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Serum HDL-C as a Potential Biomarker for Nodal Stages in Gastric Cancer

  • Gastrointestinal Oncology
  • Published:
Annals of Surgical Oncology Aims and scope Submit manuscript

Abstract

Background

Although changes in lipid profile have been documented in gastrointestinal cancers, the specific relationship between serum lipid levels and lymph node (N) stages in gastric cancer remains uncertain.

Methods

Preoperative serum lipid concentrations were retrospectively examined in 501 patients who underwent curative resection for primary gastric cancer. Univariate and multivariate analyses were carried out to investigate the association of serum lipid levels with nodal stages.

Results

The serum high-density lipoprotein cholesterol (HDL-C) levels in gastric cancer patients correlated well with N stages. Cases with low HDL-C (<40 mg/dl) presented more advanced pN2–3 disease (57.6%, 83/144) than those with normal HDL-C (36.4%, 130/357; P<0.05). The observed elevation of the TC/HDL-C ratio for patients with pN2–3 disease was statistically significant when compared with that for patients with pN0–1 disease (mean values 3.57 vs. 3.31, P < 0.05). By receiver operating characteristic analysis, the combination of serum HDL-C concentration and TC/HDL-C ratio led to a sensitivity of 70.0% and a specificity of 51.0% in predicting stage pN2–3. A logistic regression model revealed that both low HDL-C (<40 mg/dl) and high TC/HDL-C ratio (≥3.32) had an independent association with advanced pN2–3 stages. When patients’ lipid levels were stratified by means of histological differentiation, the significant correlation of serum HDL-C levels with nodal stages was only detected in differentiated gastric cancer.

Conclusions

For gastric cancer patients, preoperative low serum HDL-C concentration or high TC/HDL-C ratio might be a potential biomarker of advanced pN2–3 stages, especially for those with the histologically differentiated type.

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ACKNOWLEDGEMENTS

This work was supported by grants from the National Natural Science Foundation of China (no. 30471697 and no. 30672072), Natural Science Foundation of Zhejiang, China (no. Z204033) and Foundation of Science and Technology Department of Zhejiang Province, China (no. 2006C23G2010216). *The first two authors contributed equally to this work.

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Authors and Affiliations

  1. Department of Surgery, Second Affiliated Hospital, Zhejiang University School of Medicine, #88 Jiefang Road, Hangzhou, P.R. China, 310009

    Enqi Guo MD, Qiuping Xie MD, Jian Chen MD, Zhiyu Tang MD & Yulian Wu MD

  2. Department of Pathology, Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China

    Lirong Chen MD

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  1. Enqi Guo MD
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  2. Lirong Chen MD
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  3. Qiuping Xie MD
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  4. Jian Chen MD
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  5. Zhiyu Tang MD
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  6. Yulian Wu MD
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Corresponding author

Correspondence to Yulian Wu MD.

Additional information

The abbreviation of pT and pN denotes pathologically confirmed tumor-nodes.

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Guo, E., Chen, L., Xie, Q. et al. Serum HDL-C as a Potential Biomarker for Nodal Stages in Gastric Cancer. Ann Surg Oncol 14, 2528–2534 (2007). https://doi.org/10.1245/s10434-007-9401-0

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  • DOI: https://doi.org/10.1245/s10434-007-9401-0

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