EGFR And VEGF's Expression And Influence On The Prognosis In Patients With T3 Stage Gastric Adenocarcinoma

?Objective?1. To investigate the expression level of Epidermal growth factor receptor(EGFR) and Vascular endothelial growth factor(VEGF) in T3 stage gastric adenocarcinoma(T3-GA) tissue and influence on T3 stage gastric adenocarcinoma patients recurrence and prognosis.2. To investigate recurrence and prognosis of T3 stage gastric adenocarcinoma patients with age, sex, tumor differentiation, tumor location, tumor size, Lauren type, surgical margin, lymph node metastasis and distant metastasis. ?Methods?1. A retrospective analysis that The total of 453 cases patients with T3 stage gastric adenocarcinoma who had resected surgical in Fuzhou General Hospital from July 2003 to December2009 and followed up deadline is November 1, 2014.2. Immunohistochemistry was used to detect the expressionl of EGFR and VEGF level in T3 stage gastric adenocarcinoma and application SPSS17.0 software analysis of T3 stage gastric adenocarcinoma patients with gastric adenocarcinoma pathological features and its influence T3 stage gastric adenocarcinoma of recurrence and prognosis.3. Application software SPSS17.0 univariate analysis and Cox proportional hazard model multivariate analysis the prognosis of T3 stage gastric adenocarcinoma patients with gastric cancer clinicopathological characteristics such as age, sex, tumor differentiation, tumor location, tumor size, Lauren typing, surgical margin, lymph node metastasis and distant metastasis. ?Results?1. High EGFR expression rate of 41.1%(EGFR? +++, 186/453), The high expression of VEGF was 48.6%(VEGF?+++, 233/453) In 453 patients with T3 gastric adenocarcinoma tissue.There is no different of the EGFR and VEGF expression in patients with T3 stage gastric adenocarcinoma with age, gender, degree of differentiation, tumor size, location, Lauren type, surgical margin, distant metastasis(P > 0.05), the difference has statistically significant in lymph node metastasis(P = 0.008, P <0.01).2. The recurrence rate was 70.4%(131/186) In 186 patients with EGFR overexpression and Epidermal growth factor receptor(EGFR) high expression in the group has a shorter Median recurrence free survival(MRFS)(17 months vs.50 months,P < 0.01),mortality was 74.2%(138/186) and EGFR high expression group has a shorter Median survival time(MST)(22 months vs.54 months, P < 0.01).The recurrence rate was 68.2%(159/233)In 233 patients with VEGF overexpression group and Vascular endothelial growth factor(VEGF) high expression in the group has a shorter recurrence Median free survival(20 months vs.55 months,P < 0.01),mortality was 72.5%(169/233)and VEGF high expression group has a shorter Median survival time(28 months vs.58 months, P < 0.01).3. Univariate analysis showed that The median survival time of patients is correlated with EGFR and VEGF expression,tumor size, surgical margin, lymph node metastasis and distant metastasis, the difference is statistically significant(P < 0.01).Cox proportional hazard model multivariate analysis showed that age, tumor size, degree of differentiation, surgical margin, lymph node metastasis, distant metastasis(P < 0.01) with EGFR, VEGF expression level(P = 0.000, P = 0.000, P < 0.01) are independent risk factors for reduced median survival time. ?Conclusions?1.The expression levels of EGRF and VEGF are related with lymph node metastasis and recurrence, prognosis in T3 stage gastric adenocarcinoma patients.EGFR and VEGF high expression have a worse the prognosis, more likely to relapse in patients with T3 stage gastric adenocarcinoma,which may acted as a indicator of the malignant degree of gastric adenocarcinoma and prognosis.And targeted therapy has a certain guiding role.2. The prognosis is relate with EGFR, VEGF expression level, tumor size, surgical margin, lymph node metastasis, distant metastas in T3 stage gastric adenocarcinoma patients.Age, tumor size, degree of differentiation, surgical margin, lymph node metastasis, distant metastasis, EGFR, VEGF expression level are independent risk factors for prognosis of T3 stage gastric adenocarcinoma patients.