The Association Between Low Level Of Serum HDL-C And Lymph Node Metastasis And Prognosis In Gastric Cancer

Aims:The objective of this study was to assess the relationship between serum lipid levels and lymph node metastasis and prognosis in gastric cancer.Methods:Preoperative serum lipid concentrations and clinicopathological characteristics were retrospectively examined in 358 patients who were diagnosed as gastric cancer pathologically. Follow up was made from their surgery day. The primary endpoint was overall survival. Univariate and multivariate analyses were carried out to investigate the association of serum lipid levels with nodal status and prognosis.Results:Mean level of serum high-density lipoprotein cholesterol (HDL-C) in node-positive patients was significantly lower than that of node-negative patients (46.96±14.04 mg/dl vs 51.33±14.91 mg/dl, p=0.009). A cut-off level of serum HDL-C at 54.20 mg/dl was found, which had optimal sensitivity and specificity of 44.3% and 73.4% respectively in the prediction of lymph node metastasis. A logistic regression model revealed that low level of serum HDL-C (< or=54.20 mg/dl) was one of the independent risk factors for nodal metastasis in gastric cancer with OR value of 2.07 (95% CI:1.14～3.75). Median follow-up was 22.3 months. Kaplan-Meier curves showed that low level of serum HDL-C was not associated with patients'prognosis in gastric caner (p=0.643). Conclusions:Low level of serum HDL-C was independently associated with lymph node metastasis in gastric cancer, but not a predictor of short-term survival.