Abstract:Objective:To study the regulatory factors of perigastric and para-aortic lymph node(LN) metastasis in gastric adenocarcinoma.
Methods :Immunohistochemical staining for the expressions of survivin, p53, C-erbB-2, PCNA, Ki-67, MMP-2, MMP-7 and MMP-9 was done and those were used to analyse the relation with lymph node metastasis by analysis of single and multiple variables.
Results:The average number of metastasized LN was (5.61±0.68)/case in 238 cases, which was（27.78±24.45）% as an average rate of LN metastasis. The LN metastasis was found in 207 of the 238 cases(total metastasized rate: 86.97%). Among 53 cases with D3 operation, 13 cases(24.53%) had para-aorta LN metastasis. The average number of para-aorta LN harvested was (6.36±1.83)/case. There were 58 metastasized para-aortic LN, an average of (4.46±2.05)/case. The metastasized rate of para-arota LN was 24.52%. The combined positive expressions of p53 and survivin had significant relation with LN metastasis (P<0.01) by single analysis and was an independent risk factor for perigastric LN metastasis by multiple analysis. The Ki-67 labeling index(LI) and the MMP-2 expression indicated para-aortic LN metastasis (P<0.05, respectively) and were independent risk factors for para-aortic LN metastasis.
Conclusions:The combined expressions of p53 and survivin could be used as predictive factors for LN metastasis. Ki-67LI and MMP-2 expression are predictive factors and independent risk factors for para-aorta LN metastasis.