Changes in the clinicopathological characteristics of gastric cancer in Hehuang Valley of China–2379 cases of gastric cancer in recent 10 years

Objective： The aim of our studywas to discuss changes in the clinicopathological characteristics of gastric cancer in Hehuang Valley of China in recent 10 years. Methods： A retrospective case-control study was performed on 2379 newly-diagnosed gastric cancer patients. All of them came from Hehuang Valley. The patients were divided into two groups [recent 5 years （R5Y） and late 5 years （L5Y）] from February 2003 to February 2013, and the clinicopathological data were surveyed retrospectively. Results： The constituent ratio of upper 1/3 gastric cancer in R5Y and L5Y was 33.5% and 20.7%, respectively, and it showed a significant difference between the two groups （X2 = 21.28, P = 0.00）, The constituent ratio of squamous carcinoma/adenosquamous carcinoma was 2.7% and 1.6%, respectively, and it also showed a significant differ- ence between two groups （X2 = 50.91, P = 0.00）. The constituent ratio of moderately-poorly differentiated/poorly differentiated gastric carcinoma was 84.2% and 50.2%, respectively, and it showed statistically significant difference （X2 = 30.28, P = 0.00）. The detection rate of early gastric cancer （EGC） was 1.47% （35/2379）. The constituent ratio of the types of Borrmann II and Borrmann IV of advanced gastric cancer （AGC） among 2379 cases was 47.6% and 40.8%, respectively, and that still showed statistically significant difference （X2 = 18,80, P = 0.00）. The constituent ratio of diffuse-type of gastric cancer in R5Y and L5Y was 36.2% and 30.8%, respectively, even there was a significant difference （X2 = 7.49, P = 0.01）. Furthermore, there were also significant differences in regional lymph nodes metastasis, perineural infiltration and vascular invasion （P 〈 0.05）. The positive detection rate of HER2, ER and PR was 14.88%, 17.23% and 15.93%, respectively. The constituent ratio of HP in two groups was 43.8% and 36.2% respectively, and it also showed a significant difference （~2 = 13.51, P = 0.00）. Conclusion： The pathogenic sites in gastric cancer change to the upper stomach in Hehuang Valley in recent 10 years, and the detection rate of squamous carcinoma/adenosquamous carcinoma reveals a sharp rise. Borrmann III is still one of the main types of advanced gastric cancer, but the detection rates of Borrmann II and IV are increasing. The main type of gastric cancer is the intestinal- type, but the ratio of diffuse-type is also increasing in recent 10 years. The HP detection rate is 40.65% （967/2379）, and it has a slight rise in recent 10 years. The detection rate of poorly differentiated adenocarcinoma is increasing despite the fact that the moderately/moderately-poorly differentiated adenocarcinoma is the main histologic types. High detection rates of lymph nodes metastasis, perineural infiltration and vascular invasion indicate poor prognosis in patients with gastric cancer. There is no change in HER2 positive rate, on the contrary, there are a little increase in ER and PR expression in Hehuang Valley.