Cancer Management and Research (Feb 2020)

Mediation Analysis Reveals Potential Biological Mechanism of Ascites Influencing Recurrence in Patients with Epithelial Ovarian Cancer

  • Yang C,
  • Wang C,
  • Rong Z,
  • Xu Z,
  • Deng K,
  • Zhao W,
  • Cao L,
  • Lu Y,
  • Adnan H,
  • Li K,
  • Hou Y

Journal volume & issue
Vol. Volume 12
pp. 793 – 799

Abstract

Read online

Chunyan Yang, Ce Wang, Zhiwei Rong, Zhenyi Xu, Kui Deng, Weiwei Zhao, Lei Cao, Yaxin Lu, Humara Adnan, Kang Li, Yan Hou Department of Epidemiology and Biostatistics, Public Health School, Harbin Medical University, Harbin, People’s Republic of ChinaCorrespondence: Kang Li Tel +86-451-87502939 Fax +86-451-87202885Email [email protected] Hou Tel +86-451-87502645Fax +86-451-87202885Email [email protected]: Ascites, an accumulation of peritoneal fluid, is associated with poor prognosis of certain cancers. The potential mechanism that ascites worsens prognosis has not been well understood. Lipids have been reported to correlate with the prognosis of patients with epithelial ovarian cancer (EOC). Therefore, we aimed here to investigate whether lipids mediate the effect of ascites on the recurrence of EOC.Methods: We collected the demographic and pathological data of 437 previously untreated patients with EOC to investigate the influence of ascites on recurrence. To identify the mechanism that mediates the potential influence of ascites on recurrence, we used ultra-performance liquid chromatography coupled with mass spectrometry (UPLC-MS) to determine the plasma lipid profiles of 53 patients with EOC. We used mediation analysis to evaluate if lipids mediated the effects of ascites on the recurrence of EOC.Results: Patients with ascites had a poorer prognosis, which was associated with higher levels of carbohydrate antigen-CA125 (CA125) and FIGO stage. We identified six different lipid metabolites that were associated with ascites and recurrence. Mediation analysis revealed that the lipids LysoPC(P-15:0), PC(P-34:4), and PC(38:6) may mediate the effects of ascites on recurrence.Conclusion: Our findings suggest that LysoPC(P-15:0), PC(P-34:4), and PC(38:6) mediate the effect of ascites on the prognosis of patients with EOC. We believe therefore that it is reasonable to consider metabolic interventions targeting the metabolism of LysoPC(P-15:0), PC(P-34:4), and PC(38:6) as a palliative treatment for patients with EOC with ascites. Further studies of more patients will be required to validate our findings.Keywords: ascites, recurrence, mediation analysis, lipids, epithelial ovarian cancer

Keywords