Analysis On Clinicopathologic Features、Influencing Factors Of Survival And The Variation Of Rs13042395Loci For Patients With Concurrent Esophageal And Gastric Cardia Cancers

Objectives: Esophageal squamous cell carcinoma (ESCC) and Gastric cardiaadenocarcinoma (GCA) coexisting in the same patient is not uncommon that is definedas concurrent esophageal and gastric cardia cancers (CC). However, theclinicopathologic features, prognosis, influencing factors of survival and molecularmechanisms with CC patients were poor. The purpose of this study was to investigateon clinicopathologic features of the two tumors, influencing factors of survival,therelationship with variation of rs13042395loci and risk of CC patients、prognosis bycomparing CC and single ESCC, GCA and normal people.Methods:1.CC patients: The dates of311patients with concurrent carcinomas ofthe esophagus and gastric cardia (CC) came from our ESCC and GCA laboratorydatabase. Collected the basic data， got the clinical pathological information fromhospital.2. Blood sample collection and Sequenom genotyping: Collected33cases bloodsample of CC patients. Then, we recorded to gender, age and high and low incidencearea, selected randomly50cases of ESCC patients, GCA patients and normal peopleas the contrast. At last, the collected blood samples were genotyped detectionofrs13042395loci.3.Questionnaires, follow-up and clinical data collection: Home questionnaireswere used to collect the information for patients with SCC, GCA and CC in highincidence area of esophageal cancer, including name, age, occupation, native place,disease time, disease type, treatment hospital, treatment time, family history, contactinformation and so on. The information for clinical and pathological features withpatients was checked in department of pathology, and living conditions of patient wereabstained by telephone follow-up.4. Statistics: SPSS19.0statistical software was used for, chi-square test and consistency check, Kaplan-Meier survival analysis, Cox-regression model was used toanalyze the clinical pathology and influencing factors of survival. Chi-square test(Fisher exact test) and Kaplan-Meier survival analysis were used to analysis thegenotype dates and relationship with prognosis.Results:1.Overall gender ratio for male to female was3.1:1. Distribution ofdiagnosed age was33to82years old, high incidence age of male was60to69yearsold and females’ was60to69years old. The average age of onset respectively is:61.8±8.5,60.3±8.1years old. The histological types of tumor was based on ESCC/GCA,and the differences between ages and genders have no significant (P>0.05).2. The no consistency rate of before and after operation was34.4%. In the107cases which were diagnosed with single cancer, the advanced esophageal cancer takes43.9%.3. The TNM stage of ESCC and GCA were all base on stageⅡ, the stage Ⅳ wasthe least, but the stage Ⅲ~Ⅳ of GCA was significantly more than ESCC(P<0.05);The degree of differentiation, T stage, N stage and clinical stage of ESCC and GCAwith CC patients’ consistency were poor (the values of Kappa were less than0.3).4. The percent of survival on1year,3years and5years were77.9%,39.9%,25.4%;T and N stage were independent prognostic factors (P<0.05);The more deepinfiltration, lymph node metastasis, the prognosis of patients were more poor.5. The distribution of genotype in rs13042395loci (wild type: CC, mutant type:CT+TT)by gender、age and the high and low incidence on CC patients had nosignificant differences (P>0.05).The distribution of genotype in rs13042395site on CC,ESCC, GCA patients and normal people have no statistically significant differences(P>0.05).6. The prognosis between wild and mutant type of rs13042395loci were nosignificant difference (P>0.05).Conclusions:1.The inconsistency rate of CC diagnosis before and after operationis very high; the key reason may be hat advanced esophageal cancer hinderedgastroscopy check the cardia position.2. The percent of survival on5years is poor. T and N stage are independentprognostic factors. The more deep infiltration, lymph node metastasis, the prognosis ofpatients is poorer. 3. There is no relationship between rs13042395loci mutation with the mortalityrisk and prognosis of CC patients. It may be due to small sample size or be affected byother sites.