title: Urinary cytidine as an adjunct biomarker to improve the diagnostic ratio for gastric cancer in Taiwanese patients.
abstract: BACKGROUND
  Gastric cancer is a major public health concern as the fourth most common cancer, and it is of particular relevance as the second most common cause of cancer death worldwide. We caparisoned the urinary nucleoside concentrations between the gastric patients and healthy volunteers that try to evaluate the diagnostic value in the gastric cancer.
  
  
  METHODS
  Urinary nucleosides from 49 gastric patients and 40 healthy volunteers were evaluated by high-performance liquid chromatography/electrospray ionization-tandem mass spectrometry (HPLC/ESI-MS/MS) under optimized conditions as determined in our previous study.
  
  
  RESULTS
  The mean concentrations of 5 urinary nucleosides, cytidine, 3-methylcytidine (m3C), 1-methyladenosine (m1A), adenosine, and inosine, were found to be elevated in cancer patients, but only cytidine showed a significant elevation. Moreover, cytidine concentrations were significantly elevated by an average of 1.42-fold in patients with late stage (S3+4) disease. Combining the determined concentrations of preoperative serum alpha-fetoprotein (AFP, cutoff of 20 μg/l) or carbohydrate antigen 19-9 (CA19-9, cutoff of 37 U/ml) with the mean urinary cytidine concentration was shown to improve the diagnostic ratio (sensitivity) for gastric cancer from 16.3% (8/49 patients) to 38.8% (8+11/49 patients) or from 28.6% (14/49 patients) to 51.0% (14+11/49 patients), respectively.
  
  
  CONCLUSIONS
  Urinary cytidine may be an important adjunct biomarker for gastric cancer.
authors.affiliation: Department of Medical Research, China Medical University Hospital, Taichung, Taiwan; Graduate Institute of Integrated Medicine, China Medical University, Taichung, Taiwan; Department of Life Science, National Chung Hsing University, Taichung, Taiwan.
authors.forename: Wan-Yu
authors.initials: WY
authors.lastname: Lo
authors.affiliation: Department of Surgery, China Medical University Hospital, Taichung, Taiwan.
authors.forename: Long-Bin
authors.initials: LB
authors.lastname: Jeng
authors.affiliation: Institute of Molecular Biology, National Chung Hsing University, Taichung, Taiwan.
authors.forename: Chien-Chen
authors.initials: CC
authors.lastname: Lai
authors.affiliation: Department of Medical Research, China Medical University Hospital, Taichung, Taiwan; Graduate Institute of Chinese Medical Science, China Medical University, Taichung, Taiwan. Electronic address: d0704@mail.cmuh.org.tw.
authors.forename: Fuu-Jen
authors.initials: FJ
authors.lastname: Tsai
authors.affiliation: Department of Laboratory Medicine, China Medical University Hospital, Taichung, Taiwan; Department of Biomedical Informatics, Asia University, Taichung, Taiwan.
authors.forename: Chiung-Tsung
authors.initials: CT
authors.lastname: Lin
authors.affiliation: Department of Surgery, China Medical University Hospital, Taichung, Taiwan; Division of Colorectal Surgery, Department of Surgery, China Medical University Hospital, Taichung, Taiwan.
authors.forename: William Tzu-Liang
authors.initials: WT
authors.lastname: Chen
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D014408:Biomarkers, Tumor / Q000652:urine*; D003562:Cytidine / Q000652:urine*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D013274:Stomach Neoplasms / Q000175:diagnosis* / Q000652:urine*; D013624:Taiwan
chemical_list: D014408:Biomarkers, Tumor; D003562:Cytidine
keywords: AFP; CA19-9; Cytidine; Gastric cancer; Urinary nucleoside