Correlation Between Pathological Classification Of Gastric Cancer And Its Molecular Biological Characteristics

Backgrounds and objectives:Gastric cancer(GC)is one of the most frequently occurred gastrointestinal malignancies worldwide.The diagnosis and therapeutic strategies are partly based on its pathological classification and molecular biological characteristics.Multiple strategies have been developed to classify the GC,including Borrmann classifications,Lauren classifications and WHO classifications.With the development of molecular biology,more and more attention has been paid to its application in clinical diagnosis and treatment strategies.This study intends to analyze the correlation between pathological classifications of gastric cancer and its molecular biological characteristics,as well as the correlation between immunohistochemical molecular markers and clinicopathological characteristics.Therefore,to provide new direction and evidence for the clinical diagnosis and treatment of GC.Materials and methods:We retrospectively analyzed patients came from department of gastrointestinal surgery,the First Affiliated Hospital of Xiamen University from November 2016 to May 2018.All the patients were diagnosed as gastric cancer at first time and underwent curative resection.The clinicopathological characteristics and immune markers were collected.Gastric cancer patients were classified according to different pathological classifications.The expression level of tumor immune markers(CK7,CK8,CK20,CEA,SYN,HER-2 and Ki-67)were compared between different pathological classifications(Borrmann classification and Lauren classification).In addition,the correlations between different expression levels of HER-2 and Ki-67 and clinicopathological characteristics(maximum diameter of tumor,site of tumor occurrence,depth of invasion,degree of differentiation,lymph node metastasis and number of lymph node metastases and TNM staging)were analyzed.Results:102 patients with gastric cancer were enrolled in the present study.According to Borrmann classifications,10 patients were classified into Borrmann type I,16 cases were classified into Borrmann type ?,63 patients were classified into Borrmann type ? and 13 cases were classified into Borrmann type IV.According to Lauren classifications,62 cases were intestinal type gastric cancer,33 cases were diffuse type and 4 cases were mixed type.After analyzing the correlation between the pathological classifications and immunohistochemical markers,the results showed that there was no statistically significant correlation between the Borrmann classifications and the expression levels of CK7,CK8,CK20,CEA,SYN,HER-2 and Ki-67(all the absolute values of correlation coefficients were less than 0.2 and all the P values were greater than 0.05).There was no significant correlation between Lauren classifications and CK7,CK8,CK20,CEA,SYN;her-2 and ki-67(the absolute values of correlation coefficients were all less than 0.2 and all P values were greater than 0.05).However,the coefficient between Lauren classification and expression level of HER-2 was-0.189 and P value was 0.063,which was close to statistical significance.It showed that the expression level of HER-2 of gastric cancer tissue was significantly correlated to the degree of tumor differentiation(correlation coefficients:0.373,P<0.001).A higher positive rate was observed in tumors with higher the degree of tumor differentiation.There was no significant correlation between expression level of HER-2 with tumor diameter,tumor location,depth of invasion,the number of lymph node metastasis and TNM stages(P values were greater than 0.05).The expression level of Ki-67 of gastric cancer tissues was significantly correlated to the maximum diameter of the tumor(correlation coefficient:0.205,P=0.038),and the tumor site(correlation coefficient:-0.217,P=0.033),the degree of tumor invasion(correlation coefficient:0.297,P=0.002),and the TNM stage(correlation coefficient:0.259,P=0.009).There was no significant correlation between expression level of Ki-67 with the degree of differentiation and the number of lymph node metastases(P values was greater than 0.05).Conclusions:There was no significant correlation between the pathological classifications of gastric cancer and the expression levels of immunological markers(CK7,CK8,CK20,CEA,SYN,her-2 and ki-67).The expression level of HER-2 of gastric cancer tissues was significantly correlated with the degree of tumor differentiation.A higher positive rate could be observed in tumors with higher the degree of tumor differentiation.However,the expression level of HER-2 was not significantly correlated with tumor maximum diameter,tumor site,tumor depth,number of lymph node metastases,and TNM staging.The expression level of Ki-67 of gastric cancer was significantly correlated with the maximum diameter of the tumor,the tumor site,the degree of tumor invasion,and the TNM stage.There was no significant correlation between expression level of Ki-67 with degree of differentiation and number of lymph node metastases.A higher positive rate could be observed in gastric cancer located at fundus,the tumor with larger volume,tumor with deeper infiltration and tumors with higher TNM stages.