The Prognostic Significance Of Estrogen Receptor, Progestogen Receptor And C-myc Protein In Human Gastric Carcinoma

Objective To explore the relationship between the expression of estrogen receptor, progestogen receptor, C-myc protein and the prognostic significance in human gastric cancer. Methods The samples from 73 patients with gastric cancer, who underwent gastrectomy in our hospital during 1990 to 1999, was used for this study. Immunohistochemical technique with SP method was used to detect the expression of Estrogen Receptor(ER), Progestogen Receptor(PR) and C-myc Protein(C-myc). COX proportional regression model was used to define the prognostic factors that determine the survival of the patients. Results The incidence of the disease in female was higher than that in male when the mean age was under 40 years old, but the reverse condition presented when the mean age was over 40 years. In the patients with younger ages, the phenomenon of tumor located in distal stomach was more present than that in proximal one. While in the elder patients, the incidence of proximal gastric cancer was higher. The differentiation in male was better than that in female, and the differentiation in younger patients were worse than that in the elders. The positive expression rate of ER, PR and C-myc were 45.25% (33/73), 46.6% (34/73) and 47.9% (35/73) respectively. The iso-positive expression rate of ER and PR was 28.8% (21/73) and the iso-negative one was 40.0% (27/73), and the rates of ER and C-myc were 31.5%(23/73) and 38.4%(28/73), respectively. The rate of ER expression positively related to the tumor stage (PTNM). There were no significant differencebetween the expressions of ER, PR, C-myc and sex, age, family history and the location of tumor. The expression of ER in gastric cancer with worse differentiation was significantly higher than that with better one. The postoperative survival time in patients with positive expression of ER was significantly shorter than that with ER negative expression. The similar condition was present in patients with the expression of C-myc. There was no difference between PR expression and survival time. Based on COX regression model, the following factors including the range of the block dissection of lymph nodes, the expression of ER, PTNM stage and the degree of differentiation were independent factors that influenced the prognosis of gastric cancer. Conclusion 1. The expression of ER, PR and C-myc can be detected in the samples form gastric cancer, and their expression rate positively related to the tumor stage, worse histological differentiation, which may indicate the complete estrogen signal architectures and the important role in the occurrence and development of the tumor. 2. There is no difference between the expression of ER and sex and age in patients with gastric cancer. The modulation mechanism of ER expression is more complicated than it is expected. 3. The range of the block dissection of lymph nodes, PTNM stage and differentiation degree are independent factors that will influence the prognosis in patients with gastric cancer. 4. The survival time in patients with positive expression of ER is significantly shorter than that with ER negative expression. The expression of ER is an independent prognostic factor and presents the worse prognosis in patients with gastric cancer. It implies that antiestrogen therapy may useable in patients with gastric cancer.