Relationships Between Vessel Cancer Embolus And Histopathologic Factors And Prognosis In Patients With Gastric Carcinoma

Objective Through analyzing the relationship between the cancer embolus and lymph nodemetastasis in gastric carcinoma and their influence on the prognosis, to explain the importance of thecancer embolus and its clinical meaning.Methods Clinical and pathological data of 375 post-operative patients were analyzedretrospectively. 54 cases with cancer embolus and 321 cases without them were found. The correlationamong cancer embolus and clinical stage, depth of tumor invasion, differentiation, lymph nodemetastasis, The 3-year and 5-year survival of two groups were compared by Chi-square test. Meansurvival time(MST) of patients with and without therapy in vessel cancer embolus group in the samestage was analyzed by t-test.Results (1) Age and sex had no significant association with vessel cancer embolus(P＞0.05). (2)Obvious relationships among the presence of cancer emboli, UICC staging, depth of tumor invasion,differentiation and metastasis were noticed (P＜0.05). (3) The 3-year survival of cancer emboluspatients of Ib+Ⅱ,Ⅲstage were 50.00%, 20.00% respectively, and those with cancer embolus-free ofthe same stage were 76.25%, 45.00% respectively (P＜0.05). The 5-year survival of cancer emboluspatients of Ib+Ⅱ,Ⅲstage were 35.71%, 10.00% respectively, and those with cancer embolus-free ofthe same stage were 68.75%, 33.33% respectively (P＜0.05). The 3-year and 5-year survival ofⅣstagewere all 0. (4) MST of patients with therapy in vessel cancer embolus group of Ib+Ⅱ,Ⅲstage were 52.3 months, 32.5 months respectively, and those without therapy in the same stage were 32.8 months,15.5 months respectively (P＜0.05). MST ofⅣstage were 14.8 months, 11.7 months respectively(P＞0.05).Conclusion (1) The incidence of cancer embolus was related to clinical stage, depth of tumorinvasion, differentiation and lymph node metastasis, indicating that later stage with worsedifferentiation and deeper invasion has more cancer embolus. (2) The 3-year and 5-year survival ofcancer embolus patients were obviously lower than those with cancer embolus-free. (3) MST ofpatients with therapy in cancer embolus was longer than those without therapy, but there wasn'tobviously difference inⅣstage. (4) Intravascular cancer embolus is an important factor influencingthe patient's prognosis. Clinically, more attention should be paid to it. (5) The incidence of cancerembolus was related to prognosis of many kinds of carcinomas, it should be used in TNM as a keyindex to direct clinical and predict prognosis.