title: New utility of an old marker: serum low-density lipoprotein predicts histopathological response of neoadjuvant chemotherapy in locally advanced gastric cancer.
abstract: BACKGROUND
  Although the correlation between metabolic abnormality and gastric cancer has been extensively investigated, the question of whether metabolic parameters might influence the efficacy of chemotherapy in locally advanced gastric cancer is still unanswered. In our present study, we investigated the relationship between serum fasting glucose, lipid levels, and histopathological response of neoadjuvant chemotherapy (NAC) in locally advanced gastric cancers.
  
  
  METHODS
  A total of 128 patients were identified from a prospectively maintained database of patients with locally advanced gastric cancer who received NAC between July 2004 and December 2012. Histopathological response after NAC was analyzed according to Becker's tumor-regression grade. Univariate analyses and multivariable regression analyses were performed to determine the correlation between tumor size, differentiation, fasting glucose, lipid levels, and tumor histopathological response after NAC.
  
  
  RESULTS
  Univariate analysis revealed that low-density lipoprotein level and total cholesterol, as well as tumor size and differentiation, correlated significantly with histopathological response. Low-density lipoprotein levels and tumor size were found to be independent predictors for histopathological response, according to multivariable regression analyses.
  
  
  CONCLUSIONS
  In this observational, hypothesis-generating study, serum low-density lipoprotein measurement was found to be useful in predicting chemosensitivity to locally advanced gastric cancer patients undergoing NAC. Incorporation of serum low-density lipoprotein levels into individualized treatment protocols could be considered in clinical practice.
authors: Department of Surgical Oncology, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine.
authors: Ji-Chun
authors: JC
authors: Zhou
authors: Department of Surgical Oncology, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine; Department of Surgical Oncology, Hangzhou First People's Hospital, Hangzhou, People's Republic of China.
authors: Ju-Feng
authors: JF
authors: Guo
authors: Department of Surgical Oncology, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine.
authors: Rong-Yue
authors: RY
authors: Teng
authors: Department of Surgical Oncology, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine.
authors: Qin-Chuan
authors: QC
authors: Wang
authors: Department of Surgical Oncology, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine.
authors: Ji
authors: J
authors: Wang
authors: Department of Surgical Oncology, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine; Department of International Medicine and Molecular Biology, University of Texas Southwestern Medical Center, Dallas, TX, USA.
authors: Qun
authors: Q
authors: Wei
authors: Department of Surgical Oncology, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine; Dendritic Cell Biology and Therapeutic Group, ANZAC Research Institute, University of Sydney, Sydney, NSW, Australia.
authors: Zi-Duo
authors: ZD
authors: Li
authors: Department of Surgical Oncology, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine.
authors: Jian-Guo
authors: JG
authors: Shen
authors: Department of Surgical Oncology, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine; Biomedical Research Center and Key Laboratory of Biotherapy of Zhejiang Province, Hangzhou, People's Republic of China.
authors: Lin-Bo
authors: LB
authors: Wang
keywords: gastric cancer; histopathological response; low-density lipoprotein; neoadjuvant chemotherapy; predictive biomarker