Abstract
BackgroundGastric cancer is one of the most common malignant tumors in the world. Finding effective diagnostic biomarkers in urine or serum would represent the most ideal solution to detecting gastric cancer during annual physical examination. This study was to evaluate the potential of endothelial lipase (EL) as a urinary biomarker for diagnosis of gastric cancer.MethodsThe expression levels of EL was measured using Western blotting and immunohistochemical staining experiments on (tissue, serum, and urine) samples of gastric cancer patients versus healthy people. We also checked the EL levels in the urine samples of other cancer types (lung, colon and rectum cancers) and benign lesions (gastritis and gastric leiomyoma) to check if EL was specific to gastric cancer.ResultWe observed a clear separation between the EL expression levels in the urine samples of 90 gastric cancer patients and of 57 healthy volunteers. It was approximately 9.9 fold average decrease of the EL expression levels in the urine samples of gastric cancer compared to the healthy controls (P <0.0001), achieving a 0.967 AUC value for the ROC (receiver operating characteristic) curve, demonstrating it’s highly accurate as a diagnostic marker for gastric cancer. Interestingly, the expression levels of EL in tissue and serum samples were not nearly as discriminative as in urine samples (P = 0.90 and P = 0.79). In immunohistochemical experiments, positive expression of the EL protein was found in 67% (8/12) of gastric adjacent noncancerous and in 58% (7/12) of gastric cancer samples. There was no significant statistical in the expression levels of this protein between the gastric cancer and the matching noncancerous tissues (P =0.67).ConclusionsThe urinary EL as a highly accurate gastric cancer biomarker that is potentially applicable to the general screening with high sensitivity and specificity.Virtual SlidesThe virtual slide(s) for this article can be found here: http://www.diagnosticpathology.diagnomx.eu/vs/4527331618757552
Highlights
Gastric cancer is one of the most common malignant tumors in the world
The urinary endothelial lipase (EL) as a highly accurate gastric cancer biomarker that is potentially applicable to the general screening with high sensitivity and specificity
Urine samples were obtained from 9 lung cancer patients, 10 from colon cancer patients, 10 rectum cancer patients, 2 gastritis patients, and 2 gastric leiomyoma patients, which are used to check if EL is specific to gastric cancer
Summary
Gastric cancer is one of the most common malignant tumors in the world. Finding effective diagnostic biomarkers in urine or serum would represent the most ideal solution to detecting gastric cancer during annual physical examination. This study was to evaluate the potential of endothelial lipase (EL) as a urinary biomarker for diagnosis of gastric cancer. Effective diagnostic biomarkers in urine or serum would represent the most ideal solution to the problem, which allows testing for gastric cancer through blood or urine tests during annual physical examinations. Several diagnostic serum markers have been proposed for gastric cancer, such as MG7-Ag [5], carcinoembryonic antigen (CEA), MUC1 and MUC5AC [6]. Compared with tissue and serum, urine collection is relatively easier and less invasive It may be more suitable for large scale screening for cancer detection [8]. There is clearly an urgent need for identification and validation of novel and reliable diagnostic markers for screening gastric cancer
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