| Objective To compare the clinicopathological features and explore prognostic factors of Borrmann type,Lauren type and WHO classification in Gastric cancerMethods A comparative study about clinical pathological characteristics and Prognosis for advanced gastric cancer patient treated in our department from January2003to December2007is carried out according to their difference in macroscopic classification. A Chi-square test is used to compare constitutive ratio between groups meanwhile a T test is used to compare continuous variable. K-M survival method is used to calculate survival rate, draw survival Curves. Inner-group survival rate is compared by LOG-RANK test. Cox multivariate analysis is used to test the possible factors affect prognosis. All the data is analysis by SPSS17.0software, P<0.05is regard as significant differences.Results1、In Borrmann type, they were divided into4groups:Borrmann I type72(9.4%), Borrmann II type226(29.5%), Borrmann III type407(53.2%), Borrmann IV type60(7.8%). Their clinicopathologic characteristics and overall survival data were analyzed. Results Age, sex, tumor size,tumor location, lymph node metastasis, distant metastasis, TNM classification were discrepant between Borrmann type IV and other macroscopic Borrmann types of cancer.The5-year survival rate of the patients with Borrmann type IV cancer was21.4%, while the Borrmann Ⅰ Borrmann Ⅱ Borrmann Ⅲ was52.1%,43.8%,39.1%(p<0.05), respectively. Only in stage TNM Ⅲ, the5-year survival rate of Borrmann type IV gastric cancer which was13.6%and Borrmann Ⅰ Borrmann Ⅱ Borrmann Ⅲ which was30.5%,27.7%,25.4%respectively has significance.2、In Lauren type, we retrospectively reviewed the medical records of765gastric cancer patients, including389intestinal type (50.8%) and376diffuse type (49.2%).Their clinicopathologic characteristics and overall survival data were analyzed. And trying to compare Lauren type with WHO pathological type differences in prognosis of gastric cancer. Results Age, sex, tumor location,Borrmann type, lymph node metastasis, Surgical approach were discrepant between intestinal type and diffuse type of cancer.The5-year survival rate of the patients with intestinal type cancer was46.8%, while the diffuse type of cancer was33.5%(p<0.05). The5-year survival rate of intestinal type IV gastric cancer and the diffuse type gastric cancer samely only has significance in stage III (P<0.05).3、In WHO type, tubular adenocarcinoma465cases(60.8%), papillary adenocarcinoma36cases(4.7%), mucinous adenocarcinoma123cases(16.1%), signet ring cell carcinoma141cases(18.4%).There are significant differences among them in age, gender, tumor size, T stage and adjuvant therapy, age, sex, tumor location, depth of invasion, lymph node metastasis, distant metastasis, TNM classification and surgical type were discrepant between gastric signet ring cell and non-signet ring cell among the WHO type.The5-year survival rate of the patients with gastric signet ring cell cancer was34.6%, while the non-signet ring cell cancer was41.8%(p<0.05). The5-year survival rate for each stage of gastric signet ring cell cancer and non-signet ring cell cancer was80.0%and80.5%for stage1,48.6%and56.8%for stage11,16.2%and27.6%for stage III,and the differences only exist in III stage(P<0.05).Conclusion Borrmann type carcinoma has unique clinicopathological features compared with other types of gastric carcinomas and is an important independent prognostic factor. The signet ring cell carcinoma has unique clinicopathological features compared with non-signet ring cell carcinoma and is an important independent prognostic factor. Early detection and treatment can improve the prognosis of gastric signet ring cell carcinoma. WHO classification is the weakest of the three type in prognosis, Lauren classification is best, followed by Borrmann type. |
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