Significance of preoperative ischemia- modified albumin in operable and advanced gastric cancer

Article type: Research Article

Authors: Huang, Qing-Xing^{a; 1} | Ma, Jun^{a; 1} | Wang, Yu-Sheng^{b; *}

Affiliations: [a] From the Department of Digestive Surgery, Shanxi Cancer Hospital, Taiyuan 030013, Shanxi, China | [b] From the Digestive System Department, Shanxi Cancer Hospital, Taiyuan 030013, Shanxi, China

Correspondence: [*] Corresponding author: Yu-Sheng Wang, Digestive System Department, Shanxi Cancer Hospital, No.3 Zhigong New Street, Xinghualing District, Taiyuan 030013, Shanxi, China. Tel.: +86 351 4651509; Fax: +86 351 4651509; E-mail: [email protected].

Note: [1] Dr. Yu-Sheng Wang contributed to the conception of the study. Dr. Qing-Xing Huang and Dr. Jun Ma contributed significantly to analysis and manuscript preparation and wrote the manuscript; Dr. Qing-Xing Huang and Dr. Jun Ma contributed to this work equally.

Abstract: BACKGROUND: Oxidative stress plays an important role in promoting proliferation and metastases of cancer, which can be represented by ischemia-modified albumin (IMA). The purpose of this study was to evaluate serum IMA level in patients with operable advanced gastric cancer and analyze its prognostic significance. MATERIALS AND METHODS: A total of 274 patients with primary stage III gastric cancer underwent curative operation were enrolled in this study. Serum IMA level was measured within 24 hours before surgery, comparing with 112 healthy donors. The correlation between serum IMA level and survival outcome was analyzed by the Kaplan-Meier with Log-Rank test and Cox’s regression methods, respectively. RESULTS: Serum IMA level from gastric cancer was higher than healthy control (0.41 ± 0.12 VS 0.23 ± 0.08; P< 0.001). Finally, 173 and 181 patients out of all 274 patients studied had died and recurrent, respectively. All patients were stratified into two groups using the optimal cutoff value (0.45) of IMA level using a sensitivity of 92.5% and a specificity of 65.2% as optimal conditions from receiver operating curve analysis. Patients with a IMA ⩾ 0.45 had poorer mean overall survival (44.68 months VS 30.94 months, P= 0.010) and mean recurrence free survival (42.36 months VS 28.82 months, p= 0.01) than patients with a IMA < 0.45 in univariate analysis and IMA also been confirmed as independent predictor for survival for GC patients in multivariate analysis (OR, 0.731; 95% CI: 0.329–1.282; p= 0.023). CONCLUSIONS: Serum IMA level can be considered as an independent prognostic factor for operable and advanced gastric cancer.

Keywords: Ischemia-modified albumin, survival, gastric cancer

DOI: 10.3233/CBM-171090

Journal: Cancer Biomarkers, vol. 22, no. 3, pp. 477-485, 2018