| Objective To investigate the relationship between clinicopathologic features andprognosis of gastric cancer. To study the expression and diagnostic value of prognostic genes ingastric cancer tissue. Methods The clinicopathologic data of 356 gastric carcinoma patientswere analyzed retrospectively. All patients underwent radical or palliative gastrectomy in TiarJinUniversity Cancer Hospital.. Age, sex, tumor location, PLT counting, radical resection, totalgastrectomy, intraoperative bleeding, preoperative transfusion, histological type, depth of tumorinvasion, lymphatic invasion, distant metastases, TNM staging, tumor diameter, extranodalmetastasis (EM), postoperative chemotherapy were monitored. SP immunohistochemistry methodwas used to determine the expression of HAb18G in tissue specimens from 365 cases with gastriccancer and investigate prognostic values of HAb18G. Continuous 100 gastric carcinoma wereexamined Her-2/neu,nm23,Ki-67,CEA,p53protein expression by IHC method. Weinvestigated the relationship between the expression of the genes and the clinicopathologicalcharacteristics of tumors, including survival. We used FISH to observe the gene amplificationstatus in the 9 patients whose Her-2/neu protein show overexpression by IHC. The correlationbetween the protein expression and gene amplification of Her-2/neu were studied. The prognosticvalue of Her-2/neu gene amplification was studied. Results [1]. The mean age of 365gastriccancer patients was 58.6 years, 266 males and 99 females, All the patients were followed up formore than 60 months or to death. The mean survival time of 365 gastric cancer patients was 41.67months and the overall 5-year survival rates were 36.6%. [2]. Univariate analysis showed that thepredictors of survival in gastric cancer patients were sex, tumor location, PLT counting, radicalresection, total gastrectomy, intraoperative bleeding, preoperative transfusion, depth of tumorinvasion, lymphatic invasion, distant metastases and TNM staging, tumor diameter, extranodalmetastasis and postoperative chemotherapy(p＜0.05). Age and histological type can not effect theprognosis of gastric cancer (p＞0.05). [3]. Multivariate analysis showed that only distantmetastases, TNM staging, tumor diameter, extranodal metastasis and postoperative chemotherapywere independent factors. [4]. The positive rate of HAb18G is 56.7% in tissue specimens from365 cases with gastric cancer. HAb18G is related to the tumor location, pathological type andtumor diameter (p＜0.05). The overall 5-year survival rates of HAb18G negative 41.7%, which ishigher positive than the 32.8%, but there is no statistical significance (p=0.156). [5]. 9of 100(9.0%) patients expressed the Her-2/neu protein by IHC, Her-2/neu is related to the distantmetastases (p=0.027). The overall 5-year survival rates of Her-2/neu negative 35.3%, which ishigher than the negative 29.6%, but there is no statistical significance(p=0.946). [6]. 43 of 100(43.0%)patients expressed the nm23 protein by IHC, nm23 is related to the tumor location(p=0.038) and the histological type (p=0.027). The overall 5-year survival rates of nm23 negative39.2%, which is higher than the negative 28.6%, but there is no statistical significance(p=0.196).[7]. 56 of 100(56.0%) patients expressed the Ki67 protein by IHC, Ki67 is related to thelymphatic invasion (p=0.038). The overall 5-year survival rates of Her-2/neu negative38.8%, which is higher than the negative 31.4%, but there is no statistical significance(p=0.072).[8]. 60 of 100(60.0%) patients expressed the CEA protein by IHC, CEA is not related to anyclinicopathologic features (p＞0.05). The overall 5-year survival rates of CEA negative50.4%, which is higher than the negative 24.6%, there is statistical significance(p=0.004). [9]. 20of 100(20.0%) patients expressed the p53 protein by IHC, p53 is related to the lyrnphatie invasion(p=0.021) and TNM staging (p=0.036). The overall 5-year survival rates of p53 negative 35.6%,which is higher than the negative 17.1%, there is statistical significance(p=0.047). [10]. There isrelations between HAb18G and Her-2/neu (p=0.011). There is relations between Ki67 and nm23(p=0.001). There is no relations between any other two genes (p＞0.05). [11].All of the 2 patientswith score (3+) by IHC were positive for Her-2/neu by FISH, with 1 cases being haploid. 1 of the4 patients with score (2+) by IHC showed Her-2/neu gene amplification. All the patients withscores (1+, number=3) by IHC failed to show amplification. The 3 patients showedHer-2/neugene amplification are all poor differentiation, all lymphatic invasion, 2 of 3 distantmetastases and are all died in 18 months. Conclusion [1] The following prognostic factors caninfluence the survival of gastric cancer patients: sex, tumor location, PLT counting, radicalresection, total gastrectomy, intraoperative bleeding, preoperative transfusion, histological type,depth of tumor invasion, lymphatic invasion, distant metastases, TNM staging, tumor diameter,extranodal metastasis, postoperative chemotherapy. [2] Distant metastases, TNM staging, tumordiameter, extranodal metastasis and postoperative chemotherapy are the independence prognosisfactor for gastric cancer patients. [2] HAb18G is related to the tumor location, pathological typeand tumor diameter. [3] Her-2/neu is related to the distant metastases. [4] Association detectionprotein expression ofHAb18G,Her-2/neu,nm23,Ki-67,CEA,p53can help us to judge prognosisand direct therapy. [5] Detection the Her-2/neu gene amplification by FISH is a goldstandard. Her-2/neu amplification might constitute potential candidates for the use of humanized monoclonal antibodies.
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