| Objective : The real-world study of gastric cancer based on hospital information platform system evaluates the impact of treatment on patients’ health in the real world,and then obtains real-world evidence about the diagnosis and treatment of gastric cancer.Methods:Based on the hospital information platform system,the etiology,diagnosis,treatment and prognosis of gastric cancer patients in the Department of Gastrointestinal surgery of the affiliated Hospital of Inner Mongolia Medical University from January 2015 to December 2019 were collected.Input all the data into the EXCEL database,according to the different research purposes,select the research objects that meet the requirements,and make a systematic analysis and multi-dimensional interpretation of these data.After finishing the data,SPSS 23.0version was used for statistical analysis.Results:(1)The EXCEL database of gastric cancer was established,which contains a series of complete data,such as basic information of patients,examination results,surgical process,postoperative pathology,follow-up treatment,complications and follow-up information.As of December 2020,the continuous data of 757 patients with gastric cancer were collected in the gastric cancer database;(2)Among the 80 patients with EGC(Early gastric cancer),regional lymph node metastasis was detected in 10 patients(12.5%).Univariate analysis showed that the maximum diameter,depth of invasion,vascular invasion and the number of lymph node dissection were correlated with lymph node metastasis in early gastric cancer(P<0.05).Multivariate analysis showed that vascular tumor thrombus was an independent risk factor for lymph node metastasis.The 3-year cumulative survival rate of patients with EGC was 93.8%(75/80),including 95.7%(67/70)in patients without lymph node metastasis and 80%(8/10)in patients with lymph node metastasis.Although the survival rate of the former was better than that of the latter,the difference was not statistically significant(P>0.05);(3)Univariate results showed that Borrmann classification,tumor diameter,pathological grade,operation mode,p N-stage,r N-stage were all prognostic factors of gastric cancer patients(P<0.05).The results of univariate analysis showed that tumor type,tumor diameter,pathological grade,mode of operation,number of p N-stage,r N-stage were all factors affecting the prognosis of gastric cancer patients.Multivariate analysis showed that Borrmann classification,pathological grade,p N stage and r N stage were independent risk factors for the prognosis of patients with gastric cancer.The area under the ROC r N staging was larger than that of p N staging(0.756 vs0.707)in predicting the prognosis of patients with gastric cancer;(4)The clinical data of 80 patients with LAGC(Locally advanced gastric cancer),who received chemotherapy after SOX and FOLFOX6 were analyzed retrospectively,including 38 patients in SOX group and 42 patients in FOLFOX6 group.There was no significant difference in baseline data between SOX group and FOLFOX6 group.There was no significant difference in1-year,3-year,5-year progression-free survival rate and 1-year,3-year,5-year cumulative survival rate between SOX group and FOLFOX6 group.In terms of adverse reactions,the incidence of gradeⅠ～Ⅱnausea,vomiting and diarrhea in SOX group was lower than that in FOLFOX6 group during chemotherapy.There was no significant difference in other adverse reactions between the two groups.Conclusion :(1)EGC patients with maximum tumor diameter>2cm,submucosal infiltration and vascular invasion have a higher risk of regional lymph node metastasis.standard lymph node dissection is the key to accurately judge lymph node metastasis.The effect of lymph node metastasis on the prognosis of patients with EGC needs further long-term follow-up study;(2)MLR(Metastatic lymph nodes ratio,lymph node metastasis rate is one of the independent factors affecting the prognosis of gastric cancer,and its accuracy in predicting the prognosis of patients with gastric cancer may be better than that of p N staging;(3)The efficacy of SOX regimen in postoperative chemotherapy of LAGC is similar to that of FOLFOX6 regimen,but the risk of gastrointestinal adverse reactions is lighter than that of the latter,so it is recommended for clinical application. |
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