Tumor Biology

, Volume 37, Issue 8, pp 10715–10721 | Cite as

Elevated serum apolipoprotein E is associated with metastasis and poor prognosis of non-small cell lung cancer

Original Article


Apolipoprotein E (ApoE) is a factor involved in Alzheimer’s disease, which recently attracted great attention as an important protein related to tumorigenesis and metastasis. However, serum ApoE levels and its diagnosis and prognosis value in non-small cell lung cancer (NSCLC) patients are still unknown. In 196 NSCLC patients and 203 healthy controls, serum ApoE was measured by turbidimetric immunoassay. The associations of serum ApoE levels with the clinicopathological characteristics and clinical outcomes of NSCLC patients were analyzed. Serum ApoE levels were obviously elevated in NSCLC patients compared with healthy controls (41.6 ± 11.63 vs. 33.8 ± 6.24 mg/L) and were associated with TNM stage, lymph node metastasis status, and distant metastasis status (all P < 0.0001). For NSCLC diagnosis, the area under the receiver operating characteristic (ROC) curve was 0.71 at a specificity of 0.90 and sensitivity of 0.47. For lymph node metastasis predicting, the area under the ROC curve was 0.68 at a specificity of 0.56 and sensitivity of 0.73. From ROC/area under curve (AUC) analysis, we used 41.25 mg/L as the serum ApoE cut-off value, to divide NSCLC patients into two groups, the median survival was 11.0 weeks (95 % CI = 8.7 to 13.3) for patients in high serum ApoE group and 20.0 weeks (95 % CI = 15.0 to 25.0) in low serum ApoE group. Serum ApoE levels elevated in NSCLC patients, which also associated with TNM stages, lymph node metastasis, distant metastasis, and poor prognosis, suggest that serum ApoE may act as a useful clinical serological biomarkers for evaluating the progress of NSCLC.


ApoE NSCLC Metastasis Prognosis Biomarker 



The work was supported by grants from the Specialized Research Fund for the Doctoral Program of Higher Education of China (Grant No. 20130171120069 to LSL), and the Science and Technology Department of Guangdong Province (Grant No. 2014A020212477 to LSL, 2014A020212720 to JML), and the Natural Science Foundation of Guangdong Province, China (Grant No. 2015A030313035 to LSL), and the Science and Technology Department of Guangzhou City, China (Grant No. 201400000004–2 to ML). The funder had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.

Authors’ contributions

LSL and ML designed the experiment, interpreted the data, and prepared the manuscript. JML, JLS, PNF, YHW, and WQL conducted the experiment, collected the data, and helped to prepare the manuscript. LSL and ML interpreted the data. All authors read and approved the final manuscript.

Compliance with ethical standards

Conflicts interest



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Copyright information

© International Society of Oncology and BioMarkers (ISOBM) 2016

Authors and Affiliations

  1. 1.Department of Laboratory MedicineThe First Affiliated Hospital of Sun Yat-sen UniversityGuangzhouChina
  2. 2.Department of Medical Intensive Care UnitThe Third Affiliated Hospital of Sun Yat-Sen UniversityGuangzhouChina
  3. 3.Reproductive Medicine CenterThe First Affiliated Hospital of Sun Yat-sen UniversityGuangzhouChina

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