| Objective: Gastric cancer is one of the most threaten to human health, while China have a high incidence of gastric cancer. The incidence and mortality of gastric cancer is at the top of malignant tumors. The 5-year survival rate of gastric cancer is less than 40%. Chinese traditional medicine achieved some results to prevent the recurrence of tumors and prolong survival in patients with gastric cancer in clinical practice. The microsatellite status as one of the important mechanism of oncogenesis of gastric cancer or as a epigenetic marker, is caught the attention of many researchers nowdays. Therefore, this study analysed the microsatellite status, Chinese traditional medicine treatment effection on the prognosis and recurrence rate of patients with gastric cancer. And the possible mechanism through which the Chinese traditional medicine effected the microsatellite was discussed.Methods:80 patients with primary gastric cancer from Jiangsu Province Hospital of Traditional Chinese Medicine and People's Liberation Army eighty-one Hospital were analysed. All of the cases were stage II or III gastric cancer diagosised since 2009, The radical gastrectomy were performed and followed by 5-FU-based chemotherapy.47 cases from Jiangsu Province Hospital of Traditional Chinese Medicine were setted as experimental group. In this group patients accept the personalized TCM Jian Pi Yang Wei Fang treatment, except 5-FU-based chemotherapy.33 cases from People's Liberation Army eighty-one Hospital, who were treated only by chemotherapy were setted as control group. Multiple fluorescence PCR fragment analysis was used to detect the tumors five microsatellite loci:BAT-26, BAT-25, D17S250, D5S346, and D2S123. Statistical analysis of disease-free survival and overall survival were performed between the groups of different treatment and microsatellite status. The distribution of microsatellite status were also analysed.Results:77 patients got the followed up data. Follow-up time spans 1 month to 18 months in patients. Recurrence is founded in 7 patients which were confirmed by radiology.3 cases of them belong to the experimental group and 4 patients to the control group. No patients died during follow-up period. At the 11th month, the differences of disease-free survival rate between the experimental group and control group reached the maximum. It is 80.0% and 66.7% respectively. While the experimental group had a higher survival rate trend, but failed to reach a statistical significance.36 cases were successfully detected the microsatellite status. Tumor microsatellite instability were found in 7 cases, the rate was 19.4%(7/36). There was 1 case belong to MSI-H, 6 cases belong to the MSI-L.29 cases were microsatellite stable.12 patients also have the follow-up endoscopic bioposy 3 months after the operation.1 case of postoperative biopsy show different microsatellite with the tumor and resection margin. The rest follow-up endoscopic mucosa were MSS status. There was no recurrence in MSI group. And the disease-free survival rate was 100%(7/7), while in the MSS group, disease-free survival rate was 86.2%(25/29). The difference between them have no statistical significance. The incidence of microsatellite instability in the 5 loci were:BAT-26,42.9%(3/7), BAT-25,42.9%(3/7), D17S250,28.6%(2 /7), D5S346,14.3%(1/7), D2S123,14.3%(1/7). The heterozygous status of microsatellite were:BAT-26,5.6%(2/36), BAT-25,22.2%(8/36), D17S250,22.2%(8/36), D5S346,44.4% (16/36), D2S123,66.7%(24/36).Conclusion:The results of this study showed that 5-FU based chemotherapy add jian pi yang wei fang group have a higher rate of disease free survival in advantaged gastric cancer, but did not reach statistical significance. And microsatellite instability has not played a significant prognosis and predictors for response to treatment.
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