Analysis of Clinicopathologic Characteristics in 958 Cases of Gastric Cancer_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

XIE Honghu , LChengyu , CHEN Wei , Wang Bei.

Department of General Surgery, Nanjing Medical University Affiliated Nanjing First Hospital, Nanjing 210006, Jiangsu Province, China;

Corresponding author：

Keywords：

Gastric cancer; Clinicopathologic characteristics; Epidemiology; Incidence; Surgical treatment

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ObjectiveTo investigate the clinicopathologic and epidemiological characteristics of patients with gastric cancer at our hospital in the past six years． Methods A total of 958 patients with gastric cancer were selected from January 2004 to December 2009 and clinicopathologic characteristics such as basic data, pathological type, tumor location, and TNM stage were retrospectively analyzed. ResultsOf the 958 patients，697 cases (72.8%) were male and 261 cases (27.2%) were female, and the age ranged from 26 to 91 years old (mean 62.6 years old). The occurrence rate of gastric cancer was higher in the patients of 46-65 years old (49.4%, 473/958) than that in the patients of ≥66 years old (42.3%, 405/958) and ≤45 years old (8.3%, 80/958). Regarding pathologic type, the majority of advanced gastric cancers (70.1%) were Borrmann Ⅱ, the adenocarcinoma and signetring cell carcinoma accounted for 82.3% and 7.8%, respectively. The cancer of gastric cardia accounted for 53.0%. Stagestratified analysis revealed that the majority of gastric cancers (47.4%) were stage Ⅲ. Conclusion①A prevalence of gastric cancer is found in middle, elderly male patients. Poorly differentiated adenocarcinoma in cardia is prominent. ②Patients with high malignant ganstrie cancer are younger. ③The majority of patients who underwent the surgical treatments have advanced or metastatic tumor, therefore it is necessary to improve the early diagnosis of gastric cancer.

Citation： XIE Honghu,LChengyu,CHEN Wei,Wang Bei.. Analysis of Clinicopathologic Characteristics in 958 Cases of Gastric Cancer. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2011, 18(2): 153-158. doi: Copy

1.	Parkin DM, Bray F, Ferlay J, et al. Global cancer statistics, 2002 [J]. CA Cancer J Clin, 2005, 55(2): 74108.
2.	Lambert R, Guilloux A, Oshima A, et al. Incidence and mortality from stomach cancer in Japan, Slovenia and the USA [J]. Int J Cancer, 2002, 97(6): 811818.
3.	Cunningham SC, Kamangar F, Kim MP, et al. Survival after gastric adenocarcinoma resection: eighteenyear experience at a single institution [J]. J Gastrointest Surg, 2005, 9(5): 718725.
4.	Hamilton SR, Aaltonen LA. World Health Organization Classification of Tumours. Pathology and Genetics of Tumours of the Digestive System [M]. Lyon: IARC Press, 2000: 3839.
5.	Washington K. 7th Edition of the AJCC Cancer Staging Manual: Stomach [J]. Ann Surg Oncol, 2010: DOI: 10.1245/s104340101362z.
6.	Dassen AE, Lemmens VE, van de PollFranse LV, et al. Trends in incidence, treatment and survival of gastric adenocarcinoma between 1990 and 2007: a populationbased study in the Netherlands [J]. Eur J Cancer, 2010, 46(4): 11011110.
7.	Bertuccio P, Chatenoud L, Levi F, et al. Recent patterns in gastric cancer: a global overview [J]. Int J Cancer, 2009, 125(3): 666673.
8.	IARC Working Group on the Evaluation of Carcinogenic Risks to Humans. Tobacco smoke and involuntary smoking [M]. IARC Monogr Eval Carcinog Risks Hum, 2004, 83: 11438.
9.	Furukawa H, Iwanaga T, Koyama H, et al. Effects of sex hormones on carcinogenesis in the stomach of rats [J]. Cancer Res, 1982, 42(12): 51815182.
10.	Sipponen P, Correa P. Delayed rise in incidence of gastric cancer in females results in unique sex ratio (M/F) pattern: etiologic hypothesis [J]. Gastric Cancer, 2002, 5(4): 213219.
11.	Lee SA, Kang D, Shim KN, et al. Effect of diet and Helicobacter pylori infection to the risk of early gastric cancer [J]. J Epidemiol, 2003, 13(9): 162168.
12.	La Vecchia C, Negri E, Franceschi S, et al. Casecontrol study on influence of methionine, nitrite, and salt on gastric carcinogenesis in northern Italy [J]. Nutr Cancer, 1997, 27(1): 6568.
13.	Shikata K, Kiyohara Y, Kubo M, et al. A prospective study of dietary salt intake and gastric cancer incidence in a defined Japanese population: the Hisayama study [J]. Int J Cancer, 2006, 119(1): 196201.
14.	Negri E, La Vecchia C, D’Avanzo B, et al. Salt preference and the risk of gastrointestinal cancers [J]. Nutr Cancer, 1990, 14(34): 227232.
15.	Hassan HA, Sharma VK, Raufman JP. Changing trends in gastric carcinoma at a university medical center: a twelveyear retrospective analysis [J]. J Clin Gastroenterol, 2001, 32(1): 3740.
16.	Hansen S, Vollset SE, Derakhshan MH, et al. Two distinct aetiologies of cardia cancer, evidence from premorbid serological markers of gastric atrophy and Helicobacter pylori status [J]. Gut, 2007, 56(7): 918925.
17.	Uemura N, Okamoto S, Yamamoto S, et al. Helicobacter pylori infection and the development of gastric cancer [J]. N Engl J Med， 2001, 345(11): 784789.
18.	Merry AH, Schouten LJ, Goldbohm RA, et al. Body mass index, height and risk of adenocarcinoma of the oesophagus and gastric cardia: a prospective cohort study [J]. Gut， 2007, 56(11): 15031511.
19.	赵晨燕, 张祥宏, 薛丽英, 等. 河北省食管癌和胃癌高发区居民胃癌发生部位的变化及趋势分析 [J]. 中华肿瘤杂志, 2008, 30(11): 817820.
20.	荆晓岳，王建国，周兵, 等. 10年豫北地区胃癌临床流行病学特征 [J]. 中国普外基础与临床杂志, 2010, 17(1): 2933.
21.	王喜, 吴春晓, 郑莹, 等. 上海市区胃癌发病的时间趋势和特点分析 [J]. 中华流行病学杂志, 2007, 28(9): 875880.
22.	Hosokawa O, Kaizaki Y, Watanabe K, et al. Endoscopic surveillance for gastric remnant cancer after early cancer surgery [J]. Endoscopy, 2002, 34(6): 469473.
23.	Tanigawa N, Nomura E, Lee SW, et al. Current state of gastric stump carcinoma in Japan: based on the results of a nationwide survey [J]. World J Surg, 2010, 34(7): 15401547.
24.	Nozaki I, Nasu J, Kubo Y, et al. Risk factors for metachronous gastric cancer in the remnant stomach after early cancer surgery [J]. World J Surg, 2010, 34(7): 15481554.
25.	Arai T, Esaki Y, Inoshita N, et al. Pathologic characteristics of gastric cancer in the elderly: a retrospective study of 994 surgical patients [J]. Gastric Cancer, 2004, 7(3): 154159.
26.	Kim DY, Joo JK, Ryu SY, et al. Clinicopathologic characteristics of gastric carcinoma in elderly patients: a comparison with young patients [J]. World J Gastroenterol, 2005, 11(1): 2226.
27.	Inoshita N, Yanagisawa A, Arai T, et al. Pathological characteristics of gastric carcinomas in the very old [J]. Jpn J Cancer Res, 1998, 89(10): 10871092.
28.	Ishigami S, Natsugoe S, Saihara T, et al. Clinical and pathologic features of early gastric cancer in elderly patients [J]. Hepatogastroenterology, 1997, 44(16): 11641168.
29.	Fujiya T, Endoh K, Mikuni J, et al. Clinicopathological characteristics and surgical outcome of gastric carcinoma with regard to aging [J]. Jpn J Gastroenterol Surg, 1997, 30(7): 16991705.
30.	Kitamura K, Yamaguchi T, Taniguchi H, et al. Clinicopathological characteristics of gastric cancer in the elderly [J]. Br J Cancer, 1996, 73(6): 798802.
31.	Kunisaki C, Kobayashi S, Kido Y, et al. Clinicopathological evaluation of senile patients with gastric cancer [J]. Jpn J Clin Surg, 1996, 57(6): 18311837.
32.	Sho M, Imagawa A, Hosoi T, et al. Clinical study of surgical cases of gastric cancer in patients over 80 years old [J]. Jpn J Soc Clin Surg, 1996, 57(9): 18381843.
33.	AlRefaie WB, Tseng JF, Gay G, et al. The impact of ethnicity on the presentation and prognosis of patients with gastric adenocarcinoma. Results from the National Cancer Data Base [J]. Cancer, 2008, 113(3): 461469.
34.	王正林, 胡祥. 老年胃癌特点及手术治疗进展 [J]. 中国普外基础与临床杂志, 2010, 17(1): 3739.
35.	Siewert JR, Bttcher K, Stein HJ, et al. Relevant prognostic factors in gastric cancer: Tenyear results of the German Gastric Cancer Study [J]. Ann Surg, 1998, 228(4): 449461.
36.	Yokota T, Kunii Y, Teshima S, et al. Significant prognostic factors in patients with early gastric cancer [J]. Int Surg, 2000, 85(4): 286290.
37.	Chukwuemeka U, Ihemelandu RL, DeWitty, et al. Trends in clinicopathologic characteristics and prognostic predictors of survival outcome in black patients with gastric carcinoma: a single institution’s experience [J]. J Surg Res, 2009, 156(2): 325332.

1. Parkin DM, Bray F, Ferlay J, et al. Global cancer statistics, 2002 [J]. CA Cancer J Clin, 2005, 55(2): 74108.
2. Lambert R, Guilloux A, Oshima A, et al. Incidence and mortality from stomach cancer in Japan, Slovenia and the USA [J]. Int J Cancer, 2002, 97(6): 811818.
3. Cunningham SC, Kamangar F, Kim MP, et al. Survival after gastric adenocarcinoma resection: eighteenyear experience at a single institution [J]. J Gastrointest Surg, 2005, 9(5): 718725.
4. Hamilton SR, Aaltonen LA. World Health Organization Classification of Tumours. Pathology and Genetics of Tumours of the Digestive System [M]. Lyon: IARC Press, 2000: 3839.
5. Washington K. 7th Edition of the AJCC Cancer Staging Manual: Stomach [J]. Ann Surg Oncol, 2010: DOI: 10.1245/s104340101362z.
6. Dassen AE, Lemmens VE, van de PollFranse LV, et al. Trends in incidence, treatment and survival of gastric adenocarcinoma between 1990 and 2007: a populationbased study in the Netherlands [J]. Eur J Cancer, 2010, 46(4): 11011110.
7. Bertuccio P, Chatenoud L, Levi F, et al. Recent patterns in gastric cancer: a global overview [J]. Int J Cancer, 2009, 125(3): 666673.
8. IARC Working Group on the Evaluation of Carcinogenic Risks to Humans. Tobacco smoke and involuntary smoking [M]. IARC Monogr Eval Carcinog Risks Hum, 2004, 83: 11438.
9. Furukawa H, Iwanaga T, Koyama H, et al. Effects of sex hormones on carcinogenesis in the stomach of rats [J]. Cancer Res, 1982, 42(12): 51815182.
10. Sipponen P, Correa P. Delayed rise in incidence of gastric cancer in females results in unique sex ratio (M/F) pattern: etiologic hypothesis [J]. Gastric Cancer, 2002, 5(4): 213219.
11. Lee SA, Kang D, Shim KN, et al. Effect of diet and Helicobacter pylori infection to the risk of early gastric cancer [J]. J Epidemiol, 2003, 13(9): 162168.
12. La Vecchia C, Negri E, Franceschi S, et al. Casecontrol study on influence of methionine, nitrite, and salt on gastric carcinogenesis in northern Italy [J]. Nutr Cancer, 1997, 27(1): 6568.
13. Shikata K, Kiyohara Y, Kubo M, et al. A prospective study of dietary salt intake and gastric cancer incidence in a defined Japanese population: the Hisayama study [J]. Int J Cancer, 2006, 119(1): 196201.
14. Negri E, La Vecchia C, D’Avanzo B, et al. Salt preference and the risk of gastrointestinal cancers [J]. Nutr Cancer, 1990, 14(34): 227232.
15. Hassan HA, Sharma VK, Raufman JP. Changing trends in gastric carcinoma at a university medical center: a twelveyear retrospective analysis [J]. J Clin Gastroenterol, 2001, 32(1): 3740.
16. Hansen S, Vollset SE, Derakhshan MH, et al. Two distinct aetiologies of cardia cancer, evidence from premorbid serological markers of gastric atrophy and Helicobacter pylori status [J]. Gut, 2007, 56(7): 918925.
17. Uemura N, Okamoto S, Yamamoto S, et al. Helicobacter pylori infection and the development of gastric cancer [J]. N Engl J Med， 2001, 345(11): 784789.
18. Merry AH, Schouten LJ, Goldbohm RA, et al. Body mass index, height and risk of adenocarcinoma of the oesophagus and gastric cardia: a prospective cohort study [J]. Gut， 2007, 56(11): 15031511.
19. 赵晨燕, 张祥宏, 薛丽英, 等. 河北省食管癌和胃癌高发区居民胃癌发生部位的变化及趋势分析 [J]. 中华肿瘤杂志, 2008, 30(11): 817820.
20. 荆晓岳，王建国，周兵, 等. 10年豫北地区胃癌临床流行病学特征 [J]. 中国普外基础与临床杂志, 2010, 17(1): 2933.
21. 王喜, 吴春晓, 郑莹, 等. 上海市区胃癌发病的时间趋势和特点分析 [J]. 中华流行病学杂志, 2007, 28(9): 875880.
22. Hosokawa O, Kaizaki Y, Watanabe K, et al. Endoscopic surveillance for gastric remnant cancer after early cancer surgery [J]. Endoscopy, 2002, 34(6): 469473.
23. Tanigawa N, Nomura E, Lee SW, et al. Current state of gastric stump carcinoma in Japan: based on the results of a nationwide survey [J]. World J Surg, 2010, 34(7): 15401547.
24. Nozaki I, Nasu J, Kubo Y, et al. Risk factors for metachronous gastric cancer in the remnant stomach after early cancer surgery [J]. World J Surg, 2010, 34(7): 15481554.
25. Arai T, Esaki Y, Inoshita N, et al. Pathologic characteristics of gastric cancer in the elderly: a retrospective study of 994 surgical patients [J]. Gastric Cancer, 2004, 7(3): 154159.
26. Kim DY, Joo JK, Ryu SY, et al. Clinicopathologic characteristics of gastric carcinoma in elderly patients: a comparison with young patients [J]. World J Gastroenterol, 2005, 11(1): 2226.
27. Inoshita N, Yanagisawa A, Arai T, et al. Pathological characteristics of gastric carcinomas in the very old [J]. Jpn J Cancer Res, 1998, 89(10): 10871092.
28. Ishigami S, Natsugoe S, Saihara T, et al. Clinical and pathologic features of early gastric cancer in elderly patients [J]. Hepatogastroenterology, 1997, 44(16): 11641168.
29. Fujiya T, Endoh K, Mikuni J, et al. Clinicopathological characteristics and surgical outcome of gastric carcinoma with regard to aging [J]. Jpn J Gastroenterol Surg, 1997, 30(7): 16991705.
30. Kitamura K, Yamaguchi T, Taniguchi H, et al. Clinicopathological characteristics of gastric cancer in the elderly [J]. Br J Cancer, 1996, 73(6): 798802.
31. Kunisaki C, Kobayashi S, Kido Y, et al. Clinicopathological evaluation of senile patients with gastric cancer [J]. Jpn J Clin Surg, 1996, 57(6): 18311837.
32. Sho M, Imagawa A, Hosoi T, et al. Clinical study of surgical cases of gastric cancer in patients over 80 years old [J]. Jpn J Soc Clin Surg, 1996, 57(9): 18381843.
33. AlRefaie WB, Tseng JF, Gay G, et al. The impact of ethnicity on the presentation and prognosis of patients with gastric adenocarcinoma. Results from the National Cancer Data Base [J]. Cancer, 2008, 113(3): 461469.
34. 王正林, 胡祥. 老年胃癌特点及手术治疗进展 [J]. 中国普外基础与临床杂志, 2010, 17(1): 3739.
35. Siewert JR, Bttcher K, Stein HJ, et al. Relevant prognostic factors in gastric cancer: Tenyear results of the German Gastric Cancer Study [J]. Ann Surg, 1998, 228(4): 449461.
36. Yokota T, Kunii Y, Teshima S, et al. Significant prognostic factors in patients with early gastric cancer [J]. Int Surg, 2000, 85(4): 286290.
37. Chukwuemeka U, Ihemelandu RL, DeWitty, et al. Trends in clinicopathologic characteristics and prognostic predictors of survival outcome in black patients with gastric carcinoma: a single institution’s experience [J]. J Surg Res, 2009, 156(2): 325332.

CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Analysis of Clinicopathologic Characteristics in 958 Cases of Gastric Cancer

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