Study On The Correlation Between Perineural Invasion And Clinical And Pathological Characteristics Of Gastric Cancer

1. BackgroundThe recent studies had shown that gastric cancer has risen to become the firs t killer of human, during the digestive tract tumor. The incidence of gastric can cer has been increasing in the past 20 years, and the mortality has risen to the s econd place of the entire world, in China each year the mortality due to gastric cancer ratio is close to 25.32/10 million, and gastric cancer has become graduall y younger age and low state of differentiation. Although with the improvement o f operation mode,5 years survival rate of gastric cancer is still less than 35%. The cause of gastric cancer’s high incidence and high mortality include screenin g mechanism of gastric cancer is not perfect, the rapid progress of gastric cane er, as well as the occurrence in the early stages of invasion to the surrounding tissue. In traditional opinion, lymph node metastasis, direct spread, metastasis a nd blood metastasis are the main metastasis ways for gastric cancer. But in rec ent years, perineural invasion had been known, with the development of anato mical and molecular biology.Gastric cancer perineural invasion is refers to the pathological processof gastri c cancer cells invade surrounding nerves or nerve bundle. The mechanism of ner ve infiltration is still not clear as so far. Some research shows that, the occurr ence of neural invasion may be associated with a nerve growth factor receptor, and some scholars think that neurotrophin-3, nerve growth factor and brain-de rived neurotropic factor are related to neural invasion.In the overall operation in patients with gastric cancer, the postoperative pat hological shows that average occurrence rate of perineural invasion is about 40. 5%. With the deepening of research, the correlation of nerve invasion in maligna nt tumor and pathological index has been recognized. Especially in the study of neural invasion of pancreatic cancer, there is a close relationship between th e prognosis and the occurrence of neural invasion of pancreatic cancer. It has not been proven that neural invasion is the independent prognostic factors of gastric cancer. However more and more studies have shown that gastric cancer invasio n may have a close relationship with the prognosis. Therefore, to explore the rel evance of occurrence of gastric cancer invasion and clinical characteristics, pathol ogical features, will speculate that the relationship between the nerve invasion a nd prognosis, it may become a new breakthrough in the diagnosis and treatment of gastric cancer.2. Purpose2.1 To explore the correlations of gastric cancer perineural invasion and clin ical features, including age, gender, underlying diseases, abdominal pain, acid reg urgitation, nausea, vomiting, tumor marker.2.2 To explore the correlations of gastric cancer perineural invasion and pos toperative pathological characteristics, including tumor site, size, depth of invasio n, lymph node metastasis, vascular invasion, TNM stage, Borrmann type, cell typ e, degree of differentiation of gastric cancer.2.3 To evaluate the correlation between prognosis of gastric cancer and per ineural invasion, with the relationship between perineural invasion and clinical c haracteristics, pathological features.3. Methods3.1Collection of clinical dataThe information of 130 patients of gastric cancer, without chemotherapy, re ceipting radical resection of gastric cancer, are collected, which includes the ex amination results before the operation (age, gender, blood pressure, blood glucose levels of tumor markers, etc.), clinical symptoms (abdominal pain, nausea, vomiti ng) and postoperative pathological results (tumor cell type, depth of invasion, lym ph node invasion). There are 74 men,56 women, with an average age for 65 years old, from age 53 to 86 years old.3.2 Statistical analysisWith SPSS Statistics V19.0, the relationship between the neural invasion of gastric cancer and the clinical symptoms, pathological result, physiological and biochemical indexes has been evaluated, using variance analysis, chi-square test, and independent sample mean t-test. According to the postoperative pathologica 1 findings in patients with perineural invasion occurs or not, the data of 130 patie nts were divided into two groups, including PNI (+) nerve infiltration group and n on-invasion group (-PNI). Two groups of patients with clinical data and postope rative pathological results were analyzed.4. Results4.1 Perineural invasion is obviously related to blood glucose, CA-199 level (p<0.05);4.2 The ratio of abdominal pain is significantly increased during patients wit h nerve invasion (p<0.05);4.3 Nerve infiltration is significantly associated with the depth of tumor in vasion, lymph node metastasis, vascular invasion, TNM staging, degree of mali gnant tumor cells (p<0.05).5. ConclusionPerineural invasion of gastric cancer may lead to the occurrence of abdom inal pain. At the same time, the levels of blood sugar, serum CA-199 can refl ect the situation of gastric carcinoma perineural invasion. Perineural invasion in gastric carcinoma has a certain relationship with depth of invasion, lymph nod e metastasis, vascular invasion, TNM staging, degree of malignant tumor cells, as a result the perineural invasion will become an important role to evaluate th e condition of patients with gastric cancer, guide the therapy as well as evalua te prognosis of the patients.