title: Clinicopathologic factors and molecular markers related to lymph node metastasis in early gastric cancer.
abstract: OBJECTIVE
  To analyze predictive factors for lymph node metastasis in early gastric cancer.
  
  
  METHODS
  We analyzed 1104 patients with early gastric cancer (EGC) who underwent a gastrectomy with lymph-node dissection from May 2003 through July 2011. The clinicopathologic factors and molecular markers were assessed as predictors for lymph node metastasis. Molecular markers such as microsatellite instability, human mutL homolog 1, p53, epidermal growth factor receptor (EGFR) and human epidermal growth factor receptor 2 (HER2) were included. The χ(2) test and logistic regression analysis were used to determine clinicopathologic parameters.
  
  
  RESULTS
  Lymph node metastasis was observed in 104 (9.4%) of 1104 patients. Among 104 cases of lymph node positive patients, 24 patients (3.8%) were mucosal cancers and 80 patients (16.7%) were submucosal. According to histologic evaluation, the number of lymph node metastasis found was 4 (1.7%) for well differentiated tubular adenocarcinoma, 45 (11.3%) for moderately differentiated tubular adenocarcinoma, 36 (14.8%) for poorly differentiated tubular adenocarcinoma, and 19 (8.4%) for signet ring cell carcinoma. Of 690 EGC cases, 77 cases (11.2%) showed EGFR overexpression. HER2 overexpression was present in 110 cases (27.1%) of 406 EGC patients. With multivariate analysis, female gender (OR = 2.281, P = 0.009), presence of lymphovascular invasion (OR = 10.950, P < 0.0001), diameter (≥ 20 mm, OR = 3.173, P = 0.01), and EGFR overexpression (OR = 2.185, P = 0.044) were independent risk factors for lymph node involvement.
  
  
  CONCLUSIONS
  Female gender, tumor size, lymphovascular invasion and EGFR overexpression were predictive risk factors for lymph node metastasis in EGC.
authors.affiliation: Eun Hyo Jin, Ji Yeon Seo, Hyun Chae Jung, Department of Internal Medicine and Liver Research Institute, Seoul National University College of Medicine, Seoul 110-744, South Korea.
authors.forename: Eun Hyo
authors.initials: EH
authors.lastname: Jin
authors.affiliation: Eun Hyo Jin, Ji Yeon Seo, Hyun Chae Jung, Department of Internal Medicine and Liver Research Institute, Seoul National University College of Medicine, Seoul 110-744, South Korea.
authors.forename: Dong Ho
authors.initials: DH
authors.lastname: Lee
authors.affiliation: Eun Hyo Jin, Ji Yeon Seo, Hyun Chae Jung, Department of Internal Medicine and Liver Research Institute, Seoul National University College of Medicine, Seoul 110-744, South Korea.
authors.forename: Sung-Ae
authors.initials: SA
authors.lastname: Jung
authors.affiliation: Eun Hyo Jin, Ji Yeon Seo, Hyun Chae Jung, Department of Internal Medicine and Liver Research Institute, Seoul National University College of Medicine, Seoul 110-744, South Korea.
authors.forename: Ki-Nam
authors.initials: KN
authors.lastname: Shim
authors.affiliation: Eun Hyo Jin, Ji Yeon Seo, Hyun Chae Jung, Department of Internal Medicine and Liver Research Institute, Seoul National University College of Medicine, Seoul 110-744, South Korea.
authors.forename: Ji Yeon
authors.initials: JY
authors.lastname: Seo
authors.affiliation: Eun Hyo Jin, Ji Yeon Seo, Hyun Chae Jung, Department of Internal Medicine and Liver Research Institute, Seoul National University College of Medicine, Seoul 110-744, South Korea.
authors.forename: Nayoung
authors.initials: N
authors.lastname: Kim
authors.affiliation: Eun Hyo Jin, Ji Yeon Seo, Hyun Chae Jung, Department of Internal Medicine and Liver Research Institute, Seoul National University College of Medicine, Seoul 110-744, South Korea.
authors.forename: Cheol Min
authors.initials: CM
authors.lastname: Shin
authors.affiliation: Eun Hyo Jin, Ji Yeon Seo, Hyun Chae Jung, Department of Internal Medicine and Liver Research Institute, Seoul National University College of Medicine, Seoul 110-744, South Korea.
authors.forename: Hyuk
authors.initials: H
authors.lastname: Yoon
authors.affiliation: Eun Hyo Jin, Ji Yeon Seo, Hyun Chae Jung, Department of Internal Medicine and Liver Research Institute, Seoul National University College of Medicine, Seoul 110-744, South Korea.
authors.forename: Hyun Chae
authors.initials: HC
authors.lastname: Jung
mesh_terms: D000230:Adenocarcinoma / Q000737:chemistry / Q000175:diagnosis* / Q000235:genetics / Q000473:pathology / Q000601:surgery; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D014408:Biomarkers, Tumor / Q000032:analysis* / Q000235:genetics; D002454:Cell Differentiation; D016009:Chi-Square Distribution; D055088:Early Detection of Cancer / Q000379:methods; D066246:ErbB Receptors / Q000032:analysis*; D005260:Female; D005743:Gastrectomy; D006801:Humans; D007150:Immunohistochemistry; D016015:Logistic Models; D008197:Lymph Node Excision; D008198:Lymph Nodes / Q000737:chemistry* / Q000473:pathology* / Q000601:surgery; D008207:Lymphatic Metastasis; D008297:Male; D018895:Microsatellite Repeats; D008875:Middle Aged; D015999:Multivariate Analysis; D009361:Neoplasm Invasiveness; D016017:Odds Ratio; D011237:Predictive Value of Tests; D012189:Retrospective Studies; D012307:Risk Factors; D012737:Sex Factors; D013274:Stomach Neoplasms / Q000737:chemistry / Q000175:diagnosis* / Q000235:genetics / Q000473:pathology / Q000601:surgery; D047368:Tumor Burden; D015854:Up-Regulation
chemical_list: D014408:Biomarkers, Tumor; C512478:EGFR protein, human; D066246:ErbB Receptors
keywords: Carcinoma; Epidermal growth factor; Lymph node; Neoplasm metastasis; Receptor; Stomach neoplasms