Analysis Of Clinicopathological Features And Prognostic Factors Of Perineural Vascular Invasion For Gastric Cancer Patients

Objective:To retrospectively analyze the pathological features of gastric/vascular infiltration and prognosis risk actors in 154 gastric cancer patients underwent radical gastrectomy.Methods:1.Clinical data of 154 gastric cancer patient without radio-or chemotherapy were collected.The patients were diagnosed,underwent radical gastronomy and hospitalized and at the Department of Gastrointestinal Surgery,the First Affiliated Hospital of Kunming Medical University between January 2014 and 2015.Patients data were separated in two groups:experimental group that showed nerves and vessels infiltration(74 patients)and control group that were negative for nerves and vessels infiltration(80 patients)2.Compare the general conditions of two groups by X2 test(age group,body mass index(BMI),gender,smoking history,drinking history,combined hypertension,diabetes mellitus,blood type);3.Compare the tumor related biomarkers NLR,CA199,AFP,CEA)in two groups by X2 test.4.Comparison of postoperative pathological factors(tumor location,tumor size,Borrmann classification,degree of differentiation,depth of invasion,TNM stage,presence and degree of lymph node metastasis,cytological typing,Lauren classification)by X2 test.5.Logistic regression analysis of the multiple factors affecting nerve and vascular invasion(tumor size,Borrmann classification,depth of invasion,presence and degree of lymph node metastasis).6.The effect of single factors on disease-free survival was exa1ined by X2 test,including age group,BMI,gender,smoking history,drinking history,hypertension,diabetes,tumor location,tumor size,degree of differentiation,depth of invasion,TNM stage,lymph node metastasis,Borrmann classification,cytological typing,Lauren classification,tumor related biomarkers,blood type,nerve/vascular invasion.7.The effect of multifactor on patients prognosis was analyzed by Cox regression,including invasion depth,lymph node metastasis,nerve/vascular invasion.8.compare the of overall survival and disease-free survival between the two groups of gastric cancer patients by Kaplan-Meier survival analysis.9.Follow-up through with outpatient,telephone,email,WeChat,etc.(follow-up time 6-60 months).Analyze the influence of nerve/vascular infiltration on the prognosis of patients.Results:1.No significant difference in the general condition(age,body mass index,gender,smoking history,drinking history,combined hypertension,diabetes mellitus,blood type)between the two groups before surgery(P>0.05).No significant differences(P>0.05)in preoperative indexes(NLR,CA199,AFP).No significant differences in tumor location,differentiation degree,cytological classification,Lauren classification between the two groups(P>0.05).4.Tumor size,Borrmann classification,depth on invasion,lymph node metastasis incidence,degree of lymph node metastasis,and TNM staging were significantly(P<0.05)different between groups.5.Patient age,BMI,gender,smoking history,drinking history,tumor location,degree of differentiation,hypertension,diabetes,NLR,cytology,Lauren classification,CA199,AFP,blood type were not significantly related to the postoperative disease-free Survival;tumor size,Borrmann classification,depth of invasion,TNM stage,presence and degree of lymph node metastasis,CEA,and nerve/vascular invasion significantly correlate with prognosis(P<0.05).6.Invasion depth,lymph node metastasis,nerve/vascular invasion were closely related to prognosis(P<0.05);tumor size,Borrmann classification,TNM stage,lymph node metastasis,CEA and patient prognosis were not significanly(P>0.05)associated with prognosis.7.The total survival rate and disease-free survival rate of the patients were significantly higher than those of the neuron/vascular positive group(P<0.05).Conclusions:1.Large tumor(tumor diameter>4cm),deeper infiltration depth,increased incidence of lymph node metastasis,higher degree of lymph node metastasis,higher Borrmann classification(mainly type III and IV)associated with a greater likelihood of simultaneous nerves and vessels infiltration.2.Three-year disease-free survival rate and overall survival rate of patients with simultaneous infiltration of nerves and vessels were significantly lower than those without.3.Neural and vascular infiltration is an important prognostic factor for gastric cancer.It has potential to be included in the TNM staging system for scientific and systematic staging of patients,with a guiding role for further treatment after surgery.