Abstract
Objective Gastric cancer is a malignant tumor originating from gastric mucosal epithelium. Here, we aimed to investigate the analysis of the threshold change of gastric cancer tumor mutation burden (TMB) and its relationship with the prognosis of patients. Methods 256 patients with gastric cancer were selected as subjects. All patients were in the advanced stage and received surgical resection of D2 lymph node dissection. After the operation, a follow-up was performed for 24 months, and the disease-free survival and overall survival of patients were counted. The NGS molecular biological was detected to obtain gastric cancer tumor mutation burden (TMB) data. Pearson correlation analysis software was used to analyze the correlation between TMB threshold and disease-free survival or overall survival of patients with gastric cancer, and the multivariate logistic analysis was performed as well. Results The disease-free survival period and the overall survival period of patients in the low-to-medium TMB group were both longer than those in the high TMB group. Pearson correlation analysis results showed that the TMB threshold was negatively correlated with the disease-free survival and overall survival of gastric cancer patients. Results from multivariate logistic analysis showed that high TMB thresholds have a greater impact on disease-free survival and overall survival of patients, but the impact of medium and low TMB thresholds on disease-free survival and overall survival of patients is weakened. Conclusions The TMB threshold level has a predictive effect on the effect of surgical resection of D2 lymph node dissection, and high levels of TMB can significantly affect disease-free survival and overall survival of patients with advanced gastric cancer.
Highlights
Gastric cancer is a malignant tumor that originates from the epithelium of the gastric mucosa, and with the changes in the diet of Chinese residents, increased work pressure, and Helicobacter pylori infection, the incidence of the disease is showing a younger trend [1]
Results showed that the disease-free survival time of patients in the low-to-medium tumor mutation burden (TMB) group was 14.39 ± 3.23 months, and the overall survival time was 17.41 ± 2.12 months, which were longer than the disease-free survival time (11.51 ± 2.59 months) and the overall survival time of the high TMB group (13.15 ± 2.05 months) (P < 0.05; P < 0.05) (Figures 1(a) and 1(b))
Results from multivariate logistic analysis showed that the high TMB threshold of gastric cancer patients had a greater impact on disease-free survival and overall survival of patients, but the impact of medium and low TMB thresholds on disease-free survival and overall survival of patients was weakened, as given in Table 2 and Table 3
Summary
Gastric cancer is a malignant tumor that originates from the epithelium of the gastric mucosa, and with the changes in the diet of Chinese residents, increased work pressure, and Helicobacter pylori infection, the incidence of the disease is showing a younger trend [1]. Previous studies have shown that gastric cancer is more likely to occur in people over the age of 50, and the incidence of men is slightly higher than that of women, and more than 50.0% of patients occur in the antrum, greater curvature, and lesser curvature of the stomach [2]. Tumor mutational burden (TMB), an emerging independent biomarker, is the detection of the total number of mutations in the coding region of tumor genes, which is widely used to stratify the patient’s response to treatment. Previous studies have shown that TMB refers to the exon coding region of the evaluation gene in the tumor cell genome and the total number of substitution, insertion, or deletion mutations per megabase [6]. There are few studies on the relationship between TMB and the prognosis of patients with gastric cancer
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