| Objective: To explore the prognostic factors of patients with gastric stromal tumors,and establish a correlation and survival model for all prognostic factors.Methods: A total of 60 patients with gastric stromal tumors admitted to our hospital from June 2014 to June 2019 were selected.All patients were classified according to their risk classification criteria(very low-risk,low-risk,intermediate-risk and high-risk four levels).Very low-risk and low-risk patients were classified into group A(19 cases).Medium-risk and high-risk patients were classified into group B(41 cases).A comprehensive clinical data collection of all patients was finished,including demographic data,clinical symptoms,tumor markers(CEA,CA125,CA199)and diagnosis results,tumor pathological features,immunohistochemical examination results(CD34,CD117,DOG-1),drug-assisted treatment plan,and survival time of postoperative patients.Univariate analysis and multivariate logistics regres-sion analysis models were used to analyze the existing prognostic factors;the prognostic factors were selected and included in the COX regression model,and the patient survival curve was drawn.Results: There were 6 patients with extremely low-risk,13 patients with low-risk,17 patients with intermediate-risk,and 24 patients with high-risk,which is 19 patients in group A and 41 patients in group B.The disease location is: 28 cases of gastric fundus(46.67%),21 cases of gastric body(35.00%),11 cases of gastric antrum(18.33%),including 9 cases of gastric fundus(47.37%)in group A and 7 cases of gastric body(36.84%)),3 cases of gastric antrum(15.79%),19 cases of gastric fundus(46.34%),14 cases of gastric body(34.15%),8 cases of gastric antrum(19.51%).The number of patients with tumor necrosis in group A was 2 cases(10.53%),which was significantly lower than that in group B was 23 cases(56.10%),and the pathological morphology was 1 case(5.26%),which was significantly lower than that in group B was 19 cases(46.34%).The levels of tumor markers CEA,CA125,and CA199 were significantly lower than those in group B.The number of DOG-1 positive cases was 9 cases(47.37%),which was significantly lower than that in group B 34 cases(82.93%),which all were statistically significant(P<0.05),the results of single factor analysis of the remaining factors did not show significant differences(P>0.05).Multivariate Logistics regression analysis showed that tumor necrosis showed a correlation with the patient's risk classification(P = 0.011,OR = 6.341),and pathological morphological abnormalities showed a correlation with the patient's risk classification(P = 0.027,OR = 3.532),CEA and CA125 levels are correlated with the patient's risk classification(P = 0.010,0.037,OR = 15.919,1.502),DOG-1 is correlated with the patient's risk classification(P = 0.002,OR = 6.314).To do the ROC curve of the risk index of CEA and CA125,CEA is cut off at 4.85 ng / m L,sensitivity is 80.49%,specificity is 89.47%;CA125 is cut off at 15.45 U / m L,sensitivity is 60.98%,specificity is 66.16%.The average RFS was(3.43 ± 0.64)years in group A and(1.53 ± 0.33)years in group B.The Cox regression model showed that there was no significant difference in the survival of patients with different disease locations and different surgical methods,and the survival of patients without chemotherapy was significantly worse(P = 0.010,OR = 2.418).The survival of patients with pathological morphological abnormalities in the covariates The condition was poor(P = 0.034,OR = 2.418),and patients with higher CEA had poorer survival(P = 0.014,OR = 1.572).Conclusion: The factors affecting the prognosis of patients with gastric stromal tumors are related to their conditions and treatment options.In order to improve the prognosis of patients and prolong their survival time,it is necessary to carry out targeted interventions on the existing prognostic factors and further explore other prognostic factors. |
PDF Full Text Request