Analysis Of Prognostic Factors Of Gastrointestinal Tromal Tumor And Establishment Of Survival Prediction Nomogram Model

Objective: To analyze the prognostic factors of gastric stromal tumor(GST)by collecting clinical data and establish the survival prediction nomogram model of GST patients,so as to provide reference for clinical decision-making.Methods:A total of 849 cases were collected retrospectively.796 patients with gastric stromal tumor diagnosed by pathology from 2010 to2015 were extracted from SEER database and randomly divided into training group(n = 398)and verification group(n = 398).Kaplan Meier survival curve,Lasso analysis and Cox regression model risk were used to analyze the influence of each variable on the prognosis of the training group data.Independent prognostic factors were selected to create a nomogram,and the validation group data were used for the internal validation of the nomogram.The data of 53 cases of gastric stromal tumor diagnosed in 2010-2015 were collected from Changsha hospital and the First Affiliated Hospital of Hunan Normal University for external verification of nomogram.The accuracy and practicability of the model were evaluated by using the correction curve,clinical decision curve and sensitivity curve.Results:Cox single factor analysis and lasso analysis showed that the older the age,the worse the prognosis,with statistical significance.The prognosis of female patients is better than that of male patients.There was no significant difference between tumor diameter range of2-10 cm and tumor diameter ≤ 2cm,but the prognosis of tumor diameter ≥ 10 cm was worse than tumor diameter ≤ 2cm.Compared with grade Ⅰ,grade Ⅱ,grade Ⅲ and grade IV have a greater impact on theprognosis of tumor differentiation,which is statistically significant.In TMN staging,stage III and stage IV had a greater impact on the prognosis than stage I,which was statistically significant.In T stage of primary tumor,T4 has a worse prognosis than T1,which is statistically significant.In M stage of distant metastasis,the prognosis of M1 was worse than that of M0.The prognosis of liver metastasis was worse than that of non liver metastasis,and the prognosis of operation was better than that of non operation.The 8 variables included in the analysis were independent prognostic factors of gastric stromal tumors.The C index of the training group was 0.8(95% CI: 0.753-0.878),and that of the verification group was 0.8(95% CI: 0.740-0.861).The correction curves were consistent.ROC analysis showed that AUC of OS in one year,three years and five years in training group reached 0.917,0.809 and 0.842 respectively,and AUC of validation queue reached 0.898,0.798 and0.770 respectively.AUC of the external validation group reached 0.812,0.693 and 0.712 respectively.Conclusion:1.The age,sex,TNM stage,tumor differentiation,tumor diameter,liver metastasis,and surgical treatment of primary tumor are independent prognostic factors for patients with gastric stromal tumor.2.The linear map of survival prognosis of gastric stromal tumors established in this study has a good predictive value,and can provide a more practical prediction tool,which is conducive to the accurate assessment of survival prognosis.