Epidemiology
Elevated preoperative Lp(a) triples the risk of shorter survival after biliary tract cancer surgery in 78 patients (Cancer Med 2024)
Original title: Association of preoperative elevated lipoprotein (a) with poor survival in patients with biliary tract cancers
In 78 patients with biliary tract cancer, the authors examined preoperative lipid indices, including Lp(a), alongside clinical and pathological characteristics as predictors of survival. Univariate Cox regression found BMI, tumour location, surgical margin, N stage, and abnormally elevated LDL-C, triglycerides, and Lp(a) all significantly associated with poorer prognosis. On multivariate Cox regression, only N stage (hazard ratio 3.393, p < 0.001) and abnormally elevated Lp(a) (hazard ratio 2.814, p = 0.004) remained significant independent predictors of shorter survival. The authors propose Lp(a) as a novel biochemical marker that could help guide treatment strategy and identify biliary tract cancer patients, particularly those with abnormal preoperative lipid metabolism, who may benefit from more effective therapy and closer postoperative surveillance.
Original abstract
Background: Biliary tract cancers have garnered significant attention due to their highly malignant nature. The relationship between abnormal lipid metabolism and tumor occurrence and development is a research hotspot. However, its correlation with biliary tract cancers is unclear.
Methods: We enrolled 78 patients with biliary tract cancers and obtained data on clinical characteristics, pathological findings, and preoperative blood lipid indices, including total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), triglycerides (TG), and lipoprotein (a) [Lp(a)]. Receiver operating characteristic (ROC) curves were used to determine the optimal predictive cutoff values of lipid indicators among the participants. Independent risk factors were determined using Cox regression, and survival was predicted using the Kaplan-Meier method. Statistical analyses were performed using SPSS software.
Results: Univariate Cox regression analysis revealed that the body mass index (BMI), tumor location, surgical margin, N stage, and abnormally increased LDL-C, TG, and Lp(a) levels were significantly associated with poor prognosis of biliary tract cancers (p < 0.05). Multifactor Cox regression demonstrated that only N stage (HR = 3.393, p < 0.001) and abnormally increased Lp(a) levels (HR = 2.814, p = 0.004) were significantly associated with shorter survival. N stage and Lp(a) were identified as independent prognostic risk factors for patients with biliary tract cancers.
Conclusion: This study presents Lp(a) as a novel biochemical marker that can guide clinical treatment strategies for patients with biliary tract cancers. More effective treatment options and intensive postoperative testing should be considered to prolong the survival of these patients with preoperative abnormal lipid metabolism.
Summary written by lp-a.org from the published abstract; figures as published. Page updated 18 August 2026. Methods.