| Abstract: | Objective To explore the influencing factors of metastasis and prognosis in patients with primary gastric cancer （GC）, and trying to find out the clinical indicators for early prediction of metastasis. Methods A retrospective study was conducted on the clinicopathological data of 318 patients with primary GC who were admitted to Yunnan Cancer Hospital from January 2018 to December 2021 and were divided into 2 groups: metastasis group （213 cases） and non-metastasis group （105 cases） according to whether metastasis occurred. The relationship between clinicopathological factors and GC metastasis and prognosis was analyzed, and the diagnostic efficacy of these factors for GC metastasis was explored. Results （1） The median overall survival （OS） and average progression-free survival （PFS） were 27 months and 22.16 months respectively in the metastasis group. While the median OS and average PFS in the non-metastasis group were 45 months and 41.98 months respectively. The differences in OS and PFS between these two groups were statistically significant （P < 0.0001）. （2） Multivariate analysis suggested that infiltration depth > mucosal layer, no chemotherapy and carbohydrate antigen-125 （CA-125）≥14.4KU/L were independent risk factors for GC patients with metastasis （P < 0.05）. （3） The drawing of receiver operating characteristic curve （ROC curve） suggested that the combination of infiltration depth, prealbumin and CA-125 had more accurate sensitivity and specificity for predicting GC patients’ metastasis than the combination of double single or indexs. （4） Log-rank test and COX multivariate analysis suggested that total chemotherapy cycle < 8 cycles and CA-125≥14.4KU/L were independent risk factors for OS in patients with metastasis. The independent risk factors for PFS in patients with metastasis were no surgical treatment in the primary lesion, combined with metastasis at initial diagnosis, combined with distant metastasis during the course of disease and CA-125≥14.4KU/L, with statistically significant differences （P < 0.05）. Conclusions The prognosis of GC patients with metastasis is truly poor, clinical attention should be paid more attention to the early detection, diagnosis and treatment. The combination of multiple indexs has been proven to be more accurate in sensitivity and specificity for the diagnosis of GC metastasis, suggesting that GC patients should be actively evaluated and individualized treatment should be developed to diagnose and treat after metastasis as soon as possible, to provide a theoretical basis for improving patients’ prognosis, prolonging survival and improving life treatment. |
