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10.1245/s10434-006-9091-z
Annals of Surgical Oncology 14:84-93 (2007)
© 2007 Society of Surgical Oncology
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Original Article

Evaluation of Serum Amyloid A as a Biomarker for Gastric Cancer

De-Chuan Chan, MD1, Cheng-Jueng Chen, MD1, Heng-Cheng Chu, MD2, Wei-Kuo Chang, MD2, Jyh-Cherng Yu, MD1, Yu-Ju Chen3, Li-Li Wen4, Su-Ching Huang5, Chih-Hung Ku6, Yao-Chi Liu, MD1 and Jenn-Han Chen, MD5

1 Division of General Surgery, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
2 Division of Gastroenterology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
3 Institute of Chemistry, Academia Sinica, Taipei, Taiwan
4 Department of Clinical Laboratory, En Chu Kong Hospital, Taipei, Taiwan
5 Department of Dentistry, Tri-Service General Hospital, National Defense Medical Center, National Defense University, Taipei, 114, Taiwan
6 School of Public Health, National Defense Medical Center, Taipei, Taiwan

Correspondence: Address correspondence and reprint requests to: De-Chuan Chan, MD; E-mail: chrischan1168{at}yahoo.com.tw, Jenn-Han Chen, MD; E-mail: jhc.ndmc{at}msa.hinet.net

Background: Serum amyloid A (SAA) is a useful biomarker for gastric cancer in an animal model. We investigated the potential of SAA as a biomarker for gastric cancer in humans.

Methods: Serum levels of SAA from 96 gastric cancer patients were measured before and after curative gastrectomy; 32 patients with gastric ulcers and 52 healthy subjects were the control groups. The immunohistochemical study was performed to evaluate the protein expression over gastric cancer tissue slides.

Results: The mean SAA concentration was higher in gastric cancer patients (88.54 ± 50.44 mg/l) than in healthy subjects (3.36 ± 2.29 mg/l) and gastric ulcer patients (10.48 ± 8.97 mg/l) (P < .05). The SAA concentration was associated with tumor stage (P = .0244) and location (P = .0016) but not with Lauren’s histological type (P = .839). In the multivariate analysis, SAA level was correlated with tumor location (P < .0001) and lymph node status (P < .05). During follow-up, the mean SAA concentration increased significantly in 24 patients with tumor recurrence (P < .05) but did not change in 77 patients without recurrence. In the survival analysis, patients with SAA levels > 97 mg/l had a nearly fourfold increase in risk of death. Immunoreactivity was most prominent in blood vessel regions but not within cancer cells.

Conclusions: These data not only demonstrated SAA was useful in predicting survival of patients with gastric cancer, but they also showed that SAA was a valuable tool for postoperative follow-up.

Key Words: Serum amyloid A (SAA) protein • Stomach neoplasm • Serum marker • Mass spectrometry (MS)






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