Conrad Hal Waddington phenomenon and a novel molecular classification of gastric cancer
Summary. The aim of the study: to study the influence of malignant cell biology on the survival rate of gastric cancer patients treated by standard protocols. Object and methods of research. This paper presents the results of a clinical study been conducted on the basis of the research department of thoracic tumors of the National Cancer Institute and abdominal oncology surgery department of the Odessa Regional Oncology Dispensary of the Odessa Regional Council in 221 patients operated on for gastric cancer. 2007-2013. The average patient`s age was 60.88 ± 10.5 years, men — 180, women — 41. 143 total resections and 78 distal subtotal gastrectomies have been performed. Results. All patients included in the study have been radically operated. Tumors removed during surgery have been examined deploying histological, cytological, immunohistochemical methods and some genetic tests. From the point of view of researcher, received results concerning presence/absence of clinical parallels and mathematical correlations between markers are detected, analysed and discussed. It is concluded that some combinations of immunohistochemical (IHC) markers are effective in separating groups of patients with different tumor biology pattern. Survival scenario of patients was analyzed on the basis of analysis of different molecular models, including VEGFR, p53, Her2, Ki-67 combinations and routine histological markers (stage, degree of differentiation, etc.). The analysis of the survival of patients with stomach cancer have been introduced as an arbiter of the effectiveness of novel classification. Conclusions. Performing more advanced modality of surgical operations, including D2 lymph dissection, tends to be more effective option in the cases of microsatellite-unstable and Epstein — Barr virus-associated stomach cancer models.
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