| Objective:Gastric cancer is one of the most common malignant tumors in the world and most of the patients have been in progressive stage at the time of diagnosis.In recent years,with the popularity of gastroscopy,the diagnosis rate of gastric cancer has increased year by year.However,gastroscopy cannot be accepted by most people because of its invasiveness.Therefore,more non-invasive methods or indicators for diagnosing gastric cancer need to be discovered,such as hematology.Lipoprotein-a is an independent and complex plasma lipoprotein.In recent years,some scholars have focused on the role of lipoprotein-a in tumor growth and development,finding that it has a great influence on tumor growth,such as lung cancer,breast cancer and blood system.So far,the relationship between lipoprotein-a and the occurrence,development,stage,differentiation as well as the prognosis of gastric cancer has been unreported.This study was aimed to investigate the significance of the level of serum lipoprotein-a in the diagnosis and prognosis of gastric cancer.Methods:A total of 220 patients with newly diagnosed gastric cancer admitted to Affiliated Hospital of Qingdao University and 101 healthy checker in the corresponding period were studied and their age,gender,BMI,gastric cancer pathological staging,grade and serum lipoprotein-a were collected.Lipoprotein-a is greatly affected by estrogen.It increases with the decrease of estrogen.Most people with high incidence of gastric cancer are middle-aged and elderly,which affects the comparison of lipoprotein-a levels between female patients and healthy people.Therefore,this study separated male patients from gastric cancer.In the meantime,152 male patients with newly treated gastric cancer and 90 male health examiners were selected as study objects.The statistical indicators are as described above.Statistical methods:The data was analyzed through SPSS 22.0.The data of categorical variables were compared by variance analysis.The correlation between the level of serum lipoprotein-a and the tumor stage,differentiation degree as well as the pathological classification was evaluated by t-test of independent samples.The critical value of lipoprotein-a was determined according to the ROC curve and the area under the curve of the patients in the male gastric cancer group,and the patients receiving stage III and IV chemotherapy were divided into groups.The survival curve was constructed through Kaplan-Meier method.Cox proportional risk regression model was used for univariate and multivariate analysis to evaluate prognostic factors.Only factors with statistical significance in univariate analysis were included in multivariate analysis.When p<0.05,the difference was statistically significant.Results:1.There was no significant correlation between serum lipoprotein-a level and gastric cancer staging in the comparison between gastric cancer group and control group(p=0.058).2.Serum lipoprotein a levels were significantly higher in the male gastric cancer group compared with the male control group(p=0.000);3.In the subgroup analysis,the lipoprotein-a level in patients with stage i-iii gastric cancer showed an increasing trend,while the lipoprotein-a level in patients with stage IV gastric cancer was higher than that in stage III patients,but there was no statistical difference(p=0.298).4.The level of lipoprotein-a in the low differentiated group of male patients with gastric cancer was higher than that in the high and middle differentiated group(p=0.018).5.There was no significant difference in the level of lipoprotein-a(p=0.892)in different pathological types of male patients with gastric cancer.6.Among the male gastric cancer patients receiving chemotherapy at stage III and IV,the cut-off point was lipoprotein a=308mg/L,and the median survival time of lipoprotein a>308mg/L was shorter than that of lipoprotein a<308mg/L(p=0.046).Conclusion:1.According to the experimental results,the level of serum lipoprotein-a is correlated with the staging and differentiation degree of gastric cancer but has nothing to do with the pathological classification of gastric cancer.2.In this study,it was also shown that the level of lipoprotein-a was correlated with the prognosis of patients with gastric cancer. |
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