Department of Pathology, Zhongshan Hospital, Fudan University, Shanghai, China.
Shanghai Chest Hospital, Shanghai Jiao Tong University, Department of Pathology, Shanghai, China.
Aging (Albany NY). 2020 Jun 20;12(12):11416-11430. doi: 10.18632/aging.103204.
Rectal gastrointestinal stromal tumors (RGISTs) are biologically characterized tumors that are relatively rare. Thus, few studies have reported a specific prognostic system for this subset of tumors but integrated it into parallel systems, such as small intestine. Our aim is to develop a new predictive staging system nomogram (named FD-ZS system) for RGISTs.
Tumor size and mitotic rate were independent risk factors for tumor recurrence in RGISTs according to univariate and multivariate survival analyses. A prognostic predictive nomogram was developed, and a cut-off value of 65 points was calculated by X-tile to discriminate risk based on tumor size and mitotic rate. The C-indices for the FD-ZS, FD-Hou, NIH, and WHO systems were 0.706, 0.693, 0.687, and 0.680, respectively.
In the present study, a concise two-tier grading system (FD-ZS) for prognostic prediction of RGISTs that is simpler to several reported systems was developed, and a cut-off value was established to help RGIST patients determine whether to undergo adjuvant imatinib treatment.
A nomogram was employed, and its predictive accuracy and discriminative ability were determined by concordance index (C-index) and calibration curve analyses. The nomogram was then compared with three stratification systems used for GISTs (FD-Hou, NIH, and WHO).
直肠胃肠道间质瘤（RGIST）是生物学特征明确的相对罕见肿瘤。因此，很少有研究针对这组肿瘤建立特定的预后系统，而是将其纳入小肠等平行系统。我们旨在为 RGIST 开发一种新的预测分期系统列线图（命名为 FD-ZS 系统）。
根据单因素和多因素生存分析，肿瘤大小和有丝分裂率是 RGIST 肿瘤复发的独立危险因素。建立了一个预后预测列线图，并通过 X-tile 计算出 65 分的截断值，以根据肿瘤大小和有丝分裂率来区分风险。FD-ZS、FD-Hou、NIH 和 WHO 系统的 C 指数分别为 0.706、0.693、0.687 和 0.680。
本研究建立了一种用于 RGIST 预后预测的简明两阶段分级系统（FD-ZS），与几种报道的系统相比更为简单，并建立了一个截断值，以帮助 RGIST 患者确定是否需要接受辅助伊马替尼治疗。
采用列线图，通过一致性指数（C 指数）和校准曲线分析确定其预测准确性和区分能力。然后将该列线图与三种用于 GIST 的分层系统（FD-Hou、NIH 和 WHO）进行比较。
