Huang BJ, Xu HM, Zhao YJ, Wang TJ, Tian DT, Chen JQ.
Multivariate analysis of predicting lymph node metastasis in gastric cancer. Shijie Huaren Xiaohua Zazhi
2004; 12(2): 266-270 [DOI: 10.11569/wcjd.v12.i2.266
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AIM: To analyze the factors influencing lymph node metastasis in gastric cancer and to screen the indicators that could predict more exactly the extent of lymph node metastasis before surgery.
METHODS: The mRNA expression of heparanase, MMP-7, VEGF-C, S100A4, hRad17, hTERT, CDH1, KAI1 and nm23H1 genes were examined in 62 gastric cancer tissues by reverse transcription polymerase chain reaction (RT-PCR). In combination with clinicopathological features, univariate and multivariate analyses were carried out in order to screen the factors affecting lymph node metastasis of gastric carcinoma.
RESULTS: All the genes above were expressed more or less in gastric cancer tissues. With regard to the positive rate, S100A4 and hTERT were the highest (both 96.8%) and CDH1 was the lowest (64.5%). Multivariate analysis with binary logistic regression showed that lymphatic invasion and heparanase mRNA expression were independent factors that judged whether there was lymph node metastasis, and the odds ratios [Exp (B)] were 21.137 (95%CI 2.115-211.211) and 9.768 (95%CI 1.582-60.300) respectively. When predicting the extent of the lymph node metastasis (the number of lymph node metastasis of no more than 6 was regarded as the fewer and lighter; no less than 7 as the more and heavier), MMP-7, hTERT and CDH1 genes mRNA expression and Lauren type of carcinoma were the independent factors (P = 0.037, 0.009, 0.021 and 0.012 respectively), Exp (B) was 8.046, 9.159, 0.087 and 10.068 respectively. The area of serosa involvement was also an important factor.
CONCLUSION: Heparanase mRNA expression and lymphatic invasion of gastric cancer tissue correlate with lymph node metastasis positively. The degree of lymph node metastasis is more serious in patients with diffusive histological type, area of serosa involvement more than 20 cm2 and MMP-7, hTERT mRNA overexpression, and CDH1 loss of expression in gastric cancer. Above examinations before surgery are indicated to arrive at an optimum treatment scheme.