Relationship Between The Serum Apolipoprotein A-1 Levels And Prognosis Of Patients With Small Cell Carcinoma Of Esophagus

Background and objective:Although primary small cell carcinoma of the esophagus(SCEC)is a rare histological type of esophageal cancer,which only accounted for 0.6%-2.8% the incidence of esophageal malignant tumor,the SCEC has the characteristics of high malignancy,strong invasiveness,early in the disease prone to distant metastasis,sensitivity to the chemotherapy but is easy to appear recurrence and poor prognosis.At present,the clinical indicators for evaluating the prognosis of SCEC are not clear.A number of studies have found that the serum apolipoprotein A-1(ApoA-1)levels are associated with the development and prognosis of a variety of malignant tumors(such as breast cancer,ovarian cancer,colorectal cancer).But the relationship between the ApoA-1 and the SCEC has not been studied.Therefore,this study is aim to expelor the relationship between the pre-treatment serum ApoA-1 levels of SCEC patients and its prognosis,in order to find new prognostic factor and improve the existing prognosis models of SCEC,so we can evaluate the prognosis of the SCEC more accurately.Materials and methods:We collected 38 cases of SCEC in the First Affiliated Hospital of Zhengzhou University from February 2012 to May 2016,the data including age,sex,smoking,drinking,lesion location,TNM stage,VALSG stage,treatment method,serum ApoA-1 levels,the date of diagnosis and the date of death of all patients were collected.According to the levels of serum ApoA-1,all patients were divided into group a(ApoA-1 ? 1 g/L)18 cases and group b(ApoA-1 < 1 g/L)20 cases.All datas were analyzed by SPSS21.0 statistical software,Fisher precise test was used to compare the difference between the group a and group b.The survival time of the patients was calculated monthly,and the survival was analyzed by Kaplan-Meier method.The difference of survival curve was tested by log-rank method.Cox proportional hazards regression model was used to study the influence of multiple factors on survival time,the difference was statistically significant as P<0.05(two-sided test).Results:1.Fisher precise test showed that there were no significant difference between the group a and the group b in the clinical indicators(P > 0.05).2.Univariate survival analysis showed that: the median survival time of patients with limited and extensive esophageal small cell carcinoma was 19.64 months vs 16.87 months,and the median survival time was 19.64 months vs 17.08 months for patients with esophageal small cell carcinoma in group a and group b;the limited and extensive disease(21.00 + 1.03 months vs 16.60 + 0.60 months)and the group a and group b(21.05 + 1.12 months vs 16.77 + 0.74 months)SCEC patients have significant difference during the total survival time(P < 0.05).3.Cox multivariate survival analysis showed that the serum ApoA-1 level was a prognostic factor for SCEC(P=0.021).Conclusion:The decrease of serum ApoA-1 level can shorten the overall survival time of SCEC,it is an independent risk factor for the prognosis of SCEC.