| Part1.Multivariate analysis of advanced gastric cancer based on 24 prognostic markersObjective:To retrospectively analyze the clinicopathologic characteristics, serum tumor markers, inflammatory factors and prognosis of advanced gastric cancer.Methods:A total of 463 patients with advanced gastric cancer in Nanjing Drum Hospital from May 2004 to December 2012 were enrolled in this trial. The data concerning clinicopathologic characteristics, serum tumor markers and inflammatory factors. These patients were followed up by telephone and outpatient clinic. The results were analysed by SPSS 17.0 statistic software. Survival curves were constructed according to the method of Kaplan-Meier. Univariate analysis was done by Log-rank test and multivariate Cox regression analysis was performed between multiple factors.Results:In univariate analysis, age, tumor size, T staging, N staging, vascular invasion, surgical modalities, carcinoembryonic antigen(CEA), carbohydrate antigen (CA)724, CA199, CA242, CA125, neutrophil to lymphocyte ratio(NLR) and platelet to lymphocyte ratio (PLR) were associated with overall survival in patients with advanced gastric cancer. Multivariate analysis revealed that old people, palliative surgery, stage of T4b, CEA overexpression, CA125 overexpression were independent risk factors of poorer prognosis.Conclusion:Age, Tumor size, T staging, N staging, vascular invasion, surgical modalities, CEA, CA724, CA199, CA242, CA125, NLR and PLR were valuable to judge prognosis of gastric carcinoma.Part 2. Clinicopathological characteristics and immunohistochemistry between gastric signet ring cell carcinoma and gastric adenocarcinomaObjective:Compared with gastric adenocarcinoma (GAC), it s generally agreed that advanced gastric signet ring cell carcinoma (SRC) is a group of carcinoma characteristic of Highly malignant, invasion and poor prognosis. Reports about the clinical and pathological features of SRC is rare, this literature focused on the clinical and immunohistochemistry features with SRC and GAC.Methods:Clinical data of 849 gastric cancer patients treated in our hospital were analyzed retrospectively, clinicopathological characteristics and immunohistochemistry were compared between SRC and GAC patients.Results:There were significant differences in the proportions of age (P<0.001), tumor location (P<0.001), tumor size (P<0.001), N staging (P=0.001), perineural invasion (P<0.001), Lauren classification (P<0.001), Her-2 (P<0.001), COX2 (P=0.014) and Ki67(P=0.022), but not in gender(P=0.135), T staging(P=0.182), vascular invasion (P=0.224),EGFR (P=0.051) and VEGF (P=0.472) between SRC and GAC patients.Conclusions:Advanced SRC tend to occures in young people, more located in total stomach, higer tatio of larger tumor size, later lymph node staging, perineural invasion, diffuse common, lower Her-2 positive rate, higher ratio of COX2-positive and Ki67-positive. |
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