Correlation Between The Intravascular Cancer Embolus And Pathological Factor In Gastric Carcinoma And Their Influence On The Prognosis

Background: So far, gastric cancer is still one of the commonest cancer in the world. It is one of the highest incidence tumor in China. The recent date show, the mortality rate of gastric cancer was 59.4 / 100,000, while surgery is still the fundamental treatment. With the development of integrated treatment, including new antitumor drugs, neoadjuvant radiotherapy and chemotherapy, biotherapy, the prognosis and survival rate of gastric cancer patients has been greatly improved. But higher postoperative recurrence and metastasis rate impact the treatment effect. One of the main factors of poor prognosis is cell trans fer. Another ignored important factor is the formation of intravascular cancer embolus, and the majority of scholars pay more attention to it.Objective: To study the correlation between the intravascular cancer embolus and lymph node metastasis or other pathological factor in gastric carcinoma and their influence on the prognosis.Methods: Retrospective analysis postoperative clinical and pathological data,786 cases with gastric cancer of the First Affiliated Hospital of Dalian Medical University in 2008-2009. Exclusion criteria:(1)primary tumor lesion location can not be determined;(2)distant metastasis or invasion of adjacent organs, or palliative surgery;(3)the specific clinical data is unknown and failed to follow-up patients(4)the residual gastric surgery again;(5) patients died due to non tumor factors. A total of 704 patients were selected, including pathological vascular tumor thrombus detected 97 positive cases, 607 Cases of patients with negative. All patients were followed up. Analyze the relationship between the intravascular cancer embolus and staging, lymph node metastasis, tumor invasive depth, the extent of tissue differentiation. We compared difference of positive and negative patients with tumor thrombus and compared the same period in gastric cancer 5 year survival rate.Results:1. The data of this study shows that gastric cancer patients generate intravascular cancer embolus regardless of gender and age. There is no significant difference between two groups(P >0.05).2. The data of this study shows that gastric cancer patients with vascular tumor thrombus of positive and negative correlation with UICC staging, There is statistically significance.(P<0.01).3. The data of this study shows that gastric cancer patients with vascular tumor thrombus of positive and negative correlation with degree of histological differentiation, depth of tumor invasion, lymph node metastasis. There is statistically significance.(P<0.01).4. The data of this study shows that in the stageⅠB+Ⅱ of gastric cancer patients, 5 years survival rate of intravascular cancer embolus negative group and positive group were 78.90% and 53.57%(P <0.01); in the stageⅢ of gastric cancer patients, the 5 year survival rate of intravascular cancer embolus negative group and positive group were 43.96% and 18.42%(P <0.01). In the stage IV of gastric cancer patients, 5 years survival rate of intravascular cancer embolus positive group and negative group was 0, no significant difference. Conclusion:1. In patients with gastric cancer, there is a close relationship between intravascular cancer embolus and UICC stage, depth of invasion, lymph node metastasis, the degree of tissue differentiation. The late staging, infiltration depth is deeper. The degree of tissue differentiation is the more likely to cause cancer embolus. At the same time that the transfer of intravascular cancer embolus prone to metastasis of lymph node.2. 5 years survival rate of gastric cancer patients with positive intravascular cancer embolus compared of negative intravascular cancer embolus at the same period was significantly decreased.3. Intravascular cancer embolus is an important prognostic factor. For gastric cancer patients, a scientific and systematic classification is helpful to scientific and reasonable treatment.