Serum HDL-C as a potential biomarker for nodal stages in gastric cancer
Serum HDL-C as a potential biomarker for nodal stages in gastric cancer
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血清 HDL-C 作为胃癌淋巴结分期的潜在生物标志物
DOI：
10.1245/s10434-007-9401-0
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发表时间：
2007-09-01
影响因子：
3.7
通讯作者：
Wu, Yulian
中科院分区：
文献类型：
--
作者：
Guo, Enqi;Chen, Lirong;Wu, Yulian
背景资料：虽然血脂谱的变化已被记录在胃肠道肿瘤，血脂水平和淋巴结（N）阶段在胃癌之间的具体关系仍不确定。方法：术前血脂浓度进行了回顾性研究，在501例接受根治性切除术的原发性胃癌。结果：胃癌患者血清高密度脂蛋白胆固醇（HDL-C）水平与N分期有较好的相关性。HDL-C < 40 mg/dl者pN（2-3）病变发生率（57.6%，83/144）明显高于HDL-C正常者（36.4%，130/357; P < 0.05）。pN（2-3）组TC/HDL-C比值升高与pN（0-1）组比较有统计学意义（平均值3.57 vs.3.31，P < 0.05）。经受试者操作特征分析，血清HDL-C浓度和TC/HDL-C比值联合预测pN（2-3）期的敏感性为70.0%，特异性为51.0%。Logistic回归模型显示，低HDL-C（< 40 mg/dl）和高TC/HDL-C比值（>= 3.32）与晚期pN（2-3）分期独立相关。结论：胃癌患者术前低HDL-C或高TC/HDL-C比值可能是晚期pN（2-3）分期的潜在生物标志物，尤其是组织学分化型胃癌患者。
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 pN(2-3) 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 pN(2-3) disease was statistically significant when compared with that for patients with pN(0-1) 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 pN(2-3). 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 pN(2-3) 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 pN(2-3) stages, especially for those with the histologically differentiated type.