Cancer Res Treat.  2021 Apr;53(2):445-456. 10.4143/crt.2020.599.

Associations of Serum Lipid Level with Gastric Cancer Risk, Pathology, and Prognosis

• Pih GY
• Gong EJ
• Choi JY
• Kim MJ
• Ahn JY
• Choe J
• Bae SE
• Chang HS
• Na HK
• Lee JH
• Jung KW
• Kim DH
• Choi KD
• Song HJ
• Lee GH
• Jung HY

• KMID: 2514926
• DOI: http://doi.org/10.4143/crt.2020.599

Abstract

Purpose
The association of serum lipids with gastric cancer is controversial. We clarified the role of serum lipids in the development, progression, and prognosis of gastric cancer.
Materials and Methods
In total, 412 patients diagnosed with gastric cancer were prospectively recruited, and 2,934 control subjects who underwent screening endoscopy were enrolled from December 2013 to March 2017 to conduct a case-control study in a tertiary center. Serum lipid profiles, including total cholesterol, high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), triglyceride (TG), apolipoprotein A-I (apoA-I), and apolipoprotein B, and clinicopathologic characteristics were analyzed.
Results
The gastric cancer group showed significantly lower HDL-C, higher LDL-C, and lower apoA-I level than the control group. In multivariate analysis, old age (odds ratio [OR], 1.051; p < 0.001), smoking (OR, 1.337; p < 0.001), a family history of gastric cancer (OR, 2.038; p < 0.001), Helicobacter pylori seropositivity (OR, 4.240; p < 0.001), lower HDL-C (OR, 0.712; p=0.020), and higher LDL-C (p=0.002) were significant risk factors for gastric cancer. Lower HDL-C and higher LDL-C remained significant after adjustments for covariates, including age and sex. In a subgroup analysis of the gastric cancer group, lower TG levels were associated with undifferentiated histology. No serum lipids were associated with overall survival.
Conclusion
Lower HDL-C and higher LDL-C were associated with the risk of gastric cancer, even after adjusting for age, sex, and other factors. In the gastric cancer group, undifferentiated histology was associated with lower TG levels.

Keyword

Stomach neoplasms; Dyslipidemias; Incidence; Prognosis

Figure

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  Fig. 1 Study flowchart.

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  Fig. 2 Comparison of serum lipid levels the between control and gastric cancer groups. Comparison of total cholesterol levels between the gastric cancer and control groups among the total population (A), male (B), and female (C) groups. High-density lipoprotein cholesterol levels were significantly lower in the gastric cancer group than in the total population (D), male (E), and female (F) control groups. Low-density lipoprotein cholesterol levels were higher in the gastric cancer group (G-I). No significant association was found between triglyceride levels and gastric cancer in the (J) total population or (K) male group, but a significant association was found in the (L) female group.

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  Fig. 3 Comparison of serum lipid levels between differentiated and undifferentiated gastric cancer groups. Total cholesterol levels showed no significant difference between the differentiated and undifferentiated gastric cancer subgroups among the total population (A) and male groups (B), but a significant difference was seen in the female group (C). No significant association was found between high-density lipoprotein cholesterol and differentiation in the total population (D), male (E), and female (F) groups. Low-density lipoprotein had no significant difference between the differentiated and undifferentiated gastric cancer subgroups in the total population (G) and male groups (H), but a significant difference was seen in the female group (I). Triglyceride levels were lower in the undifferentiated subgroup than in the total population (J), male (K), and female (L) groups.

Reference

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