Wang Yi-Wei, Zhu Mei-Ling, Wang Rui-Fen, Xue Wen-Ji, Zhu Xue-Ru, Wang Li-Feng, Zheng Lei-Zhen
Department of Oncology, Xin Hua Hospital affiliated to Shanghai Jiaotong University School of Medicine, NO.1665, Kong Jiang Road, Shanghai, 200092, People's Republic of China.
Department of Pathology, Xin Hua Hospital affiliated to Shanghai Jiaotong University School of Medicine, NO.1665, Kong Jiang Road, Shanghai, 200092, People's Republic of China.
Tumour Biol. 2016 Jul;37(7):8567-78. doi: 10.1007/s13277-015-4721-3. Epub 2016 Jan 5.
Predicting lymph node metastasis (LNM) accurately is very important to decide treatment strategies preoperatively. The aim of this study was to explore risk factors that predict the presence of LNM in early gastric cancer (EGC). A total of 230 patients with EGC who underwent curative gastrectomy with lymph adenectomy at Xinhua Hospital from January 2006 to July 2014 were retrospectively reviewed. We studied the relationship between clinicopathological factors, biological markers (p53, ki67, nm23, vascular endothelial growth factor (VEGF), epidermal growth factor receptor (EGFR), E-cadherin (E-cad), beta-catenin (b-catenin), glutathione S-transferase (GST), and topoisomerase II (Topo II)), 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. 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 that large tumor size (≥20 mm, odds ratio (OR) = 2.168, p = 0.041), submucosa (OR = 4.000, p = 0.0005), and 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). Tumor size (≥20 mm), 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. The results need further validation in single large studies.
准确预测淋巴结转移（LNM）对于术前制定治疗策略非常重要。本研究的目的是探索预测早期胃癌（EGC）中LNM存在的危险因素。回顾性分析了2006年1月至2014年7月在新华医院接受根治性胃切除术及淋巴结清扫术的230例EGC患者。我们通过卡方检验和逻辑回归分析研究了临床病理因素、生物标志物（p53、ki67、nm23、血管内皮生长因子（VEGF）、表皮生长因子受体（EGFR）、E-钙黏蛋白（E-cad）、β-连环蛋白（b-catenin）、谷胱甘肽S-转移酶（GST）和拓扑异构酶II（Topo II））与EGC患者LNM之间的关系。进一步进行荟萃分析以评估这些蛋白质（P53、ki67、E-cad和b-catenin）对EGC患者LNM的影响。230例患者中有42例（18.3%）检测到LNM。LNM的发生率在不同肿瘤大小（p = 0.044）、黏膜下浸润深度（p < 0.0001）和P53过表达（p = 0.004）方面存在差异。多因素分析进一步确定，肿瘤较大（≥20 mm，比值比（OR）= 2.168，p = 0.041）、黏膜下层（OR = 4.000，p = 0.0005）和P53过表达（OR = 3.010，p = 0.022）是EGC患者LNM的独立危险因素。荟萃分析显示，P53、ki67和b-catenin与EGC患者LNM风险增加存在显著统计学关联（P53，OR = 1.81，p = 0.017；ki67，OR = 2.53，p = 0.0003；b-catenin，OR = 0.53，p = 0.01）。肿瘤大小（≥20 mm）、浸润深度（黏膜下层）和P53过表达可能是EGC患者LNM的有用预测指标。此外，荟萃分析结果显示，P53、ki67过表达和b-catenin异常表达可能与EGC患者的LNM有关。这些结果需要在单个大型研究中进一步验证。
