In this paper, the blood lipid levels of 694 patients with gastrointestinal stromal tumor are analyzed, and the results indicates that the blood lipid levels of patients with gastrointestinal stromal tumor was related to multiple factors, including gender, tumor site, tumor size, CD34, CD117 and S-100. The contents of TG, LDL-C, HDL-C and CHOL in patients with highly malignant gastrointestinal stromal tumors are significantly lower than those in patients with other dangerous levels of stromal tumors, which suggests that stromal tumors affect lipid metabolism to some extent, and lipid levels can predict their malignancy to a certain extent.
Currently, there are many studies on gastrointestinal stromal tumors, the pathogenesis of which is mainly tyrosine kinase receptor (KIT) and/or platelet derived growth factor receptor-alpha (PDGFRA) gene mutations. However, there exists wild-type KIT /PDGFRA in 10-15% GISTs, in which clinicopathological characteristics are related to a variety of factors. Lipid metabolism disturbance is proved to exist in most tumor patients, and elevated lipid levels promote multiple types of tumors[8–10]. However, some studies have shown that obesity plays a protective effect on gastrointestinal stromal tumors. In the 1920s, Warburg, a German scientist, discovered for the first time that tumor cells would give priority to anaerobic fermentation even in the case of sufficient oxygen supply, providing tumor cells with sufficient energy and the prerequisite material needed for the synthesis of biological macromolecules, which is the Warburg effect. Warburg effect indicates that tumor cells not only need energy to grow, but also need to synthesize a large number of macromolecules. Aerobic glycolysis can not only improve the efficiency of tumor cells to produce energy, but also provide necessary conditions for the synthesis of biomolecular molecules to meet their growth, adhesion, metastasis and other biological characteristics. The results in this paper may due to these mechanisms as follows. On the one hand, lipid is an important component of cell membrane, and there are increasing evidences that lipid metabolism plays an important role in tumor progression. Lipid raft, rich in neurolipids and cholesterol, is a unique small lipid domain on cell membrane, which acts as selective signal transduction to regulate lipid metabolism, tumor cell growth, adhesion, and metastasis, and promote tumor progression. On the other hand, lipids are also an important source of energy for tumor cells. In order to meet the needs of rapid growth of tumor cells, lipid metabolism is greatly accelerated and lipid content is reduced. In terms of nutritional support in patients with malignant tumors, abnormal host metabolism can lead to mobilization of host tissues and ineffective supplementation. Increased fat breakdown, reduced or increased fat production, increased turnover of free fatty acids (FFA) and glycerol, and increased FFA-triacylglycerol circulation all contribute to the disorder of lipid metabolism. Moreover, lipids are also the prerequisite for synthesizing signal molecules, which can change the microenvironment of tumor cells and promote the development of tumor cells. In addition, one of the main functions of HDL is to maintain normal intracellular cholesterol homeostasis by binding to receptors on the cell surface to remove excess cholesterol from the cell.
In recent years, there are evidences that TG/ HDL-C can be used as an independent risk factor for predicting the prognosis of triple negative breast cancer and gastric cancer, and its prediction effect is better than that of TG. TG/ HDL-C may be related to insulin resistance, which is related to gastrointestinal tumors such as gastric cancer. The results in this study show that TG/ HDL-C is different in gastrointestinal stromal tumors with different clinical characteristics, which suggests that insulin resistance may be related to gastrointestinal stromal tumors.
The advantages of this study are that a large number of patients with gastrointestinal stromal tumors were included in the study, and multiple clinicopathological features of the patients and their blood lipid levels were statistically analyzed. The outcomes indicate that there is a close association between blood lipid levels and gastrointestinal stromal tumors, and it is of certain value in the judgment of benign and malignant tumors. The limitation of this study is that no prospective studies have been conducted to determine whether changes in lipid levels occurred before or after the tumor. In addition, the effect of serum lipid levels on the prognosis of patients with gastrointestinal stromal tumors is still unclear, and further studies are needed to confirm this in the future.