Characteristics And Clinical Significance Of Lymph Node Metastasis In Adenocarcinoma Of The Esophagogastric Junction And The Reserch Of Molecular Mechanism

Objective: To investigate the characteristics of lymph node metastasis and its clinical significance in Siewert II and III adenocarcinoma of esophagogastric junction.Methods: 67 patients with adenocarcinoma of the esophagogastric junction were performed an operation and lymphadenectomy from August 2014 to August2016.The specimens of lymph node were dissected and collected by pathologists and clinicians.With histopathological and immunohistochemical examination of each Lymph node,we determine whether the lymph node metastasis and calculate the rate of lymph node metastasis and degree of lymph node metastasis.The relationship between lymph node metastasis and size of tumor,TNM staging,Borrmann classification and tumor type was analyzed.Results: There were 31 patients with lymph node metastasis(63.3%)In the 49 Siewert II tumor.A total of 961 lymph nodes were harvested In the Siewert II tumor.There were 11 patients with lymph node metastasis(61.1%)In the 18 Siewert III tumor.A total of 512 lymph nodes were harvested In the Siewert III tumor.There was no significant difference between the tumor size and rate of lymph node metastasis(P> 0.05),but there was significant difference between tumor size and degree of lymph node metastasis(P <0.001).The rate of lymph node metastasis increased with the TNM stage.There was high rate of lymph node metastasis in IIIB and IIIC patients(P <0.001).There was high rate of lymph node metastasis in Borrmann III patients(P <0.05).The rate of lymph node metastasis in Siewert II tumor from high tolow was 3?1?2?7=11?4=8?9=5=110 group.The rate of lymph node metastasis in Siewert type III tumor was from high to low was 3?1=2?7=11?9=6?4=8=5 group.There was no significant difference between tumor type and rate of lymph node metastasis(P> 0.05).the degree of lymph node metastasis in Siewert II tumor from high to low was 2,1,110,3,11,5,7,4,8 and 9 group.the degree of lymph node metastasis of Siewert III tumor from high to low was 2,3,11,7,6,5,1,9,8 and 4group.Group 1(P = 0.001),group 2(p = 0.015)and group 6(p = 0.03)were different between Siewert II and III in the degree of lymph node metastasis.Conclusion: The clinical pathological features of Siewert II and III adenocarcinoma of esophagogastric junction are significantly different.There is no significant difference in the rate of lymph node metastasis of adenocarcinoma of esophagogastric junction.In the degree of lymph node metastasis,Group 1(P <0.05)and group 2(P <0.05)was significant difference in different types.Compared with the Siewert III tumor,the Siewert II tumors were more likely to metastasize to the group 110.Therefore,Siewert II type of tumor need to clean 110 group,1 group of lymph nodes.Siewert III type of tumor need to clean 2 group of lymph nodes.Objective: To reserch the expression and interaction of PDZK1 and PDGFR-?in Siewert II adenocarcinoma of the esophagogastric junction.To compare the expression of PDZK1 and PDGFR-? in Siewert II adenocarcinoma of the esophagogastric junction and distal gastric cancer.Methods: Paraffin sections were prepared for immunohistochemical staining.Semi-quantitative scoring system was used to evaluate the results of immunohistochemical staining and then statistical analysis was performed.Results: There was 30%(12 / 40)positive rate of PDZK1 in the adenocarcinoma of the esophagogastric junction.There was 95%(38/40)positive rate of PDZK1 in the normal tissue of esophagogastric junction.There was significant difference between two tissues(?2=36.053,P <0.001).There was 80%(32 / 40)positive rate of PDGFR-? in the adenocarcinoma of the esophagogastric junction.There was 28%(11 / 40)positive rate of PDGFR-? in the normal tissue of esophagogastric junction.There was significant difference between two tissues(?2=22.175,P<0.001).There was no significant correlation between PDZK1 and PDGFR-? in the normal tissue of the esophagogastric junction(R = 0.026,P = 0.874)and the adenocarcinoma of the esophagogastric junction(r = 0.111,P = 0.497).Compared with distal gastric cancer,the expression of PDZK1 in the normal tissue of the esophagogastric junction was higher than that in the distal gastric tissue(?=-1.997,P=0.046).the expression of PDGFR-? in the adenocarcinoma of the gastroesophageal junction was higher than that in the distal gastric tissue(?=-3.811,P=0.000),there was significant difference.Conclusion: There was highly expression of PDGFR-? in adenocarcinoma of the esophagogastric junction.There was highly expression of PDZK1 in normal tissue of the esophagogastric junction.There was no significant correlation between PDZK1 and PDGFR-? in the normal tissues of the esophagogastric junction and the adenocarcinoma of the esophagogastric junction.Combined with the clinical characteristics,the adenocarcinoma of esophagogastric junction may be different from the distal gastric cancer.With expression of PDZK1,It is possible to provide some reference value in AEG molecular classification and targeted therapy.