Retrospective Study
Copyright ©The Author(s) 2018. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Nov 28, 2018; 24(44): 5046-5056
Published online Nov 28, 2018. doi: 10.3748/wjg.v24.i44.5046
Prognostic value of fibrinogen and D-dimer-fibrinogen ratio in resectable gastrointestinal stromal tumors
Hua-Xia Cai, Xu-Qi Li, Shu-Feng Wang
Hua-Xia Cai, Xu-Qi Li, Shu-Feng Wang, Department of General Surgery, First Affiliated Hospital of Xi’an Jiaotong University, Xi’an 710061, Shaanxi Province, China
Hua-Xia Cai, Department of General Surgery, Xi’an 141 Hospital, Yanliang 710089, Shaanxi Province, China
Author contributions: Cai HX and Wang SF designed the study; Cai HX analyzed and interpreted the data and drafted the manuscript; Li XQ and Wang SF revised the controversial parts of the manuscript; all authors read and approved the final manuscript.
Institutional review board statement: This study was approved by the Medical Ethics Committee of the First Affiliated Hospital of Xi’an Jiaotong University.
Informed consent statement: All the patients or their legal guardians signed informed consent before the operation. Since this study used anonymous clinical data, patients did not need to give informed consent.
Conflict-of-interest statement: There was no conflict of interest in the present study.
Data sharing statement: No additional data are available.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See:
Corresponding author to: Shu-Feng Wang, MD, PhD, Doctor, Full Professor, Surgeon, Department of General Surgery, First Affiliated Hospital of Xi’an Jiaotong University, 277 West Yanta Road, Xi’an 710061, Shaanxi province, China.
Telephone: +86-18991232452
Received: August 17, 2018
Peer-review started: August 17, 2018
First decision: October 14, 2018
Revised: October 27, 2018
Accepted: November 9, 2018
Article in press: November 9, 2018
Published online: November 28, 2018
Research background

It is well known that moderate and high-risk gastrointestinal stromal tumor (GIST) patients have a high recurrence rate and need adjuvant targeted therapy to improve prognosis. Therefore, early screening of this protion of patients to give adjuvant treatment is particularly important. At present, the prediction of GISTs is obtained by postoperative pathology, and there is no effective index to predict the prognosis of GISTs before operation. The purpose of this retrospective study was to investigate the role of fibrinogen (FIB), D-dimer-fibrinogen ratio (DFR) in the prognosis of GISTs before operation.

Research motivation

The increase of blood coagulation indexes such as fibrinogen content and D-dimer before operation can predict the adverse prognosis of many kinds of cancer, but there is little discussion about the relationship between these indexes and GISTs.

Research objectives

The retrospective study analyzed the role of FIB, D-dimer, DFR, and platelet count (PLT) in the prognosis of GISTs before operation.

Research methods

This study included 170 patients with GISTs who met the criteria. The data of all the patients were collected before and after operation to make statistical analysis. All data were analyzed using the SPSS 18.0 statistical software, with a P-value below 0.05 considered statistically significant.

Research results

In the present study, univariate analysis showed that FIB, D-dimer, DFR, and PLT were correlated with the 3- and 5-year survival rates of GIST patients. In addition, there was a correlation between the clinical features and FIB, D-dimer, DFR, and PLT in GISTs. Moreover, multivariate analysis showed that FIB and DFR had an independent effect on the prognosis of GIST patients.

Research conclusions

This retrospective study showed that FIB, D-dimer, DFR, and PLT were the prognostic factors of GISTs, but there was an independent correlation between FIB and DFR and GIST prognosis. These factors may help screen out high-risk patients early and to administer adjuvant intervention as soon as possible.

Research perspectives

For patients with GISTs, the prognosis can be preliminarily estimated according to hematological indexes such as FIB and DFR before the operation, and adjuvant therapy can be given early to improve the prognosis of patients. Of course, the results of this study need to be further verified by a large sample size prospective study.


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