CLINICO-PATHOLOGICAL ANALYSIS OF GASTRIC CANCER – A SINGLE INSTITUTION EXPERIENCE

Abstract

Introduction: Gastric cancer (GC) is one of the leading causes of cancer related morbidity and mortality. Morphologically, GC is a heterogeneous neoplasm consisting of several histological types. Majority of the patients are diagnosed in an advance stage of the disease. Conventional surgical and systemic treatment has demonstrated limited achievement. Evolution in personalized therapy is a main factor to improve the outcome, but for a successful application, a careful stratification of patients is required. Aim: The purpose of the present paper was to analyze the mandatory clinical and pathological characteristics of patients with GC. Material and methods: A total 74 patients who have undergone total or partial gastric resection, endoscopic and laparoscopic biopsy due to GC were included. Results: The average age of the patients was 69,6 years, with a male predominance in all age groups. Most frequent histological type was intestinal type, according to Lauren and tubular type, according to WHO classifications. 82,3% (p<0,05) of GC located in cardia were diagnosed in males. 37/42 tubular, papillary and mucinous types by WHO classification were classified as intestinal type by Lauren. All signet ring cell and poorly cohesive adenocarcinomas by WHO classification were accordingly assigned as diffuse type by Lauren. 52,2% of the tubular/intestinal type of tumors were graded as G1 or G2, and 93,1% of signet ring and poorly cohesive/diffuse type GC were graded as G3. Significant correlations were observed between perineural invasion and histological type by Lauren (p<0,043), degree of differentiation (p<0,04) and lymphovascular invasion (p<0,000); between а degree of inflammatory reaction and М status (p<0,022). Conclusion: Precise histological typification of GC is a key to better stratification of the patients. Certain histological types are associated with aggressive tumor behavior, as we found diffuse type to correlate with poor differentiation and presence of perineural invasion. Degree of inflammatory reaction may be an independent indicator of the presence of distant metastases.