| Objective: To analyze the relationship between clinicopathological characteristics of gastric cancer(GC)and nerve invasion(NI),and to explore the effect of NI on the prognosis of GC patients.Methods: To collect clinical and pathological data(gender,age,tumor site and tumor size,tissues degree of differentiation,depth of tumor invasion,lymph node metastasis,TNM stage,vascular and nerve invasion)of GC patients Who underwent radical gastrectomy in the Gastrointestinal Gland Surgery Department of the First Affiliated Hospital of Guangxi Medical University and undergoing radical gastrectomy,from December 2013 to December 2016.Specimens from patients meeting the inclusion criteria were stained with hematoxylin-eosin staining(HE staining)to assess NI status.The included patients were also followed up for a long time.The relationship between NI and the clinicopathological characteristics of GC was analyzed by χ~2 test,and the risk factors affecting NI were discussed by binary Logistic regression analysis.Kaplan-meier method was used to analyze the effect of NI on prognosis of GC patients,and Cox model was used to explore the risk factors affecting the prognosis of GC patients.Results:1.A total of 557 GC patients meeting the inclusion criteria were collected in this study,including 387 male patients(69.78%)and 170 female patients(30.52%).There were 341 patients(61.22%)were ≤ 60 y,and 216 patients(39.78%)were>60y.The median age was 57 years old,and the age range was19 to 87 years old.The total NI(+)patients were 218(39.14%)and PNI(-)patients were 339(60.86%).The results of Chi-square test about the relationship between clinicopathological characteristics and NI showed that It was significant that NI was correlated with tumor size,lymph node stage,depth of invasion,vascular invasion(VI),tumor location,degree of differentiation,and TNM stage(p<0.05).2.Logistic multivariate analysis presented that tumor size(95%CI=1.047 ～1.329,P=0.007),tumor infiltration depth(95%CI=1.105 ～ 2.002,P=0.009),TNM staging(95%CI=1.071 ～ 2.216,P=0.020),vascular invasion(95%CI=0.265 ～ 0.614,P=0.000)and tissue differentiation(95%CI=1.018 ～2.130),P=0.040)were independent risk factors affecting NI.T test results showed that tumor size of the NI(+)group was larger than that of the NI(-)group in T2 and T4 groups,with statistical significance(P < 0.05).There was no significant difference in T3 tumor size between NI positive and NI negative groups(P =0.065).In T2-T4 group,the positive number of lymph node metastasis in NI(+)was more than that in NI(-).(P < 0.05).3.Until January 31,2020,412 cases were returned and 145 cases were lost to follow-up,207 died and 205 alive.Median follow-up time was 37.5 months,and median overall survival time was 24.5(12 ～ 46.5)months.After follow-up,The median survival time in NI(+)group was 16(9-37),and that in NI(-)group was 34(18-50).NI was significantly correlated with postoperative survival time of GC(P =0.000).the prognosis of patients in the NI(-)group was better than positive group.It was found that the survival time of the NI positive group(25.02±20.471)was shorter than that of the negative group(32.24±20.300)in T4(P =0.003).4.COX regression model analysis of multiple factors affecting postoperative prognosis of GC patients showed that NI positive(95%CI=1.044-1.941,P =0.026),TNM stage(95%CI= 1.329-3.578,P =0.002)and age(95%CI= 1.012-1.037,P =0.000)were independent risk factors affecting prognosis of patients.Conclusion:1.NI of GC is correlated with tumor location,tumor size,tumor tissue differentiation degree,infiltration depth,positive number of lymph node metastasis,vascular invasion,and TNM stage of tumor.2.Compared with the NI(-)group,the NI(+)group has larger tumor diameter and more positive lymph node metastasis.Tumor size,TNM,depth of tumor invasion,VI and degree of tissue differentiation are risk factors affecting the NI of GC.3.In T4 patients,NI of GC would lead to poor postoperative prognosis,and NI is an independent risk factor affecting postoperative survival of patients. |
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