Analysis Of Clinical Pathological Features And Prognostic Factors Between 734 Cases Of Hui And Han Patients With Adenocarcinoma Of The Esophagogastric Junction In Ningxia Hui Autonomous Region

Objective To explore the Clinicopathological features and prognostic factors of 734 cases of Hui and Han patients with adenocarcinoma of the esophagogastric junction(AEG).Methods 734 patients confirmed to be AEG by gastroscopy and pathology in the General Hospital of Ningxia Medical University during January 2002 to December 2012 were involved. All relevant data including gender, age, nation, clinical situation, body mass index(BMI), blood type, cigarette and alcohol addiction, family history, date and type of surgery, tumor size, Siewert classification, Borrmann type, histological grading, tumor pathology and lymph node staging, the number and location of removed and positive lymph nodes, perioperative chemoradiotherapy, vital status and date of death were collected and input into excel. SPSS17.0 software was used to analyze the differences of the Clinicopathological features and prognostic factors between Hui and Han patients with gastroesophageal junction adenocarcinoma. The survival comparison was assessed by the log-rank test and multivariate analysis was assessed by Cox Regression.Results(1) Among 734 AEG patients with surgical intervention, 169 cases were Hui patients and 565 cases were Han patients(23.0% vs 77.0%). The average ages in Hui and Han patients were 61.4±7.4 and 61.1±8.9 years old, respectively.(2) Han patients were more likely to have cigarette smoking history and alcohol consumption history than Hui patients(58.8% vs 29.4%, p<0.001; 45.8% vs 14.6%, p<0.001). There were no differences in type of surgery, Siewert classification, Borrmann type between two groups(χ~2=2.797, P=0.424; χ~2=0.290, P=0.865; χ~2=3.945, P=0.267); There were no differences in tumor differentiation, tumor histopathology, and TNM stage between two groups(χ~2=2.714, P=0.257; χ~2=3.911, P=0.141; χ~2=1.697, P=0.638); Also, there were no differences in adjuvant chemoradiotherapy between two groups(χ~2=1.725, P=0.189).(3) Survival data were available for 265 of the 734 patients(36.1%). For Hui patients, the median follow-up time was 38.4 months and the 5-year overall survival rate was 54.3%; For Han patients, the median follow-up time was 46.4 months and the 5-year overall survival rate was 39.9%. Univariate analysis identified that the following factors were significantly associated with the 5-year overall survival: age, gender, alcohol addiction, type of surgery, Borrmann type, tumor size, tumor differentiation, pathologic T stage, pathologic N stage, pathologic M stage. Multivariate analysis of prognostic factors identified that age(p=0.005), gender(p=0.015), pathologic T stage(p=0.056), pathologic N stage(p<0.001), pathologic M stage(p<0.001), number of resected lymph nodes(p=0.003) and adjuvant chemoradiotherapy(p=0.005) were significant and independent prognostic factors.Conclusion(1) AEG has a higher incidence in older male who has smoking and drinking history. Pathological type was low differentiated adenocarcinoma and TNM stage was mainly IV stage.(2) Han patients were more likely to have cigarette smoking history and alcohol consumption history than Hui patients. Early diagnosis and treatment as long as healthy and rational lifestyle may be helpful in prevention and treatment of AEG.(3) Age, gender, pathologic T stage, pathologic N stage, pathologic M stage, number of resected lymph nodes and adjuvant chemoradiotherapy were significant and independent factors for the poor prognosis.