title: Serum HDL-C as a potential biomarker for nodal stages in gastric cancer.
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 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 (> or =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.
authors.affiliation: Department of Surgery, Second Affiliated Hospital, Zhejiang University School of Medicine, #88 Jiefang Road, Hangzhou, PR China 310009.
authors.forename: Enqi
authors.initials: E
authors.lastname: Guo
authors.forename: Lirong
authors.initials: L
authors.lastname: Chen
authors.forename: Qiuping
authors.initials: Q
authors.lastname: Xie
authors.forename: Jian
authors.initials: J
authors.lastname: Chen
authors.forename: Zhiyu
authors.initials: Z
authors.lastname: Tang
authors.forename: Yulian
authors.initials: Y
authors.lastname: Wu
mesh_terms: D000230:Adenocarcinoma / Q000097:blood* / Q000473:pathology / Q000601:surgery; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D014408:Biomarkers, Tumor / Q000097:blood; D016009:Chi-Square Distribution; D008076:Cholesterol, HDL / Q000097:blood*; D008078:Cholesterol, LDL / Q000097:blood; D005260:Female; D005743:Gastrectomy; D006801:Humans; D016015:Logistic Models; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D011446:Prospective Studies; D012680:Sensitivity and Specificity; D013274:Stomach Neoplasms / Q000097:blood* / Q000473:pathology / Q000601:surgery; D014280:Triglycerides / Q000097:blood
chemical_list: D014408:Biomarkers, Tumor; D008076:Cholesterol, HDL; D008078:Cholesterol, LDL; D014280:Triglycerides