Risk Factors Of Peirneural Invasion In Patients With Advanced Adenocarcinoma Of Esophagogastric Junction

Objective： To investigate the risk factors of perineural invasion of advancedadenocarcinoma of esophagogastric junction (AEG).Methods：The specimen from98patients with advanced AEG who underwent radicaltotal gastrectomy and esophagugastric Roux-en-Y anastomosis from January2011toAugust2012in the First Affiliated Hospital of Anhui Medical University were collected.Serial section cutting was done and the upper and bottom incisional edges of everysection were marked. The specimens were stained by hematoxylin-eosin solution, S-100and CK immunohistochemistry. Nerve invasion could be affirmed if cancer cells wereobserved in the peripheral space of vagus nerve and vagus nerve parenchyma or cancercells infiltrated along the peripheral space of vagus nerve. Factors related to nerveinvasion were analyzed using one-way analysis of variance and multi-factor logisticregression analyses.Results: The incidence of vagus nerve invasion was29%(28/98), and the tumor onlyinvaded the vagus nerve which had the same altitude as the upper incisional edge. Theresults of one-way analysis of variance showed that Siewert classicification,intravascular cancer emboli, lymph node metastasis, the degree of lymph nodemetastasis,clinical staging,the degree of tumor differentiation were correlated with thevagus nerve invasion (χ2=14.156，14.552，5.454，10.706，6.919，14.767，P<0.05).The results of multi-factor logistic regression analysis showed that Siewertclassification, intravascular cancer emboli and degree of tumor differentiation wereindependent influencing factors of vague nerve invasion.(OR=3.667，10.368，0.249，P<0.05）Conclusions: Vagus nerve invasion is correlated with Siewert classification, intravascular cancer emboli, and degree of tumor differentiation. The range of vagusnerve invasion is restricted under the upper incisional edge of tumor section.