Association of Plasma Lipid Patterns and LDL Cholesterol Levels with Breslow Thickness and Ulceration in Melanoma Patients

Szász, István and Koroknai, Viktória and Várvölgyi, Tünde and Pál, László and Szücs, Sándor and Pikó, Péter and Emri, Gabriella and Janka, Eszter and Szabó Lőrinc, Imre and Ádány, Róza and Balázs, Margit (2025) Association of Plasma Lipid Patterns and LDL Cholesterol Levels with Breslow Thickness and Ulceration in Melanoma Patients. INTERNATIONAL JOURNAL OF MOLECULAR SCIENCES, 26. No. 1716. ISSN 1661-6596

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Abstract

Recent evidence has highlighted the critical role of lipids in tumor biology. In this study, we analyzed the plasma lipid profiles of 151 melanoma patients (University of Debrecen, Department of Dermatology, Hungary) to examine the associations between specific lipid species and commonly used LDL-C lipid parameters, as well as the Breslow thickness and ulceration of primary tumors. Our analysis included patients who underwent primary tumor resection, comprising 83 individuals without metastases and 68 with metastases at the time of blood sampling. Lipid profiling was performed using the Lipidyzer™ platform, which targets over 1100 lipid species. Following quality control filtering, 802 lipids were included in the subsequent analyses. Ten lipids were found to have decreased plasma levels, while one lipid exhibited elevated plasma levels, both associated with an increased risk of higher Breslow thickness. Additionally, patients with thicker tumors (≥2 mm) demonstrated significantly higher LDL-C levels after adjusting for age, sex, therapy, and tumor presence (p = 0.032). Using forward stepwise regression, we identified a combination of four lipids-(CE(20:5), LCER(24:1), PE(P18:1/18:1), and LPE(18:2))-that demonstrated the strongest correlation with Breslow depth (AUC = 0.779, as determined by ROC analysis). Additionally, we identified 11 lipids significantly associated with tumor ulceration. Stepwise regression analysis further revealed two lipids (FFA(16:0) and PC(15:0/18:1)) capable of predicting tumor ulceration with an AUC score of 0.740. These findings suggest that individual lipid metabolism may influence tumor thickness and ulceration during the development and progression of primary melanoma.

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