Establishment Of Scoreing System Predicting Probability Of Radical Cure In Gastric Cancer Patients Preoperatively And The Relationship Between Expression Of COX-2,MMP-2 In Gastric Cancer And Radical Cure Condition

Chapter1 Establisment of scoreing system predicting probability of radical resection in gastric cancer patients preoperativelyObjective: To establish a scoring system for preoperatively predicting the probability of radical resection in gastric cancer patients based on the preoperative clinical data.Methods: The clinical data of 1207 gastric cancer patients receiving surgical treatment were analyzed retrospectively in the First Affiliated Hospital Of Chong Qing Medical University from Jan.1997 to Dec. 2007.Anivariable analysis were performed for screeming the risk factors related to probability of radical resection, then multivariable analysis with logistic regression was performed in the selected risk factors and establish the Logistic regression model. The score of each risk factor was identified according to each coefficient and a scoreing system was established. The probability of radical resection were calculated in each patient with different scores and a receiver operating characteristic curve was drawed to evaluate the efficiency of this scoreing system.Results: The best regression model was established by course of disease(X₁),size of abdominal mass(X₂),ascites(X₃),diameter of tumor(X₄),big-soma typing(X₅),differentiate degree(X₆),infilitrating depth(X₇),lymphonode metastasis(X₈),the Logistic regression equation is logit(p)=2.902-0.159X₁-0.255X₂-0.448X₃-0.202X₄-0.212X₅-0.319X₆-0.325X₇-0.263X₈.According to this score system ,the lower score a group had,the higher radical resection rate it had,there had significant difference between group with 10～19 scores and with 20～29 scores,there also do between group with 30～39 scores and with 40～49 scores(P<0.01). The area below ROC curve was 0.76, the ideal cutpoints was 26 scores with 71.1% sensibility and 70.3% specificity. The radical resection rate was 72.3% in group with a scores lower than 26,and 42.6% in group with a scores higher than 26(inclus 26 scores)(P<0.01).Conclusion: The scoring system can provide accurate and reliable information to predict the propability of radical resection in gastric cancer patients preoperatively. It is simple and practical to use in clinical work and helpful for making an optimal therapeutic regimen for gastric cancer patient. Chapter 2 The relationship between expression of COX-2,MMP-9 in gastric cancer and radical resection condition0bjective: To study the relationship between expression of cyclooxygenase-2 (COX-2),matrix metalloproteinases-9(MMP-9) in gastric cancer and radical resection condition.Methods: 94 gastric cancer patients receiving surgical treatment were randomized into radical resection group to non-radical resection group and the clinical data of them were analyzed retrospectively. The expression of COX-2 and MMP-9 in gastric carcinoma specimen were measured by immunohistochemistry.Results: The average optical density(OD) of COX-2 in gastric carcinoma was 0.211±0.027 and 0.226±0.035 in radical resection group and non-radical resection group respectively and there had significantly statistical difference(P<0.05). The average optical density(OD) of MMP-9 in gastric carcinoma was 0.212±0.029,0.231±0.032 in radical resection group and non-radical resection group respectively and there had significantly statistical difference(P<0.05).The expression of COX-2 and MMP-9 was associated with the diameter of tumor,lymph node metastasis , cellular differentiation , histological type and TNM stage(P<0.05), but not associated with age,gender and tumor position.Conclusion: There had relationship between expression of COX-2,MMP-9 in gastric cancer and radical resection condition.