Propensity-matched Analysis Of The Predictive Effect Of Ki67 On Postoperative Survival In Patients With Resectable Gastrointestinal Stromal Tumor

Objective:To examine the ability of Ki67 to predict overall survival(OS)in the patients with resectable gastrointestinal stromal tumors(GISTs).Methods:The clinicopathological data and survival status of 281 postoperative GIST patients(224 pure GIST(P-GIST)and 57 GIST and other malignant tumors(OMT-GIST))were retrospectively analyzed From May 2015 to May 2021 at Cancer Hospital Affiliated to Shanxi Medical University;SPSS 26 were used to verify the predictive effect of Ki67 on OS in those patients.Results:The OS rate differed significantly between P-GIST and OMT-GIST patients(P<0.001).For P-GISTs,it did not differ significantly between WT GISTs and classic GISTs(P=0.965).The ROC curve showed that the best cutoff value of Ki67 was 12.5% in P-GIST patients.Before propensity matching,Cox multivariate analysis showed that Ki67 and NIH risk group were independent prognostic factors in P-GIST patients(P=0.041 and P=0.043),After propensity matching,Ki67 was directly associated with OS(P=0.027).There was a statistically significant difference in OS between the Ki67 >12.5% and Ki67≤12.5% groups before and after matching(P=0.002 and p=0.014).The risk model was established based on multifactor analysis,and the consistency index was 0.761(95% CI:0.636-0.886),sensitivity 66.7%,specificity 78.2%.The calibration curve showed that the risk assessment model was in good agreement with the actual results.Conclusion:Ki67 can evaluating postoperative survival in patients with resectable P-GIST.The recommended Ki67 cutoff value is 12.5%.OMT-GIST has a poorer prognosis than P-GIST.OS did not differ between wild-type and classic GISTs.