| ObjectiveAt present, the incidence and fatality rate of gastric cancer increases rapidly, and thefourth and the second position is occupied in the malignant tumor around the worldrespectively, according to the statistics. The incidence of this disease in developingcountries is about two-thirds, while it is top in China. In the total number of gastric canceraround the world, the number of morbidity in our country can reach up to42%. Its deathrate occupies the first position in malignant tumors, and does not see obvious downwardtrend. Although, some researches have reported that the low level of serumhigh-density-lipoprotein cholesterols (HDL-C) would have adverse effects on gastriccancer. But the special relationship between the level of serum HDL-C and gastric canceris still unknown at present. This article adopts retrospective study to research the level ofHDL in patients’ serum, because the level of this material usually reflects whether there issomething abnormal in patients’ lipid metabolism prior to surgery. And further research isbe done to study the relationship of prognosis between HDL and gastric cancer.Methods:Collect the263cases which refer to the patients who were diagnosed with gastriccancer before operations in department of general surgery of the central hospital of Taian,and received the radical treatment of gastric cancer as well as normal lymph body excision.The patients who are qualified to be included into this research includes the persons whohave been diagnosed with stomach cancer by endoscopic biopsy and never suffered frommalignant tumor before, or had no co-existence malignant tumor. Otherwise, in order toevaluate the malignant tumor staging, the patients are carried on enhanced CT inspection.If the patient was treated with oral drugs due to other accompanying diseases, whichcaused the level of serum lipid (for example, diabetes, hyperlipemia, or metabolic syndrome)increasing, then exclude them. There are a total of178cases of patients whowere never treated with oral drugs being included in this study. There are116men and62women. Their median age is67.8(from38years old to81years old). Histologically,moderately differentiated or well differentiated tubular adenocarcinoma and papillaryadenocarcinoma was regarded as differentiated carcinoma. And poor differentiationadenocarcinoma and signet ring cell carcinoma are classified as undifferentiated carcinoma.Standardized operation scheme is carried as following:(1) the stomach is cut off totally orpartly.(2) Carry on extensive lymph nodes.178patients were collected morning fasting blood samples to determine the level ofHDL–C in serum before operation2-6days. The level of HDL-C in serum under40mg/dlwas defined as the low level. ALL the patients who matched the requirements were dividedinto2groups: the group of low and normal level of HDL-C in serum. Patients from eachgroup were collected fasting venous blood3mL in the early morning. And then measurethe level of TG, TC and HDL with enzymic methods.Through telephone as well as clinical follow-up, the primary endpoint was overallsurvival. It is defined as the time which from the date of operation to the death date due toany reasons, and is used for measuring prognosis.Analyze the relationship between the level of HDL-C and gastric cancer with singlefactor or multiple factors.ResultsFeature before operation: There is no obvious difference between the two groups inage and gender. The group of the low level of HDL-C has significantly higher BMI andincidence of triglycerides compared with the group of high level(p<0.05).Operation result: Compared with the low HDL-C group, the operative time of thenormal group is obviously shorter, and the hemorrhage amount is obviously less(p<0.05).The size of the tumor, process of operation, complete resection rate, duration ofhospitalization has no obvious difference between the two groups(p>0.05).Pathological feature: The diameter of the tumor, histological type, occurrence of livermetastasis, emergence of peritoneal metastasis, inspection result of peritoneal lavagecytology, and pathological stage are similar between the two groups. But the low HDL-Cgroup is easy to come up with lympho node metastasis and capillary infiltration(p<0.05).Prognosis: There is no obvious difference between the two groups in total death rate.But compared with the normal HDL-C group, the patients from the low HDL-C havehigher death rate related with gastric cancer(p<0.05). ConclusionThis research demonstrated that there is a positive correlation between the low levelof HDL-C before operation and the prognosis of gastric cancer. As a result, the level ofHDL-C in serum may can be a factor to assess clinical prognosis for patients with gastriccancer. |
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