Clinicopathologic Characteristrics And Prognosis Of112Patients With Gastric Cancer

Objective:Aimed to retrospectively analysis the clinicopathologic characteristrics andpostoperative survival of patients with gastric cancer and to evaluate the prognosticfactors.Methods:The medical records of112patients who had undergone gastrectomy to curegastric cancer between December2005and December2007in our hospital wereretrospectively analyzed. In this study, immunohistochemial staining of p-STAT3wasperformed. The correlations between the expression of the p-STAT3andclinicopathological characteristrics were analysed.Survival curves were constructedaccording to the method of Kaplan-Meier.For differences between curves, the P valuewas calculated using the log rank test.A multivariate Cox regression analysis wasperformed to assess the prognostic significance of different staining patterns and otherpathological variables.Results:1.The clinicopathologic characteristics of gastric cancer patientsThis study included a total of112patients with gastric cancer.Among them69patients (61.6%) were men,and43(38.4%) were women.The ratio of male to female was1.6:1.The average age was60.6±9.3years (range,22-85years).The involvement sitesinclude antral (42.9%),gastric body (27.7%),gastric cardia (18.7%),extensive cancerwhich involve more than two sites (10.7%).According to the tumor size,53patients(47.3%) with diameter≤4cm,45patients (40.2%) with diameter in4~8cm,14patients(12.5%) with diameter≥8cm.According to the depth of invison,the most commonclassification was T3followed with T4.Stage Ⅲwas the major stage on the basis of theTNM staging system. Among the patients,47(42%) with diatant metastasis and65(58%) without diatant metastasis.There were64patients (57.1%) with lymph nodesmetastasis,and48(42.9%) without lymph nodes metastasis. There were72patients (64.3%) were poorly differentiated and40patients (35.7%) were well-moderatelydifferentiated. Of the112patients,58patients (51.8%) underwent distal gastrectomy,14patients (12.5%) underwent resection of the proximal gastrectomy,24patients (21.4%)underwent total gastrectomy,16patients (14.3%) underwent palliative surgery.2.The relationship between expression of p-Stat3and clinicopathologicalcharacteristics of gastric carcinoma.Gastric mucosa specimen from112patients were examined.P-STAT3stainedintensely in a cell nucleus distribution.The abnomal expression rate of p-STAT3was60%（15/25）under the age of45,89.5%（34/38）in the age of45-60years,80%（24/30）in the age of60-75years and94.7%（18/19）over the age of75. The level of p-STAT3expression in the group of over75years was higher than the others, and there weresignificant difference between the four groups(P<0.05);According to the depth ofinvision,the expression rate of p-STAT3was94.6%（35/37）in T4stage>78.3%（36/46）in T3stage>71.4%（15/21）in T2stage>62.5%（5/8）in T1stage,there were significantdifference between the four groups(P<0.05);The expression of p-STAT3in poorlydifferentiated group (95.8%) was higher than that in well-moderately differentiatedgroup(55%),there were significant difference between the two groups(P<0.05);Theexpression of p-STAT3in the group with lymph node metastasis (92.2%) was higher thanthat without lymph node metastasis (66.6%),there were significant difference betweenthe two groups(P<0.05);For the TNM-stage,The expression of p-STAT3in stage Ⅳgroup(94.1%)>stage Ⅲ group(79.5%)>stage Ⅰ~Ⅱ group(70.6%),there were significantdifference between these groups(P<0.05); The expression of p-STAT3in distantmetastasis group (97.8%) was higher than that in without distant metastasisgroup(69.2%),there were significant difference between the two groups(P<0.05);Therewas no statistically significant difference between different gender,location of tumors andtumor diameter.3.Overall survival situation：Until to the deadline of clinical follow-up,73caseswere died and39patients were still alive．The1-year,3-year and5-year survival rates ofthese patients were87％，60％，35%,respectively．The overall median survival ofpatients in this study was41month.4.Univariate analysis：The age at diagnosis, location of primary tumor, tumordiameter, depth of invasion, lymph node metastasis, TNM stage, distant metastasis, the type of surgery, the expression of p-STAT3and differentiation were significantly relatedwith postoperative survival of patients with gastric cancer by using univariate analysis.5.Multivariate analysis：This study reveal the age, TNM stage, the depth ofinvasion,distant metastasis and the type of surgery were significant independentprognostic indicator.Conclusion:1. The age，TNM stage，distant metastasis，depth of invasion，the type of surgeryare independent prognostic factors for gastric cancer patients.2.TNM stage is the major prognostic factor for gastric cancer patients.3. The expression of p-STAT3in gastric cancer tissue may contribute to evaluategastric cancer progression and may serve as an effective prognostic marker.