| Objective To study the important factors affecting the prognosis of patient with gastric cancer after surgical treatment. To investigate the expression of NDRG2 and MMP-9 genes in gastric cancer and relationship with prognosis of the patients. Methods The data of 1031 cases of resected gastric cancer from Jan. 2003 to Dec. 2007 were studied by using univariate analysis and multivariate regression analysis. Age, gender, clinical stage, tumor location, tumor size, Borrmann type, histological type, differentiation, depth of tumor invasion, lymphatic invasion, distant metastases ,TNM stage, MLR, Gastrectomy type,radical resection, tumor residue of incisal edge, operative duration, intraoperative bleeding, preoperative transfusion, hemoglobin, albumin ,CEA,CA125, living condition, postoperative chemotherapy were monitored. SP immunohistoc- hemistry method was used to determine the expression of NDRG2 and MMP-9 in tissue specimens from 80 cases with gastric cancer and investigate prognostic values of them. Results In 1031 cases, 95 cases were EGC, accounting for 9.2%, and another 936 cases were advanced gastric cancer, accounting for 90.8%. Gastrectomy was performed for 980 cases with resectability of 95.1% , among which there were 874 cases of curative resection (84.8% ) and 106 cases of non-curative resection (10.3% ), the other 51 cases of palliative operation included bypass procedures and laparotomy. Univariate analysis showed that the predictors of survival in gastric cancer patients were age, clinical stage, tumor size, Borrmann type, differentiation, depth of tumor invasion, lymphatic invasion, distant metastases ,TNM staging, MLR ,radical resection, resid 0f incisal edge, operative duration, intraoperative bleeding, preoperative transfusion, hemoglobin, albumin, CA125, postoperative chemotherapy (p<0.05). Gender, tumor location, histological type, gastrectomy type ,CEA,living condition can not effect the prognosis of gastric cancer (p>0.05). Multivariate analysis showed that only tumor size, TNM staging, MLR, preoperative transfusion, albumin, postoperative chemotherapy were independent factors. For all cases, early and advanced stage 5-year survival rate was 93.3%, 42.9%, respectively. The stage-specific 5-year survival rate was 93.2% ( Stageâ… A) , 65.1% ( Stageâ… B) ,52.3% ( Stageâ…¡) , 41.4% ( Stageâ…¢A ), 16.6% ( Stageâ…¢B )and 10.6% ( Stageâ…£) ,respectively. It was 57.4% and 36.0% in postoperative chemotherapy or not, respectively. The 1-, 3- and 5-year survival rate was 80.2% , 58.0% and 48.2% , respectively. The positive rate of NDRG2 is 22.5% in tissue specimens from 80 cases with gastric cancer. It is related to the tumor location, age, lymphatic invasion (p<0.05). The positive rate of MMP-9 is 28.8%. It is related to the tumor size, depth of tumor invasion, TNM stage (p<0.05). Conclusion The following prognostic factors can influence the survival of gastric cancer patients: age, clinical stage, tumor size, Borrmann type, differentiation, depth of tumor invasion, lymphatic invasion, distant metastases ,TNM staging, MLR ,radical resection, resid 0f incisal edge, operative duration, intraoperative bleeding, preoperative transfusion, hemoglobin, albumin, CA125, postoperative chemotherapy. Tumor size, TNM staging, MLR, preoperative transfusion, albumin, postoperative chemotherapy are the independence prognosis factor for gastric cancer patients. NDRG2 is related to the tumor location, age and lymphatic invasion. MMP-9 is related to the depth of tumor invasion, TNM stage and tumor size. Early detection and curative resection were the most important measures to improve therapeutic effect of gastric cancer. Individualizing operation and a surgery-predominant multidisciplinary treatment will contribute to improvement of therapeutic effect of gastric cancer. Tumor size, albumin, TNM staging and MLR serve as an important predictor of survival in patients with gastric cancer. Association detection protein expression of NDRG2 and MMP-9 can help us to judge prognosis and direct therapy.
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