Relationship of lymphatic metastasis with the expressions of relative genes in advanced gastric adenocarcinoma

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(P0.01)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(P0.05,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.