Study On The Relationship Between Ki67 Stratification,Clinicopathological Stage And Prognosis Of Gastric Cancer

Objective: To study the relationship between Ki67 stratification and clinicopathological stage,3-year survival rate and progression-free survival(PFS)of gastric cancer,to explore whether Ki67 stratification can provide a basis for judging the prognosis of gastric cancer.Methods: In this study,673 patients undergoing gastric cancer surgery in the affiliated Hospital of Qinghai University from January 2014 to December 2017 were collected.73 patients were divided into three groups according to Ki67 index(Ki67 <10% for group A,10% for group B,26% for group C and > 50% for group D).The characteristics of clinicopathological stage,3-year survival rate and progression-free survival(PFS)of gastric cancer patients in each group were analyzed retrospectively.Statistical analysis was carried out by SPSS21.0 statistical software.Chi-square test was used for baseline test of general data,and Kendall-taub rank correlation test was used for correlation analysis.Chi-square test was used for the difference of 3-year survival rate of different groups and different stages of the same group.Fisher exact probability method was used for the difference of 3-year survival rate of different stages of the same group and different groups of the same stage.The progression-free survival time in different groups,progression-free survival time in different stages,progressionfree survival time in the same group and different stages in the same group were analyzed by single factor analysis of variance.Kaplan-Meier survival analysis was used to analyze survival,draw survival curve,and log-rank test was used to test.The difference was statistically significant(P < 0.05),and the conclusion was drawn.Results:1.General situation: The cases collected in this study,there was no significant difference in age,sex,nationality,tumor size and location among groups A,B,C and D(p>0.05),that is,there was no significant difference in general data.Statistical analysis in each group can rule out the influence of general data.2.The relationship between Ki67 stratification and clinicopathological staging: there was a positive correlation between Ki67 stratification and clinicopathological staging.The higher the Ki67 stratification grade was,the later the TNM staging was,and the difference was statistically significant(p<0.001).3.3-year survival rate: The 3-year survival rate of all patients in different groups decreased with the increase of grouping grade,and the difference was statistically significant(p<0.05).The later the stage,the lower the 3-year survival rate of all patients with different TNM stages,and the difference was statistically significant.The 3-year survival rate of Ki67 groups and different TNM stages decreased with the increase of grade in the same stage,but the difference was not statistically significant(p>0.05).The 3-year survival rate of different stages in the same group decreased with the increase of stage grade,except that there was no significant difference in group A,but there was significant difference among the other groups.4.The progression-free survival(PFS): patients in different groups,the higher the grouping grade,the lower the progression-free survival,and the difference was statistically significant(p<0.05).The progression-free survival of all patients with different stages and late stages was significantly lower than that of late stage(p<0.05).The progression-free survival of Ki67 groups and different TNM stages,the same stage in different groups,with the increase of grade,the progression-free survival decreased,the difference was statistically significant.The progression-free survival of different stages in the same group decreased with the increase of staging grade,except that there was no significant difference in group A(p>0.05),but there were significant differences in the other groups(p<0.05).5.Survival curve: the survival curve of different groups of all patients,the higher the grade of grouping,the faster the decline of K-M curve and the lower the position of K-M curve,the difference was statistically significant(log-rank P=0.008).The survival curve of all patients in different stages,the K-M curve of late stage decreased faster,the position of K-M curve was lower,and the difference was statistically significant(log-rank P<0.001).There was no significant difference in K-M among different stages in group A,and there was no statistical significance in group A(log-rank P=0.074);In group B,C and D,the K-M curve in the same group with different stages showed that the K-M curve in late stage decreased rapidly and the position was low,and the difference was statistically significant(log-rank P<0.05).There was no significant relationship between IA,IB,IIA,IIB,IIIA,IIIB and IIIC in the same stage and different groups,and there was no statistical significance(log-rank P>0.05).Conclusions: Ki67 stratification was positively correlated with clinicopathological staging.The higher the Ki67 stratification grade,the later the TNM staging.There were significant differences in 3-year survival rate and progression-free survival time among different levels(groups).The higher the grouping grade,the lower the 3-year survival rate and progression-free survival time,and the higher the grouping grade,the faster the K-M curve decreased,and the lower the position of-M curve,that is,Ki67 stratification can be used as a basis for judging the prognosis of gastric cancer.There were significant differences in progression-free survival time among different layers(groups)of the same TNM stage.The progression-free survival time of patients with high grade in the same TNM stage was low,but there was no significant difference in 3-year survival rate and K-M curve of patients with different levels(groups)of the same TNM stage,that is,stratification grade could only predict the prognosis of patients with the same stage.