| Purpose:The main purpose of this paper is to analyze and study the prognosis of gastric cancer(GC)patients focused on their marital status,based on SEER datebase,and extraction of exosomes from serum of patients with gastric cancer by kit extraction,which can provide a new way for clinical diagnosis,monitoring and prognosis evaluation of gastric cancer.The difference of incidence of distant organ metastasis and operative acceptance in patients with GC under different marital status was revealed,and the influence of marital status on the cause specific survival of patients with GC was clarified,and the kit is a fast and effective exosome extraction technology was proved This study will comprehensively deepen the understanding of GC among clinical medical staff,remind clinical medical staff to pay attention to the important role of social factors such as marital status in the occurrence and development of GC,and achleve targeted and personalized disease monitoring and follow-up in the process of diagnosis and treatment,which has important clinical reference significance and application valueMethods:(1)The prognostic analysis of GC patients in this paper is based on the SEER database of the National Cancer Center of the United States.The exclusion criteria in the inclusion process were as follows:cases with unclear marital status were excluded;cases with incomplete follow-up information and survival time information were excluded:cases with GC confirmed by autopsy or death report were excluded;cases with age less than 15 years were excluded;cases diagnosed as GC were excluded without pathological confirmation.Finally,35191 cases of GC diagnosed from 2010 to 2015 were included,and the relationship between marital status and prognosis was analyzed statistically.In statistical analysis of data,chi-square test was used to analyze the statistical significance of the differences.Binary logistic regression was used to analyze the relationship between marital status and the incidence of surgery and distant organs.Multivariate COX regression analysis and survival analysis were used to evaluate the tumor-specific survival rate of patients with GC.Data acquisition and screening in SEER database were performed by SEER-STAT(8.1.5)software,and statistical software for data analysis was SPSS 20.0 software.(2)The exosome from serum of GC patients was extracted by Total Exosome Isolation kit,the morphology and diameter of exosome from serum were detected by transmission electron microscopy,and the expression of CD63 surface markers was verified by Western blot.Result:(1)Married patients accounted for the highest proportion of GC patients with tumors less than 1 cm.and single patients with undifferentiated GC accounted for the highest proportion.Single patients accounted for the highest proportion of GC patients diagnosed as stage IV and Ml,while married patients accounted for the highest proportion of GC patients diagnosed as stage 0-Ⅲ.(2)Married patients with gastric cancer were more likely to undergo surgical treatment,and widowed patients had the lowest rate of surgical treatment among the four states.(3)Married and insured patients have lower possibility of distant organ metastasis;middle-aged and old people have higher incidence of distant organ metastasis than young people,but patients aged 45-59 have the highest incidence;black people have higher incidence of organ metastasis,while cardiac cancer,high and middle differentiation,signet ring cell cancer and carcinoid have lower possibility of distant organ metastasis.(4)Of the four marital states,married patients had the longest cancer-specific survival and widowed patients had the shortest survival.(5)The exosome from the serum of patients with gastric cancer is a vesicle less than 100 nm in diameter and expresses CD63 moleculeConclusion:(1)GC patients with stable marital status have better prognosis(2)The kit extraction is a fast and effective method for exosome extraction. |
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