First Clinical College of Wenzhou Medical University, Wenzhou, China.
Department of Gastrointestinal Surgery, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China.
Comput Math Methods Med. 2022 Jul 18;2022:1127146. doi: 10.1155/2022/1127146. eCollection 2022.
Gastrointestinal stromal tumors (GISTs) are potential malignancies that occur in the digestive tract. This study aimed to investigate the risk factors and prognosis of recurrence and metastasis of gastrointestinal stromal tumor (GIST).
From January 2018 to December 2019, 422 patients with GIST who received surgery in the First Affiliated Hospital of Wenzhou Medical University were enrolled. Their clinical data were retrospectively analyzed, and their follow-ups were continued until March 31, 2022. Subsequently, univariate and multivariate Cox analyses, survival curves, and nomograms were adopted to explore the relationship between clinicopathological characteristics and recurrence or metastasis in patients with GIST.
Univariate and multivariate Cox analysis exhibited that the prognosis of patients was affected by tumor rupture ( = 0.040), tumor location ( < 0.001), tumor diameter ( = 0.016), mitotic figures ( < 0.001), and risk grade ( < 0.009). The above variables were selected to create the nomogram for 3-year disease-free survival (DFS). The 3-year the ROC (receiver operating characteristic) curves of the nomogram were (0.878 95% confidence interval [CI]: 0.871-0.939).
Collectively, risk factors affecting postoperative recurrence or metastasis of GIST consist of primary site of tumors, tumor rupture, tumor diameter >10 cm, high-risk tumor classification, and mitotic figures ≥10 per 50 HPFs. And the application of nomogram may help physicians provide individualized diagnosis and treatment for patients with GISTs following surgical resection.
胃肠道间质瘤（GIST）是发生在消化道的潜在恶性肿瘤。本研究旨在探讨胃肠道间质瘤（GIST）复发和转移的危险因素及预后。
回顾性分析 2018 年 1 月至 2019 年 12 月在温州医科大学附属第一医院接受手术的 422 例 GIST 患者的临床资料，对其进行随访，随访截止日期为 2022 年 3 月 31 日。采用单因素和多因素 Cox 分析、生存曲线和列线图探讨 GIST 患者临床病理特征与复发或转移的关系。
单因素和多因素 Cox 分析显示，肿瘤破裂（ = 0.040）、肿瘤部位（ < 0.001）、肿瘤直径（ = 0.016）、有丝分裂像（ < 0.001）和危险度分级（ < 0.009）影响患者预后。选择上述变量建立 3 年无病生存（DFS）的列线图。列线图的 3 年 ROC 曲线（0.878 95%CI：0.871-0.939）。
影响 GIST 术后复发或转移的危险因素包括肿瘤原发部位、肿瘤破裂、肿瘤直径>10cm、高危肿瘤分级和每 50 高倍镜视野有丝分裂像≥10 个。列线图的应用可能有助于医生为接受手术切除的 GIST 患者提供个体化的诊断和治疗。
