Prognostic value of fibrinogen and D-dimer-fibrinogen ratio in resectable gastrointestinal stromal tumors

Table 1 Area under the curve

Variable	Area	SE	P value	95%CI
FIB (g/L)	0.758	0.047	< 0.01	0.666-0.850
D-dimer (mg/L)	0.739	0.056	< 0.01	0.629-0.850
D-dimer/FIB	0.709	0.058	0.001	0.596-0.822
PLT (109/L)	0.625	0.055	0.05	0.517-0.733

FIB: Fibrinogen; CI: Confidence interval; PLT: Platelet count.

Table 2 Univariate analysis of association between clinicopathologic features and prognosis in gastrointestinal stromal tumor patients

Characteristic	Number	3-yr RFS (%)	5-yr RFS (%)	95%CI	P value
Gender
Male	91	80	75	61.170-72.86	0.498
Female	79	90	80	56.828-65.996
Age (yr)
< 61	78	85	81	58.018-66.650	0.406
≥ 61	92	83	78	61.508-73.445
NIH risk category
Very low, low	83	97	95	73.805-80.329	< 0.01
Intermediate, high	87	80	65	50.488-62.245
Tumor size (cm)
≤ 5	97	95	95	75.130-80.262	< 0.01
> 5	73	63	55	49.388-63.256
Tumor location
Gastric	122	92	85	67.968-76.637	0.001
Extragastric	48	76	55	42.703-56.229
FIB (g/L)
< 3.24	95	95	95	75.248-80.253	< 0.01
≥ 3.24	75	65	50	48.878-62.958
D-dimer (mg/L)
< 1.24	118	95	88	70.09-88.603	< 0.01
≥ 1.24	52	65	55	46.163-62.647
DFR
< 0.354	126	95	85	70.237-78.220	< 0.01
≥ 0.354	44	70	50	43.262-61.237
PLT (× 109/L)
< 197.5	81	92	85	68.060-78.540	0.014
≥ 197.5	89	76	68	55.307-67.619
Mitotic index
≤ 5/50 HPFs	125	95	90	70.431-77.808	< 0.01
> 5/50 HPFs	45	65	35	39.663-55.513
Adjuvant imatinib1
Yes	48	70	55	48.468-64.287	0.940
No	39	75	55	41.127-64.055

¹Intermediate and high risk gastrointestinal stromal tumor patients. GIST: Gastrointestinal stromal tumor; NIH: National Institutes of Health; FIB: Fibrinogen; RFS: Recurrence-free survival; DFR: D-dimer to FIB ratio (D-dimer/FIB); PLT: Platelet count.

Table 3 Multivariate analysis of the significant variables determined by univariate analysis

	B	SE	Wald	P value	RR (95%CI)
FIB	-2.035	0.622	10.692	0.001	0.131 (0.039-0.443)
Risk	-1.582	0.633	6.249	0.012	0.206 (0.059-0.711)
DFR	-1.097	0.447	6.022	0.014	0.334 (0.139-0.802)

FIB: Fibrinogen classification (FIB < 3.24 and FIB ≥ 3.24); Risk: Risk category (very low, low and intermediate, and high risk); DFR: D-dimer to FIB classification (DFR ≥ 0.354 and DFR < 0.354); RR: Risk ratio; CI: Confidence interval.

Table 4 Multivariate analysis of the significant variables determined by univariate analysis on the hierarchy of adjuvant imatinib

	B	SE	Wald	P value	RR (95%CI)
FIB	-2.223	0.632	12.385	0.000	0. 108 (0.031-0.373)
Risk	-1.795	0.645	7.736	0.005	0.166 (0.047-0.589)
DFR	-1.141	0.454	6.325	0.012	0.319 (0.131-0.777)

FIB: Fibrinogen classification (FIB < 3.24 and FIB ≥ 3.24); Risk: Risk category (very low, low and intermediate, and high risk); DFR: D-dimer to FIB ratio classification (DFR ≥ 0.354 and DFR < 0.354); RR: Risk ratio; CI: confidence interval.

Table 5 Clinicopathologic characteristics of gastrointestinal stromal tumor patients grouped by preoperative fibrinogen

Characteristic	Low FIB (< 3.24 g/L)	High FIB (≥ 3.24 g/L)	P value
Age (yr)			< 0.01
< 61	78	0
≥ 61	17	75
Gender			< 0.01
Male	91	0
Female	4	75
Location			< 0.01
Gastric	95	27
Nongastric	0	48
Tumor size (cm)			< 0.01
≤ 5	95	2
> 5	0	73
NIH risk category			< 0.01
Very low	18	0
Low	65	0
Intermediate	12	25
High	0	50
Mitotic index			< 0.01
≤ 5/50 HPFs	95	30
> 5/50 HPFs	0	45

FIB: Fibrinogen; HPFs: High power fields.

Table 6 Clinicopathologic characteristics of gastrointestinal stromal tumor patients grouped by preoperative D-dimer

Characteristic	Low D-dimer (< 1.24 mg/L)	High D-dimer (≥ 1.24 mg/L)	P value
Age (yr)			< 0.01
< 61	78	0
≥ 61	40	52
Gender			< 0.01
Male	91	0
Female	27	52
Location			< 0.01
Gastric	118	4
Nongastric	0	48
Tumor size (cm)			< 0.01
≤ 5	97	0
> 5	21	52
NIH risk category			< 0.01
Very low	18	0
Low	65	0
Intermediate	35	2
High	0	50
Mitotic index			< 0.01
≤ 5/50 HPFs	118	7
> 5/50 HPFs	0	45

NIH: National Institutes of Health; HPFs: High power fields.

Table 7 Clinicopathologic characteristics of gastrointestinal stromal tumor patients grouped by preoperative D-dimer-fibrinogen ratio

Characteristic	Low DFR (< 0.354)	High DFR (≥ 0.354)	P value
Age (yr)			< 0.01
< 61	78	0
≥ 61	48	44
Gender			< 0.01
Male	91	0
Female	35	44
Location			< 0.01
Gastric	122	0
Nongastric	4	44
Tumor size (cm)			< 0.01
≤ 5	97	0
> 5	29	44
NIH risk category			< 0.01
Very low	18	0
Low	65	0
Intermediate	37	0
High	6	44
Mitotic index			< 0.01
≤ 5/50 HPFs	125	0
> 5/50 HPFs	1	44

HPFs: High power fields; DFR: D-dimer to fibrinogen ratio.

Table 8 Clinicopathologic characteristics of gastrointestinal stromal tumor patients grouped by preoperative platelet count

Characteristic	Low PLT (< 197.5 × 109/L)	High PLT (≥ 197.5 × 109/L)	P value
Age (yr)			< 0.01
< 61	78	0
≥ 61	3	89
Gender			< 0.01
Male	81	10
Female	0	79
Location			< 0.01
Gastric	81	41
Nongastric	0	48
Tumor size (cm)			< 0.01
≤ 5	81	16
> 5	0	3
NIH risk category			< 0.01
Very low	18	0
Low	63	2
Intermediate	0	37
High	0	50
Mitotic index			< 0.01
≤ 5/50 HPFs	81	44
> 5/50 HPFs	0	45

NIH: National Institutes of Health; HPFs: High power fields.