Apolipoprotein A1 and B as risk factors for development of intraocular metastasis in patients with breast cancer

Figures & data

Table 1 The clinical characteristics of patients with breast cancer

	IOM group, n (%)	NIOM group, n (%)	Total numbers of patients, n (%)	P-value
Age (years)^a	46.59±7.78	48.21±10.41	48.19±10.38	0.26
<50	17 (53.1)	1,385 (59.0)	1,402 (58.9)
≥50	15 (46.9)	964 (41.0)	979 (41.1)
Gender^b				0.91
Woman	32 (100)	2,342 (99.7)	2,374 (99.7)
Man	0 (0)	7 (0.3)	7 (0.3)
Menopausal status^b				0.37
Premenopausal	22 (68.8)	1,422 (60.5)	1,444 (60.6)
Postmenopausal	10 (31.2)	927 (39.5)	937 (39.4)
Histopathology^b				0.48
Invasive ductal carcinoma	21 (65.6)	1,384 (58.9)	1,405 (59.0)
Other types	11 (34.4)	965 (41.1)	976 (41.0)
Axillary lymph node metastases^b				<0.001
0	4 (12.5)	902 (38.4)	906 (38.1)
1–4	7 (21.9)	698 (29.7)	705 (29.6)
>4	16 (50.0)	480 (20.4)	496 (20.8)
Unknown	5 (15.6)	269 (11.5)	284 (11.5)

Notes: ^aStudent’s t-test was used. ^bChi-square test was used. P-values<0.05 represented statistical significant.

Abbreviations: IOM, intraocular metastases; NIOM, non-intraocular metastases.

Figure 1 Clinical features of breast cancer patients with and without IOM. Notes: IOM on the left sides, NIOM on the right sides. (A) The age between IOM and NIOM, (B) the menopausal state between IOM and NIOM, (C) the pathological type between IOM and NIOM, (D) the axillary lymph node metastases between IOM and NIOM.

Abbreviations: IOM, intraocular metastases; NIOM, non-intraocular metastases.

Table 2 The differences of clinical lipids-relevant parameters between patients with and without IOM

Clinical features	IOM group	NIOM group	t	P-value
TC (mmol/L)	4.43±0.75	4.56±0.93	−0.999	0.325
TG (mmol/L)	1.31±0.70	1.36±0.86	−0.405	0.688
HDL (mmol/L)	1.34±0.49	1.36±0.35	−0.345	0.731
LDL (mmol/L)	2.59±0.61	2.72±0.77	−1.138	0.263
ApoA1 (g/L)	1.01±0.32	1.49±0.49	−8.019	<0.001
ApoB (g/L)	0.97±0.24	0.86±0.23	2.369	0.024
Lp(a) (mg/L)	210.50±156.19	211.20±221.96	−0.024	0.981

Abbreviations: TC, total cholesterol; TG, triglyceride; HDL, high density lipoprotein; LDL, low density lipoprotein; ApoA1, apolipoprotein A1; ApoB, apolipoprotein B; Lp(a), lipoprotein a; IOM, intraocular metastases.

Table 3 The binary logistic regression results

Factors	B	OR	OR (95% CI)	P-value
TC	−0.165	0.848	0.572–1.257	0.412
TG	−0.076	0.927	0.596–1.442	0.737
HDL	−0.180	0.835	0.300–2.322	0.730
LDL	−0.229	0.796	0.490–1.292	0.355
ApoA1	−7.107	0.001	0.000–0.006	<0.001
ApoB	1.630	5.106	1.359–19.178	0.016
Lp(a)	0.000	1.000	0.998–1.002	0.986

Note: P-values<0.05 represented statistical significant.

Abbreviations: TC, total cholesterol; TG, triglyceride; HDL, high density lipoprotein; LDL, low density lipoprotein; ApoA1, apolipoprotein A1; ApoB, apolipoprotein B; Lp(a), lipoprotein a.

Table 4 The ROC results of risk factors for predicting IOM in breast cancer patients

	Cutoff value	Sensitivity (%)	Specificity (%)	AUC	95% CI	P-value
ApoA1 (g/L)	1.165	0.813	0.849	0.871	0.794–0.948	<0.001
ApoB (g/L)	0.835	0.813	0.481	0.633	0.544–0.722	0.011

Abbreviations: AUC, area under the curve; ApoA1, apolipoprotein A1; ApoB, apolipoprotein B; IOM, intraocular metastases; ROC, receiver operating characteristics.

Figure 2 The ROC curves of risk factors for detecting IOM in breast cancer.

Notes: (A) The ROC curve of ApoA1. The AUC was 0.871 (P-values<0.001; 95% CI: 0.794–0.948) (IOMs<NIOMs); (B) The ROC curve of ApoB. The AUC was 0. 633 (P-values=0.011; 95% CI: 0.544−0.722) (IOMs>NIOMs).

Abbreviations: ROC, receiver operating characteristic; AUC, areas under the curve; CI, confidence interval; IOM, intraocular metastases; NIOM, non-intraocular metastases.

Table 5 Studies on the IOM from different cancers

Author	Year	Diseases with IOM
Garrett et al^Citation24	1959	Seminoma
Mcdonald et al^Citation27	1997	Esophageal carcinoma
Gangadharan et al^Citation31	1999	Choriocarcinoma
Pompeu et al^Citation30	2005	Renal cell carcinoma
Fang et al^Citation28	2007	Head and neck cancer
Kelmenson et al^Citation25	2011	Malignant melanoma
Sitaula et al^Citation29	2011	Gastric adenocarcinoma
Khawaja et al^Citation32	2015	Colorectal cancer
Niu et al^Citation26	2016	Non-small cell lung cancer

Abbreviation: IOM, intraocular metastases.

Garrett M. Ocular metastasis from seminoma. Br J Ophthalmol. 1959;43(12):759. doi:10.1136/bjo.43.12.75913826650

 PubMedGoogle Scholar

Mcdonald JW, Proia AD. Ocular metastasis as the initial presentation of esophageal carcinoma. Can J Ophthalmol. 1997;32(1):50–52.9047035

 PubMed Web of Science ®Google Scholar

Gangadharan VP, Prakash NP, Chitrathara K, Sasidharan K, Ramachandran K. Ocular metastasis of choriocarcinoma. Br J Radiol. 1999;72(864):1216–1217. doi:10.1259/bjr.72.864.1070348210703482

 PubMed Web of Science ®Google Scholar

Pompeu AC, Arap S, Silva MN, et al. Ocular metastasis as first presentation of renal cell carcinoma: report of 2 cases. Clinics. 2005;60(1):75–78. doi:10.1590/S1807-5932200500010001415838585

 PubMedGoogle Scholar

Fang KH, Chen CK, Hao SP. Acute visual loss in a head and neck cancer patient with ocular metastasis and sphenoid pyocele. Auris Nasus Larynx. 2007;34(4):569–571. doi:10.1016/j.anl.2007.02.00817490836

 PubMed Web of Science ®Google Scholar

Kelmenson AT, Grover S. Multiple bilateral ocular metastases from malignant melanoma associated with blue nevi. Eur J Ophthalmol. 2011;21(5):671–673. doi:10.5301/EJO.2011.637521360480

 PubMed Web of Science ®Google Scholar

Sitaula R, Shrestha GB, Paudel N, Shrestha JK. Ocular and orbital metastases presenting as a first sign of gastric adenocarcinoma. BMJ Case Rep. 2011;2011(dec02 1):422–425. doi:10.1136/bcr.10.2011.4927

 Google Scholar

Khawaja MR, Minturn JT, Spittler AJ, Chiorean EG. Ocular metastasis of colorectal cancer: an uncommon presentation of a common malignancy. Hematol Oncol Stem Cell Ther. 2015;8(4):176–180. doi:10.1016/j.hemonc.2015.02.00225784129

 PubMedGoogle Scholar

Niu F, Zhou Q, Yang J, et al. Distribution and prognosis of uncommon metastases from non-small cell lung cancer. BMC Cancer. 2016;16(1):149. doi:10.1186/s12885-016-2169-526911831

 PubMedGoogle Scholar