Investigation Of The Value Of Homocysteine In The Diagnosis Of Gastric Cancer And Its Association With Gastric Cancer Staging

BackgroundAs is known to all, gastric cancer is one of the common gastrointestinal malignant tumors. According to the Chinese cancer statistics, the gastric cancer takes the second place in all malignant tumors, being a serious threat to people’s health. Compared with developed countries such as Japan and Europe and the United States, the mortality rate of Chinese gastric cancer is higher, and the major reason, with the exception of the disease and treatment factors, is the deficiency of screening and early diagnosis. The methods used for screening and diagnosis of gastric cancer include hematology examinations, imaging examinations and pathological examinations. It have confirmed that the serum homocysteine (Hcy) is an independent risk factor for cardiovascular disease, and regarded as a kind of new risk factors for cancer. It may be closely related to the infiltration, metastasis, proliferation and differentiation of malignant tumor cell. Literatures reported that Hcy has certain diagnostic value in malignant tumors from digestive system, respiratory system and reproductive endocrine system. But the study about the value of homocysteine in the diagnosis of gastric cancer and its association with gastric cancer staging was not reported.ObjectiveTo investigate the value of Hcy in the diagnosis of gastric cancer, by comparing the serum Hcy concentrations of patients with benign gastric diseases and with gastric cancer. To study its associations with gastric cancer staging, by comparing the serum Hcy concentrations of patients with gastric cancer at different pathological staging.MethodsWe selected cases of benign gastric diseases and gastric cancer admitted by Shandong University Qilu Hospital during the date from 2014.03 to 2015.06, among whom there are 90 patients with benign gastric diseases and 138patients with gastric cancer. The patients with gastric cancer were divided into 4 groups, according to the 7th AJCC Cancer Staging, and the benign gastric disease patients were divided into three groups according to the results of gastro scope and pathology. All of them volunteered as subjects and received our surveys on general information and laboratory tests. Enzymatic cycling assay was used for detecting serum Hey. All of the analyses are accomplished with SPSS 19.0.Results1. The changing trend of serum Hey level between benign diseases group and cancer group is similar to other tumor markers, such as AFP, CEA, CA199, CA125, and CA724. The Hey level in benign group is significantly lower than the cancer group.(12.31±3.22 umol/L vs 16.19±4.84 umol/L,p<0.05)2. In cancer groups, the serum Hey concentration levels are associated with clinical gastric cancer staging, and increased gradually from staging I to staging Ⅳ.(13.94±4.08 umol/L vs 15.49±4.10 umol/L vs 17.10±4.80 umol/L vs 19.81±5.77 umol/L, p<0.05)3. The serum Hcy concentration level is positively correlated with the severity of gastric disease (r=0.503, P< 0.01), and it is positively correlated with the staging of gastric cancer (r=0.355, P< 0.01).4. Logistic regression analysis showed that, the serum Hcy concentration level is significantly correlated with gastric cancer, after the adjustment of other risk factors such as age, gender, CEA and CA125. (OR=1.208, p=0.003)Conclusions1. The concentration levels of serum Hcy is closely correlated with gastric cancer.2. The serum Hcy is a risk factor of gastric cancer, and can be regard as a kind of tumor markers for the early detection of gastric cancer.3. The serum Hcy concentration level is closely correlated with gastric cancer staging, and increase significantly with the cancer staging(from staging I to staging Ⅳ), so it can be used to evaluate the severity of gastric cancer.