Prognostic factors for gastrointestinal stromal tumors after radical surgery for 5 years
Objective To analyze the prognostic factors of gastrointestinal stromal tumors after radical surgery for 5 years and establish a survival prediction model to guide clinical practice.Methods A retrospective analysis was conducted on the clinical,pathological,and CT data of 297 patients with gastrointestinal stromal tumors who underwent radical surgery at our Hospital from January 5,2010 to June 20,2018.With a 5-year observation cut-off point,they were divided into non recurrence survival group(n=232)and death or recurrence metastasis group(n=65).A Logistic regression model was established by combining statistically significant clinical,pathological,and CT features,and the model efficacy was evaluated.Results The relationship between clinical pathological characteristics and 5-year prognosis of patients:Patients without adjuvant imatinib treatment,with high mitotic count,and high Ki-67 index have a higher probability of poor prognosis within 5 years,and the difference was statistically significant(P＜0.05);However,gender,age,and gastrointestinal bleeding had no statistically significant difference in 5-year prognosis(P＞0.05).The relationship between CT features and 5-year prognosis:There were statistically significant differences between the two groups in terms of location,shape,size,cystic change or necrosis,rupture,bleeding,tumor with cystic lumen communicating with the intestinal canal,is there a large blood supply artery or drainage vein,venous phase and delayed phase enhancement methods(P＜0.05);However,there was no statistically significant difference in growth mode,ulcer,calcification and transient enhancement of the overlying mucosal line(P＞0.05);Logistic regression combining clinical pathology and CT features:Tumor location,morphology,size,tumor rupture,tumor sac to intestinal communication,and mitotic imaging were independent predictors of 5-year prognosis.The AUC was 0.916,sensitivity was 0.877,specificity was 0.802,and accuracy was 0.818,all of which were higher than the subjective predictions of two radiologists.Conclusion This study established a predictive model that affects the 5-year prognosis of gastrointestinal stromal tumors after radical surgery.The predictive performance of this model is good,providing important basis for accurate judgment and evaluation of the 5-year prognosis of gastrointestinal stromal tumors in clinical practice.
gastrointestinal stromal tumorrecurrence-free survivalprediction model
国家科技期刊平台
NSTL
万方数据
