Expression And Clinical Significance Of TNS4and VEGF In Gastric Stump Cancer

Gastric stump cancer (GSC) is defined as carcinoma that occurred in gastric stump, which had undergone partial gastrectomy for benign gastric disease5years before,which is a unique type of gastic cancer.Since1970s partial gastrectomy has been performed to cure peptic ulcer,the incidence of GSC is increasing.Correlative studies reported lack of specific clinical manifestation in the early stage,compare to GC,GSC is usually more malignant,due to the change of anatomy structure,tumor is more easily infiltrate into serous,erosion the organs around,and tumor metastasis is common,so GSC is still termed as a poor prognosis disease,which needs further research.ObjectivesDetermine the tissue expressions of TNS4and VEGF proteins in GSC tissue and normal tissue around the tumor,probe into the molecular mechanisms of tumorigenesis,development and metastasis of GSC,in order to provide a hypothetical base for the early diagnosis,prognosis estimate and new target therapy for GSC.MethodsBetween January2002to August2012,44patients were diagnosed as GSC in the Second Hospital of Xiangya.There were33 patients undertaken surgery,had tumor resection and pathological diagnosis,11patients undertaken surgery and biopsy to have diagnosis, but did not have tumor resection.Tissues of tumor and normal tissues around the tumor were collected as samples for HE staining to determine the pathology diagnosis first.Tissue expressions of VEGF and TNS4proteins were determined by immunohistochemistry method (Elivision TM two step kit).Correlations between the expressions of VEGF and TNS4proteins and various clinical and pathological parameters were analyzed using SPSS19.0software.Results1. VEGF and TNS4proteins were detected in70.1%(31/44) and65.9%(29/44) amongst the44tissue samples of gastric stump cancer patients, respectively.While VEGF and TNS4proteins were detected in21.2%(7/33)、6.45%(2/33) amongst the33normal tissue samples around the tumor, respectively.The difference was significant(P<0.05).2. There is no significant correlation between VEGF,TNS4protein expression and the patient’s gender,age,size of the tumor and the location of tumor(P<0.05).While VEGF,TNS4protein expression was associated with carcinoma invasive depth,lymph node metastasis,distal metastasis and clinical stage(P<0.05).3. Using Pearson correlation analysis analyse the relationship of the expressions of VEGF and TNS4proteins.The expressions of VEGF and TNS4proteins are positively correlated in gastric stump cancers(r=0.585, K=0.582, p<0.001).Conclusion1. The significantly higher expressions of VEGF and TNS4proteins in gastric stump cancer compared to normal stomach tissue around tumor imply that VEGF and TNS4proteins possibly promotes the tumorigenesis, infiltration and metastasis of GSC, which are able to serve as two specific molecular markers for diagnosis of GSC.2. Because of the co-inductive nature of VEGF and TNS4proteins in gastric stump cancers, their co-expression may serve as an indicator for GSC patients.