Research On The Related Factors In The Survival Rate Of The Expression Of Her-2in Gastric Carcinoma

Objective: To analyze the influence on the survival rate of gastric cancerof different age, gender, surgery types, tumor size, tumor location, proximalor distal ends, pathology type, differentiation levels, lymphatic/vascularinvasion, T stage, N stage, M stage, pathology stage, lymph node metastasis,R0/R1ablation, lymphaticum invasion, nerve invasion, vessel invasion,lymphaden biopsy number, lymphaden biopsy positive number and Her-2geneexpression. To clarify Her-2gene over-expression and its influence on survivalrate of gastric cancer, and the influence of Her-2gene expression on observedsurvival rate in1-year,3-year,5-year and median survival time. Then todetermine the prognostic correlative factors of survival rate of gastric cancerpatients.Method: To collect the correlative data of Her-2gene in gastric cancer fromhome and abroad through literature search. To understand the prognostic indexsystem of gastric cancer, current research situation and developing trend ofsurvival rate of gastric cancer. This article studys the incidence cases ofgastric cancer which were determined by pathology method from January2004toJuly2011in Fuzhou General Hospital of Nanjing Military Command. Use follow-upsurvey list of treatments and survival conditions for patients as surveymanagement, and make telephone investigation of survival status, then combineclinical history and return visit to collect clinical data of patients. Verifysurvival situation of patients through death data library of Fujian Provinceand population information library of Public Security. At last,2062gastriccancer patients were selected as research targets.All data were input by using a double entry method with EPI data3.0softwareand analyzed statistically and plotted by Excel2003, SPSS13.0and SAS9.1.Continuous variables were displayed by descriptive statistics, including mean, standard deviation, median, minimum and maximum value. Classified variables werecalculated by frequence and percentage. Observed survival rate in1-year,3-year,5-year and median survival time of age, gender, surgery types, tumor size, tumorlocation, proximal or distal ends, pathology type, differentiation levels,lymphatic/vascular invasion, T stage, N stage, M stage, pathology stage, lymphnode metastasis, R0/R1ablation, lymphaticum invasion, nerve invasion, vesselinvasion, lymphaden biopsy number, lymphaden biopsy positive number and Her-2gene expression were analyzed by life table method in SPSS13.0. Different groupsof survival curve were compared and plotted by Log-Rank test. Differenced inrate of Her-2gene expression, observed survival rate in1-year,3-year,5-yearand median survival time of12indexes between Her-2gene expression negativeand positive was contrasted by Chi-square test and Chi-square trend test. Thereaction of survival time influenced by these factors was inspected. Thenprognosis factors of gastric cancer were found by Cox stepwise regressionanalysis. P＜0.05was set as statistical significance.Result:1．2062gastric cancer cases have these following features: aged peoplewere the most. Radical surgery was mostly executed. Cancer size is between2～10cm, and cancer was mainly treated by distal end excision. Pathology types weretubular carcinoma and papillary carcinoma. The most were well and moderatelydifferentiated. Pathology stage is Ⅲ period. Most of the surgery couldcompletely remove the cancer. Lymphatic/vascular invasion, lymphaticum cancerembolus, nerve invasion, vessel invasion and lymph node metastasis were foundin most patients. Body of stomach and cardia were predilection sites. Numbersof biopsy lymph nodes removed by surgery was over11. Among those, numbers oflymph nodes which was over21are the most. Biopsy positive lymph nodes between1～5were the most.2．The result of univariate analysis showed that: gastric cancer prognosisis related to age of onset, surgery types, tumor size, differentiation levels,lymphatic/vascular invasion, T stage, N stage, M stage, pathology stage, lymph node metastasis, R0/R1ablation and lymphaden biopsy positive number. Age ofonset over60, palliative operation, cancer size over10cm, poor ornon-differentiation, vessel infiltration, T in Ⅲ or Ⅳperiod, N in Ⅲ period,distant metastasis, Ⅳ period of pathology, lymph node metastasis, R1ablationand above16biopsy positive lymph nodes are risk factors of gastric cancer.The rest factors have no relation to gastric cancer prognosis.3．Gastric cancer patients, who have the following features of predilectionsite in body of stomach, well and moderately differentiated, no vesselinfiltration, distant metastasis and Ⅳ period of pathology, no nerve invasion,low numbers of biopsy lymph nodes, low numbers of biopsy positive lymph nodesand have a high expression of Her-2gene. The survival rate between two indexesincluding differentiation levels and vessel infiltration has no difference inpositive group.4．Results of Cox ’s proportional hazard model shows that surgery type,pathology type, vessel infiltration, number of lymphaden biopsy, lymphaticuminvasion, nerve invasion and Her-2gene expression are dependent factors ofgastric cancer prognosis. The RR (risk ratio) value of pathology type is maximum.Conclusion:Surgery type, pathology type, vessel infiltration, number of lymphadenbiopsy, lymphaticum invasion, nerve invasion and Her-2gene expression areindependent factors of gastric cancer prognosis.