Prognostic value of inflammatory markers in predicting recurrence-free survival in gastrointestinal stromal tumor patients: A nomogram-based approach

Table 1 Patient characteristics, n (%)

Variable	n	mean ± SD
Age (years)		58 ± 12.836
BMI		22.10 ± 3.692
Sex
Male	48 (38.70)
Female	76 (61.30)
Anatomic site of GIST
Gastric tumors	76 (61.30)
Non-gastric tumors	48 (38.70)
Tumor size (cm)
< 5	66 (53.23)
≥ 5	58 (46.77)
Targeted therapy
Yes	31 (25)
No	93 (75)
5-years RFS	93 (75)

BMI: Body mass index; GIST: Gastrointestinal stromal tumor; RFS: Recurrence-free survival.

Table 2 Cut-off value of inflammation index based on Youden index

Object	Cut-off	AUC	P value	95%CI
SII	1097	0.768	< 0.001	0.674-0.863
NLR	5.79	0.771	< 0.001	0.676-0.867
MLR	0.43	0.677	0.003	0.556-0.798
PLR	181.33	0.730	< 0.001	0.634-0.826

SII: Systemic immune-inflammation index; NLR: Neutrophil/lymphocyte ratio; PLR: Platelet/lymphocyte ratio; MLR: Monocyte/lymphocyte ratio; AUC: Area under the curve.

Table 3 Correlation between preoperative systemic immune-inflammation index, neutrophil/lymphocyte ratio, and clinicopathological parameters, n (%)/mean ± SD

Variable	SII		P value	χ2	NLR		P value	χ2
	< 1079 (n = 82)	≥ 1079 (n = 42)			< 5.79 (n = 90)	≥ 5.79 (n = 34)
Gender			0.920	0.010			0.447	0.577
Male	32 (39.0)	16 (38.1)			33 (36.7)	15 (44.1)
Female	50 (61.0)	26 (61.9)			57 (63.3)	19 (55.9)
Age	56.12 ± 12.796	56.14 ± 12.493	0.968	0.002	56.04 ± 12.556	56.59 ± 13.738	0.807	0.60
BMI	22.13 ± 3.643	22.49 ± 3.819	0.914	0.12	22.35 ± 3.970	22.00 ± 2.863	0.268	1.239
Anatomic site of GIST			0.497	0.460			0.098	2.742
Stomach	52 (63.4)	24 (57.1)			62 (68.9)	18 (52.9)
Non-Stomach	30 (36.6)	18 (42.9)			28 (31.1)	16 (47.1)
Targeted therapy			0.511	0.432			0.816	0.054
Yes	19 (23.2)	12 (28.6)			22 (24.4)	9 (26.5)
No	63 (76.8)	30 (71.4)			68 (75.6)	25 (73.5)
Tumor size, cm	5.88 ± 3.395	7.24 ± 4.057	0.078	3.160	6.15 ± 3.657	6.85 ± 3.723	0.308	1.047
Size of GIST, cm			0.920	0.10			0.111	2.536
< 5 cm	32 (39.0)	16 (38.1)			23 (28.8)	15 (44.1)
≥ 5 cm	50 (61.0)	26 (61.9)			57 (71.3)	19 (55.9)

SII: Systemic immune-inflammation index; NLR: Neutrophil/lymphocyte ratio; GIST: Gastrointestinal stromal tumor; BMI: Body mass index.

Table 4 Correlation between preoperative platelet/lymphocyte ratio, monocyte/lymphocyte ratio and clinicopathological parameters, n (%)/mean ± SD

Variable	MLR		P value	χ2	PLR		P value	χ2
	< 0.430 (n = 88)	≥ 0.43 (n = 36)			< 181.33 (n = 59)	≥ 181.33 (n = 65)
Gender			0.213	1.549			0.497	0.461
Male	31 (35.2)	17 (47.2)			21 (35.6)	27 (41.5)
Female	57 (64.8)	19 (52.8)			38 (64.4)	38 (58.5)
Age	56.22 ± 13.045	56.14 ± 12.493	0.746	0.105	56.42 ± 55.98	56.98 ± 14.318	0.083	3.059
BMI	22.1 ± 3.687	22.43 ± 3.750	0.852	0.035	22.3 ± 3.967	22.20 ± 3.453	0.262	1.272
Anatomic site of GIST			0.40	4.232			0.953	0.004
Stomach	59 (67.0)	17 (47.2)			36 (61.0)	40 (61.5)
Non-stomach	29 (33.0)	19 (52.8)			23 (39.0)	25 (38.5)
Targeted therapy			0.170	1.879			0.917	0.011
Yes	19 (21.6)	12 (33.3)			15 (25.4)	16 (24.6)
No	69 (78.4)	24 (66.7)			44 (74.6)	49 (75.4)
Tumor size, cm	5.77 ± 3.243	7.74 ± 4.296	0.016	5.928	5.40 ± 2.746	7.19 ± 4.191	0.002	10.508
Size of GIST, cm			0.704	0.144			0.425	0.637
< 5 cm	35 (39.8)	13 (36.1)			25 (42.4)	23 (35.4)
≥ 5 cm	53 (60.2)	23 (63.9)			34 (57.6)	42 (64.6)

PLR: Platelet/lymphocyte ratio; MLR: Monocyte/lymphocyte ratio; GIST: Gastrointestinal stromal tumor; BMI: Body mass index.

Table 5 Gastrointestinal stromal tumor patient recurrence-free survival single factor analysis of the results

Variable	n	RFS (month)	RFS (95%CI)	P value	χ2
Gender				0.697	0.152
Male	48	77.646	(69.98-85.31)
Female	76	79.395	(73.40-85.39)
Age				0.377	0.780
≤ 58	64	76.547	(69.617-83.477)
>58	60	81.033	(74.707-87.360)
BMI (kg/m2)				0.351	0.870
≤ 22	62	81.417	(75.325-87.599)
>22	62	76.188	(69.159-83.216)
Anatomic site of GIST				0.679	0.171
Stomach	76	79.513	(73.570-85.456)
Non-stomach	48	77.458	(69.699-85.218)
Targeted therapy				0.007	7.398
Yes	31	74.667	(68.756-80.577)
No	93	90.871	(86.591-95.151)
Tumor size, cm				0.604	0.269
<5	52	80.308	(73.454-87.162)
≥ 5	72	77.569	(71.125- 84.014)
SII				< 0.001	26.946
<1079	84	87.463	(83.346-91.580)
≥ 1079	42	61.643	(52.176-71.110)
NLR				< 0.001	26.845
<5.79	90	86.067	(81.817-90.316)
≥ 5.79	34	59.265	(48.708-69.821)
MLR				< 0.001	24.242
<0.430	88	86.227	(82.053-90.402)
≥ 0.430	36	60.361	(49.872, 70.851)
PLR
< 181.33	59	90	(86.172-93.828)	< 0.001	19.871
≥ 181.33	65	68.477	(60.985-75.969)

SII: Systemic immune-inflammation index; NLR: Neutrophil/lymphocyte ratio; PLR: Platelet/lymphocyte ratio; MLR: Monocyte/lymphocyte ratio; GIST: Gastrointestinal stromal tumor; BMI: Body mass index; RFS: Recurrence-free survival.

Table 6 Multivariate cox regression analysis

Variable	RFS
	P-value	HR (95%CI)
PLR	0.008	4.556 (1.496-13.878)
MLR	0.000	4.063 (1.855-8.901)
Targeted therapy	0.004	0.119 (0.028-0.505)

PLR: Platelet/lymphocyte ratio; MLR: Monocyte/lymphocyte ratio; RFS: Recurrence-free survival; HR: Hazard ratio.