Lower serum folate is associated with development and invasiveness of gastric cancer

Table 1 Demographic data and folate concentrations of gastric cancer patients and controls

	Case (n = 155)	Control (n = 149)	P value1
Age (yr)	62.02 ± 1.14	57.21 ± 0.86	< 0.01
Gender n (%)
Male	88 (56.8)	90 (60.4)	NS
Female	67 (43.2)	59 (39.6)
H. pylori infection n (%)
No	83 (53.5)	78 (52.3)	NS
Yes	72 (46.5)	71 (47.7)
Folate (ng/mL)	3.71 ± 0.30	8.00 ± 0.54	< 0.01
Male	3.12 ± 0.34	7.34 ± 0.74	< 0.01
Female	4.49 ± 0.54	9.01 ± 0.76	< 0.01
Age ≥ 60	3.70 ± 0.42	9.87 ± 1.17	< 0.01
Age < 60	3.72 ± 0.43	6.78 ± 0.43	< 0.01

¹All P values ≥ 0.05 were considered to be statistically non-significant (NS).

Table 2 Association between serum folate level and occurrence of gastric cancer n (%)

	Folate		Odds ratio1
	> 4.38 ng/mL	≤4.38 ng/mL	95%CI	P value
All cases
Control (n = 149)	119 (79.9)	30 (20.1)	1
Gastric cancer (n = 155)	33 (21.3)	122 (78.7)	19.77 (10.54-37.06)	< 0.001
Age < 60 (yr)
Control (n = 90)	70 (77.8)	20 (22.2)	1
Gastric cancer (n = 59)	10 (16.9)	49 (83.1)	17.39 (7.28-41.54)	< 0.001
Age ≥ 60 (yr)
Control (n = 59)	49 (83.1)	10 (16.9)	1
Gastric cancer (n = 96)	23 (24.0)	73 (76.0)	21.67 (8.27-56.80)	< 0.001
Male
Control (n = 90)	68 (75.6)	22 (24.4)	1
Gastric cancer (n = 88)	14 (15.9)	74 (84.1)	17.95 (7.93-40.62)	< 0.001
Female
Control (n = 59)	51 (86.4)	8 (13.6)	1
Gastric cancer (n = 67)	19 (28.4)	48 (71.6)	20.95 (7.66-57.31)	< 0.001

¹Age and gender were adjusted by multivariate regression analysis.

Table 3 Associations between serum folate levels and clinicopathological features of gastric cancer n (%)

	Folate		Odds ratio1
	> 2.61 ng/mL	≤2.61 ng/mL	95%CI	P value2
Stage
Early (n = 28)	14 (50.0)	14 (50.0)	1
Advanced (n = 127)	54 (42.5)	73 (57.5)	1.38 (0.60-3.14)	NS
Serosal invasion
Absent (n = 43)	26 (60.5)	17 (39.5)	1
Present (n = 112)	42 (37.5)	70 (62.5)	2.54 (1.23-5.23)	< 0.05
Lymph node metastasis
Absent (n = 51)	26 (51.0)	25 (49.0)	1
Present (n = 104)	42 (40.4)	62 (59.6)	1.54 (0.78-3.02)	NS
Venous invasion
Absent (n = 90)	42 (46.7)	48 (53.3)	1
Present (n = 65)	26 (40.0)	39 (60.0)	1.32 (0.69-2.52)	NS
Lymphatic invasion
Absent (n = 74)	40 (54.1)	34 (45.9)	1
Present (n = 81)	28 (34.6)	53 (65.4)	2.23 (1.17-4.26)	< 0.05
Liver metastasis	(> 1.9 ng/mL)	( ≤ 1.90 ng/mL)
Absent (n = 146)	104 (71.2)	42 (28.8)	1
Present (n = 8)	2 (25.0)	6 (75.0)	6.67 (1.28-34.91)	<0.05

¹Age and gender were adjusted by multivariate regression analysis;

²All P values ≥ 0.05 were considered to be statistically non-significant (NS).

Table 4 Univariate analysis of mortality predictors in gastric cancer patients

	Hazard ratio	95%CI	P value1
Age
> 60 vs ≤ 60	1.27	0.97-1.67	NS
Gender
Male vs female	1.29	0.98-1.69	NS
Stage
Advanced vs early	7.78	3.96-15.26	< 0.001
Depth of invasion
Serosal vs non-serosal invasion	3.96	2.67-5.89	< 0.001
Lymph node metastasis
Yes vs no	2.47	1.78-3.43	< 0.001
Lymphatic invasion
Yes vs no	2.17	1.53-3.07	< 0.001
Venous invasion
Yes vs no	2.45	1.73-3.46	< 0.001
Liver metastasis
Yes vs no	6.01	4.04-8.93	< 0.001
Folate
≤ 1.90 vs > 1.90 ng/mL	1.84	1.04-3.27	0.036

¹All P values ≥ 0.05 were considered to be statistically non-significant (NS).