Predictable Factors For Lymph Node Metastasis In Early Gastric Cancer-analysis Of Clinicopathologic Factors And Molecular Markers

Objective Predicting lymph node metastasis(LNM)accurately is very important to decide treatments strategies preoperatively.The aim of this study was to explore risk factors that predict the presence of LNM in early gastric cancer(EGC).Method Total of 230 patients with early gastric cancer who underwent curative gastrectomy with lymph adenectomy at Xinhua hospital affiliated to Shanghai Jiaotong University School of Medicine from January 2006 to July 2014 were retrospectively reviewed.We studied the relationship between clinicopathological factors(age,sex,smoking history,drinking history,family history,tumor size,tumor location,depth of invasion,macroscopic type,differentiation and WHO calssification),molecular markers(p53,ki67,nm23,vascular endothelial growth factor(VEGF),epidermal growth factor receptor(EGFR),E-cadherin(E-cad)and beta-catenin(b-catenin))and LNM of EGC patients by Chi-square test and logistic regression analysis.Meta-analyses were further conducted to review the effects of the proteins(P53,ki67,E-cad and b-catenin)on LNM in ECG patients.Results LNM was detected in 42(18.3%)of 230 patients.Incidences of LNM was distinct in different tumor size(P = 0.044),depth of submucosal invasion(P<0.0001)and P53 overexpression(P = 0.004).Multivariate analysis further indentified large tumor size(?20mm,OR = 2.168,P = 0.041),submucosa(OR = 4.000,P = 0.0005),P53 overexpression(OR = 3.010,P = 0.022)were independent risk factors of LNM in EGC patients.The meta-analysis revealed a significantly statistical association of P53,ki67 and b-catenin with an increased risk of LNM in EGC patients(P53,OR = 1.81,P = 0.017;ki67,OR = 2.53,P = 0.0003;b-catenin,OR = 0.53,P = 0.01).Conclusion Tumor size(? 20mm),the depth of invasion(submucosa)and P53 overexpression may be helpful predictors of LNM in EGC patients.Furthermore,the results of meta-analysis revealed that P53,ki67 overexpression and abnormal expression of b-catenin may be associated with LNM in EGC.