The Editorial Department of Chinese Journal of Clinical Research
Doi
Abstract
Objective To establish and validate a nomogram model for predicting the prognosis of advanced gastric cancer based on Ki67 expression，and to explore effect of different levels of Ki67 on progression free survival（PFS）in the same patient with different treatment lines. Methods Clinical data of 95 patients with advanced gastric cancer treated at Huaibei People,s Hospital from January 2020 to December 2023 were retrospectively collected. Univariate and multivariate survival analyses were performed using the Cox regression model to screen independent factors affecting the overall survival（OS）of advanced gastric cancer. A survival nomogram was drawn，and the consistency index（C-index） was calculated. The predictive ability of the model was validated by drawing calibration curves，receiver operating characteristic（ROC）curves，and clinical decision curve analysis（DCA）. The survival periods of patients with high Ki67 expression(≥50%）and low Ki67 expression（Results Cox regression analysis showed that age ，pathological type ，performance status score（ECOG）， whether the first-line treatment achieved disease control rate（DCR），and Ki67 expression were independent prognostic factors affecting the survival rate of advanced gastric cancer（PCI：0.637-0.765）. Calibration curves，ROC curves，and DCA curves all indicated that the model had good predictive ability. In advanced gastric cancer patients，the PFS after apatinib treatment in the third-line therapy was 6.5 months in the high Ki67 expression group and 3.9 months in the low Ki67 expression group，with a statistically significant difference（PP>0.05）. Conclusion Ki67 is an independent predictive factor for the prognosis of advanced gastric cancer. The nomogram established based on Ki67 can effectively predict the survival prognosis of advanced gastric cancer，and apatinib may have an impact on the survival of patients with advanced gastric cancer through Ki67
