherapy for nasopharyngeal carcinoma (NPC), suggesting a bright intervention target in RN treatment
The results showed that patients with higher quartiles of the ApoB/ApoA1 ratio had a larger RN volume (Figure 3a, p < .05) and a lower quality of life (QOL) scores (Figure 3b, p < .05)

Summary

Introduction

The apolipoprotein B/apolipoprotein A1 (ApoB/ApoA1) ratio is recognized as a clinical indicator of cardiovascular disease and ischemic cerebral disease. The aim of this study was to investigate the correlation between ApoB/ApoA1 ratio and the severity of radiation-induced brain necrosis (RN) in patients who underwent radiotherapy after nasopharyngeal carcinoma (NPC). Previous study suggested that radiation can cause middle cerebral artery stenosis in patients with NPC after radiotherapy (Zhou et al, 2016). In our previous study, we demonstrated that cognitive impairment was resulted from (CMBs) in patients with radiation-induced brain necrosis (RN) (Shen et al, 2016). Cerebrovascular dysfunction is widely involved in RN These results raise the issue of whether ApoB/ApoA1 ratio correlated with the RN. We design this study to explore the correlation between the ApoB/ ApoA1 ratio and the RN after radiotherapy for NPC patients

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Conclusion