Changes in composition of fatty acids in plasma of patients with gastric adenocarcinoma and its predictive efficacy for clinical staging
Objective To compare the proportion of plasma fatty acids in patients with gastric adenocarcinoma of dif-ferent clinical stages and to explore the predictive value of differential fatty acids for the clinical stage of gastric adenocarci-noma.Methods Forty patients who underwent open or minimally invasive radical resection of gastric adenocarcinoma and were confirmed as gastric adenocarcinoma by postoperative pathology were selected.The patients were categorized into two groups based on the 8th edition of the American Joint Committee on Cancer(AJCC)clinicopathological staging crite-ria:the early stage group(stage Ⅰ/Ⅱ)of 21 cases and advanced stage group(stage Ⅲ/Ⅳ)of 19 cases.In the two groups,we used gas chromatography to detect the proportion of plasma fatty acids before surgery,drew the receiver operat-ing characteristic(ROC)curve of plasma fatty acids that were relatively different between the two groups to predict clinical stage,calculated the area under the curve(AUC),and analyzed its predictive value.Results In light of length:the pro-portions of plasma short-chain fatty acids(SCFA),medium-chain fatty acids(MCFA)and long-chain fatty acids(LCFA)in the early group were 0.13%(0.04%,0.53%),1.66%(0.16%,2.41%)and 96.93%(92.20%,99.66%),respec-tively,and those in the advanced stage group were 0.49%(0.14%,0.91%),1.88%(0.24%,3.52%),and 95.64%(93.72%,98.51%),respectively;the differences between the two groups were not statistically significant(all P>0.05).In light of structure:there was no statistically significant differences in the proportion of plasma saturated fatty acids(SFA),monounsaturated fatty acids(MUFA),polyunsaturated fatty acids(PUFA)and omega-3 polyunsaturated fatty ac-ids(Ω-3PUFA)or omega-6 polyunsaturated fatty acids(Ω-6PUFA)in PUFA between these two groups(all P>0.05);the proportion of palmitic acid(PA,C16:0)in plasma SFA of the advanced stage group was higher than that of the early group,and the proportion of α-linolenic acid(ALA,C18:3n3)in Ω-3PUFA of the advanced stage group was lower than that in the early group(all P<0.05);there was no significant difference in the proportions of other plasma fatty acids be-tween the two groups(all P>0.05).The AUC and 95%CI for plasma PA and ALA detection alone,as well as in combina-tion,to predict gastric adenocarcinoma stage were 0.697(0.534-0.860),0.703(0.528-0.878),and 0.797(0.657-0.937),respectively,and the sensitivities were 58.0%,66.7%,and 63.2%,respectively,and the specificities were 76.0%,84.2%,and 90.5%,respectively.Conclusions The proportion of plasma PA is higher in gastric adenocarci-noma patients of the advanced stage than in the gastric adenocarcinoma patients of the early stage,while the proportion of ALA is lower.The combined detection of the two is helpful for the preoperative determination of the clinical stage of the pa-tients with gastric adenocarcinoma.
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