Clinicaopathological Analysis And Follow-Up Of Human Gastric Carcinoma And The Correlation With Expression Of E-cadherin And LI-cadherin In Human Gastric Carcinoma

Objective To analyze the clinicopathologic characteristics and postoperation survival rate of early gastric carcinoma(EGC)and middle stage gastric carcinoma(MGC),to explore the relating factors affecting the detection rate and prognosis.To investigate the expression of E-cadherin and LI-cadherin in gastric carcinoma,otherwise to analyze the relationship of their expression with clinicopathologic factors and prognosis.Methods 222 cases EGC and 298 cases MGC who underwent surgical resection between 2000 and 2006 at at the Department of Surgery,the First Affiliated Hospital of Anhui Medical University were followed up and analyzed,meanwhile,in contrast with the same kind of data before ten years in our hospital.Expression of E-cadherin and LI-cadherin was examined by S-P immunohistochemistry ( IHC ) in 275 archival paraffinembedded tissue specimens from gastric carcinoma and control groups.Results The average detection rate of EGC in our study between 2000 and 2006 was 5.8% exceeding that of 1990-1999, especially ,the detection rate during the last three years had increasingly reached to 7.1%. The average detection proportion of intramucosal carcinoma and early carcinoma of gastric cardia had increased from 41.8% and 16.4% respectively during 1990-1999 to 57.0% and 30.2% respectively for 2000～2006 (P<0.05).Tumor size and the depth of tumor invasion correlated with regional lymph node involvement.5-year survival rates of EGC and MGC were 91.8% and 63.6%,respectively(P<0.005).Postoperative survival time of EGC and MGC was highly correlated with tumor size,depth of invasion, pathological differentiation,lymph node metastasis and treatment with chemotherapy(P<0.05～0.001).The abnormal expression rates of E-cadherin and LI-cadherin in gastric carcinoma were 53.0% and 80.5%,respectively and they were also expressed abnormally in precancerous lesions.There was a positive correlation between the expression of E-cadherin and LI-cadherin(Kappa=0.21,P<0.01).The expression of E-cadherin and LI-cadherin were correlated with WHO pathological differentiation ( P<0.001 ) ,Lauren grouping(P<0.001)and lymph node metastasis (P<0.05).Better survival was noted in gastric carcinoma retaining normal expression of E-cadherin(P=0.018).But our study cannot detect the relationships between LI-cadherin expression and postoperative survival rate of gastric carcinoma.Multivariate analysis indicated that E-cadherin expression and lymph node metastasis were all independent prognostic factors of gastric carcinoma.Conclusions Although our detection rate of EGC showed to be elevated year by year during the last seventeen years including intramucosal carcinoma and early carcinoma of gastric cardia, our detection level is still lower than other reports.The prognosis of EGC was generally excellent with a high 5-year survival rate.Abnormal expression of E-cadherin and LI-cadherin frequently occurs in EGC and MGC. Low expression of E-cadherin and high expression of LI-cadherin maybe participate in tumorigenesis of gastric carcinoma at early stage and metastasis.Accordingly,abnormal expression of E-cadherin and LI-cadherin may be a useful diagnostic and prognostic marker for the biological behavior of EGC and survival term of gastric carcinoma.