Clinicopathological Analysis Of 491 Patients With Gastric Cancer

OBJECTIVEThis study retrospectively analyzed the characteristics of clinical data of 491 patients with gastric cancer,and compared the similarities and differences in clinicopathological data and prognosis of gastric cancer patients with or without Metabolic diseases,then explored the risk factors of vascular invasion in gastric cancer patients,so as to provide some references for clinicians.METHODSThis study retrospectively analyzed the clinical data of 491 patients with gastric cancer from The First Hospital of Lanzhou University in January 2016 to August 2019.Then described the general data,pathological features and the morbidity of metabolic disease in the gastric cancer patients and compared the general data,serological indexes and pathological data of gastric cancer patients with or without metabolic syndrome to find the differences and similarities,and to find the effects of metabolic diseases on prognostic factors of gastric cancer.Furthermore,the factors affecting vascular invasion in patients with gastric cancer were discussed by grouping comparison.RESULT1.The most common age of gastric cancer patients was 50-69 years old,and the ratio of male to female was 3.4:1.In this study,the detection rate of Hp in gastric cancer patients was relatively low.Adenocarcinoma is the most common pathological type,differentiation degree is mainly low differentiation,tumor is mainly located in the body of stomach,Borrmann Ⅲ is the most common type.Patients with gastric cancer are easy to be combined with metabolic diseases,dyslipidemia(46.2%)is the most common diseases to be combined,followed by hyperglycemia(21.8%),hypertension(21.6%),metabolic syndrome(10.6%),hyperuricemia(6.7%),obesity(4.9%).2.The age and BMI of patients in the gastric cancer with metabolic syndrome group were both greater than those in the simple gastric cancer group(P< 0.05).The systolic and diastolic blood pressures of patients in the gastric cancer with metabolic syndrome group were higher than those in the simple gastric cancer group,and the patients were more likely to have a history of hypertension and diabetes(P< 0.05).The red blood cell count,percentage of neutrophils,uric acid,fasting blood glucose,triglyceride and NLR in patients with gastric cancer combined with MS group were greater than those in patients with gastric cancer alone,and the percentage of lymphocytes and high-density lipoprotein were lower than those in patients with gastric cancer alone(P< 0.05).There were no statistically significant differences between the two groups in pathological type,differentiation degree,gastric cancer location,tumor number and Borrmann typing(P >0.05).3.Compared with patients with gastric cancer alone,patients with gastric cancer combined with MS are more likely to have vascular invasion and nerve invasion,patients with gastric cancer combined with obesity are more likely to have nerve invasion,and patients with gastric cancer combined with hyperglycemia are more likely to have vascular invasion(P< 0.05).4.Patients in the vascular invasion group were more likely to be associated with MS and hyperglycemia,and hemoglobin were all higher than those in the non-vascular invasion group,while RDW was lower than those in the non-vascular invasion group,and they were more likely to be Borrmann type IV,larger tumor diameter and more likely to be associated with nerve invasion(P< 0.05).Logistic regression analysis indicated combined with MS,bigger tumor diameter,nerve invasion,and Borrmann type IV were independent risk factors for vascular invasion.CONCLUSIONS1.Men is more common in this study,the predilection age was 50-69 years old,the pathological type was the most common adenocarcinoma,the degree of differentiation was mainly low differentiation,the tumor was mainly located in the body of stomach,the most common type was Borrmann Ⅲ,the Hp detection rate of gastric cancer patients was low,and the patients in this study were easy to combine with metabolic diseases.2.Compared with patients combined with gastric cancer alone,patients with gastric cancer combined with metabolic syndrome were older and more prone to obesity,hypertension and diabetes.The red blood cell count,percentage of neutrophils,uric acid,fasting blood glucose,triglyceride and NLR in patients with gastric cancer combined with MS group were greater than those in patients with gastric cancer alone,and the percentage of lymphocytes and high-density lipoprotein were lower than those in patients with gastric cancer alone.3.Compared with patients in the simple gastric cancer group,patients in the gastric cancer group with MS are more likely to have vascular invasion and nerve invasion,which may indicate a poor prognosis.Gastric cancer combined with metabolic diseases make no sense on the differentiation degree of gastric cancer.4.MS,bigger tumor diameter,nerve invasion,and Borrmann type IV were independent risk factors for vascular invasion.