胃肠道间质瘤术后复发危险因素及其列线图的应用
发布时间：2019-03-27 10:42
【摘要】：目的:探索胃肠道间质瘤(Gastrointestinal stromal tumor GIST)术后复发危险因素;验证美国纪念斯隆凯特林中心列线图的临床实用价值;方法:收集2000年6月-2009年1月在山西省肿瘤医院接受手术治疗(R0切除)、未服用靶向药物甲磺酸伊马替尼辅助治疗的90名胃肠道间质瘤患者的临床病理资料、随访资料,探索影响术后复发的危险因素,卡方检验进行单因素分析,Kaplan-Meier法计算生存率,Cox比例风险回归法进行多因素分析,以上各个统计学方法均通过SPSS17.0软件实现。应用美国纪念斯隆凯特林中心列线图预测每位胃肠道间质瘤患者术后的复发概率,应用SPSS软件,通过Bootstrop自抽样得到新样本概率与患者复发的真实概率比较,计算其ROC曲线下面积;经COX模型多因素分析后,应用R软件建立新的列线图模型及校准曲线;结果:应用单变量分析发现肿瘤大小、核分裂像、生长部位、CD117、CD34、NIH危险度分级、年龄等因素有统计学差异(p0.05);COX模型多变量分析筛选发现核分裂像、肿瘤大小是独立因素。成功建立了列线图模型,其校准曲线显示,此曲线比较接近于斜率为1的直线,说明列线图可以预测GIST术后复发风险。结论:核分裂像、肿瘤大小是影响胃肠道间质瘤术后复发风险的独立因素。列线图可以判定胃肠道间质瘤患者术后的复发风险概率,指导医生及患者选择合适的辅助治疗方案,提供了重要的参考依据。
[Abstract]:Objective: to explore the risk factors of postoperative recurrence of gastrointestinal stromal tumors (Gastrointestinal stromal tumor GIST), and to verify the clinical value of American Memorial Sloan Caitlin Center Line Map. Methods: from June 2000 to January 2009, the clinical and pathological data of 90 patients with gastrointestinal stromal tumors who were not treated with imatinib mesylate, who underwent surgical treatment (R0 resection) in Shanxi Cancer Hospital, were collected, and the follow-up data were followed up. To explore the risk factors of postoperative recurrence, univariate analysis was performed by chi-square test, survival rate was calculated by Kaplan-Meier method, and multi-factor analysis was carried out by Cox proportional hazard regression method. All the above statistical methods were realized by SPSS17.0 software. The recurrence probability of each patient with gastrointestinal stromal tumor was predicted by using the American Memorial Sloan Caitlin Center chart. By using SPSS software, the new sample probability was compared with the true probability of recurrence by Bootstrop self sampling. The area under the ROC curve was calculated. After multi-factor analysis of COX model, a new line diagram model and calibration curve were established by R software. Results: univariate analysis showed that there were significant differences in tumor size, mitotic image, growth site, CD117,CD34,NIH risk grade, age and other factors (p0.05). Multivariate analysis of the COX model revealed mitotic images in which tumor size was an independent factor. The calibration curve shows that the curve is close to the straight line with slope of 1, which indicates that the curve can predict the risk of recurrence after GIST. Conclusion: mitotic imaging, tumor size is an independent factor affecting the risk of postoperative recurrence of gastrointestinal stromal tumors. It can be used to determine the risk of recurrence in patients with gastrointestinal stromal tumors after operation, and to guide doctors and patients to choose the appropriate adjuvant therapy, which provides an important reference for patients with gastrointestinal stromal tumors.
【学位授予单位】：山西医科大学
【学位级别】：硕士
【学位授予年份】：2015
【分类号】：R735
本文编号：2448111
[Abstract]:Objective: to explore the risk factors of postoperative recurrence of gastrointestinal stromal tumors (Gastrointestinal stromal tumor GIST), and to verify the clinical value of American Memorial Sloan Caitlin Center Line Map. Methods: from June 2000 to January 2009, the clinical and pathological data of 90 patients with gastrointestinal stromal tumors who were not treated with imatinib mesylate, who underwent surgical treatment (R0 resection) in Shanxi Cancer Hospital, were collected, and the follow-up data were followed up. To explore the risk factors of postoperative recurrence, univariate analysis was performed by chi-square test, survival rate was calculated by Kaplan-Meier method, and multi-factor analysis was carried out by Cox proportional hazard regression method. All the above statistical methods were realized by SPSS17.0 software. The recurrence probability of each patient with gastrointestinal stromal tumor was predicted by using the American Memorial Sloan Caitlin Center chart. By using SPSS software, the new sample probability was compared with the true probability of recurrence by Bootstrop self sampling. The area under the ROC curve was calculated. After multi-factor analysis of COX model, a new line diagram model and calibration curve were established by R software. Results: univariate analysis showed that there were significant differences in tumor size, mitotic image, growth site, CD117,CD34,NIH risk grade, age and other factors (p0.05). Multivariate analysis of the COX model revealed mitotic images in which tumor size was an independent factor. The calibration curve shows that the curve is close to the straight line with slope of 1, which indicates that the curve can predict the risk of recurrence after GIST. Conclusion: mitotic imaging, tumor size is an independent factor affecting the risk of postoperative recurrence of gastrointestinal stromal tumors. It can be used to determine the risk of recurrence in patients with gastrointestinal stromal tumors after operation, and to guide doctors and patients to choose the appropriate adjuvant therapy, which provides an important reference for patients with gastrointestinal stromal tumors.
【学位授予单位】：山西医科大学
【学位级别】：硕士
【学位授予年份】：2015
【分类号】：R735
【参考文献】
相关期刊论文 前1条
1 邹庆;官泳松;;胃肠间质瘤研究新进展[J];胃肠病学和肝病学杂志;2009年01期
，本文编号：2448111
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