New utility of an old marker: serum low-density lipoprotein predicts histopathological response of neoadjuvant chemotherapy in locally advanced gastric cancer

Abstract

Ji-Chun Zhou,1 Ju-Feng Guo,1,2 Rong-Yue Teng,1 Qin-Chuan Wang,1 Ji Wang,1 Qun Wei,1,3 Zi-Duo Li,1,4 Jian-Guo Shen,1 Lin-Bo Wang1,5 1Department of Surgical Oncology, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, 2Department of Surgical Oncology, Hangzhou First People’s Hospital, Hangzhou, People’s Republic of China; 3Department of International Medicine and Molecular Biology, University of Texas Southwestern Medical Center, Dallas, TX, USA; 4Dendritic Cell Biology and Therapeutic Group, ANZAC Research Institute, University of Sydney, Sydney, NSW, Australia; 5Biomedical Research Center and Key Laboratory of Biotherapy of Zhejiang Province, Hangzhou, People’s Republic of China 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. Patients and 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. Conclusion: 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. Keywords: gastric cancer, neoadjuvant chemotherapy, low-density lipoprotein, histopathological response, predictive biomarker

Keywords

• Gastric caner
• Neoadjuvant chemotherapy
• Low-density lipoprotein
• Histopathological response
• Predictive biomarker;