Prognostic significance of hemoglobin, albumin, lymphocyte, platelet in gastrointestinal stromal tumors: A propensity matched retrospective cohort study

doi:10.3748/wjg.v28.i27.3476

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World Journal of Gastroenterology

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Retrospective Cohort Study

World J Gastroenterol. Jul 21, 2022; 28(27): 3476-3487
Published online Jul 21, 2022. doi: 10.3748/wjg.v28.i27.3476

Table 1 Baseline characteristics in patients with high or low combination index of hemoglobin, albumin, lymphocyte, and platelet before and after propensity scores matching (mean ± SD)

Characteristics	Before PSM¹				After PSM
Characteristics	All	Low HALP, < 31.5	High HALP, ≥ 31.5	P value	All	Low HALP, < 31.5	High HALP, ≥ 31.5	P value
n (%)	591	229 (38.7)	362 (61.3)	-	458	229 (50)	229 (50)	-
Age in yr	56.3 ± 12.0	56.7 ± 12.2	56.1 ± 11.8		56.8 ± 12.1	56.7 ± 12.2	57.0 ± 12.1
< 60	337 (57.0)	129	208		256 (55.9)	129	127
≥ 60	254 (43.0)	100	154	0.788	202 (44.1)	100	102	0.851
Sex
Male	280 (47.4)	98	182		233 (50.9)	131	102
Female	311 (52.6)	131	180	0.076	225 (49.1)	98	127	0.007^a
Tumor site
Stomach	424 (71.7)	143	281		299 (65.3)	143	156
Non-stomach	167 (28.3)	86	81	< 0.001^a	159 (34.7)	86	73	0.202
Tumor size in cm	6.16 ± 4.87	7.69 ± 5.65	5.18 ± 4.02		7.13 ± 5.08	7.69 ± 5.65	6.57 ± 4.38
≤ 2	86 (14.6)	10	76		27 (5.9)	10	17
2.1-5.0	251 (42.5)	87	164		177 (38.6)	87	90
5.1-10.0	184 (31.1)	95	89		184 (40.2)	95	89
> 10.0	70 (11.8)	37	33	< 0.001^a	70 (15.3)	37	33	0.514
Mitotic index/50 HPF
≤ 5	332 (56.2)	107	225		220 (48.0)	107	113
6-10	100 (16.9)	45	55		91 (19.9)	45	46
> 10	91 (15.4)	49	42		89 (19.4)	49	40
Unknown	68 (11.5)	28	40	0.001^a	58 (12.7)	28	30	0.764
Ki67
≤ 10	417 (70.6)	140	277		308 (67.3)	140	168
> 10	98 (16.6)	61	37		94 (20.5)	61	33
Unknown	76 (12.9)	28	48	< 0.001^a	26 (12.2)	28	28	0.004^a
NIH risk category
Very low risk	72 (12.2)	9	63		21 (4.6)	9	12
Low risk	178 (30.1)	52	126		113 (24.7)	52	61
Intermediate risk	114 (19.3)	43	71		100 (21.8)	43	57
High risk	227 (38.4)	125	102	< 0.001^a	224 (48.9)	125	99	0.106
Adjuvant therapy
Yes	201 (34.0)	99	102		193 (42.1)	99	94
No	390 (66.0)	130	260	< 0.001^a	265 (57.9)	130	135	0.636
Recurrence
Yes	62 (10.5)	42	20		61 (13.3)	42	19
No	529 (89.5)	187	342	< 0.001^a	397 (86.7)	187	210	0.002^a

¹Method = nearest; Cliper value = 0.02.

^aP < 0.05 was considered statistically significant.

HALP: Combination index of hemoglobin, albumin, lymphocyte, and platelet; HPF: High-power field; NIH: National Institutes of Health; PSM: Propensity scores matching; SD: Standard deviation.

Table 2 Univariate and multivariate regression analysis of prognostic factors in patients before and after propensity scores matching

Risk factors	Before PSM				After PSM
Risk factors	Univariate analysis, HR (95%CI)	Univariate analysis, P value	Multivariate analysis, HR (95%CI)	Multivariate analysis, P value	Univariate analysis, HR (95%CI)	Univariate analysis, P value	Multivariate analysis, HR (95%CI)	Multivariate analysis, P value
Age	1.009 (0.987-1.030)	0.431		NS	1.006 (0.984-1.027)	0.607		NS
Sex: Male vs female	0.639 (0.386-1.056)	0.081		NS	0.711 (0.429-1.179)	0.186		NS
Tumor site: Stomach vs non-stomach	2.273 (1.377-3.752)	0.001^a	2.979 (1.716-5.171)	< 0.001^a	1.702 (1.028-2.818)	0.039^a	2.865 (1.631-5.032)	< 0.001^a
Tumor size in cm: ≤ 2/2.1-5.0/5.1-10.0/> 10.0	2.629 (1.948-3.548)	< 0.001^a	1.070 (1.032-1.109)	0.001^a	1.086 (1.056-1.116)	< 0.001^a	1.068 (1.029-1.107)	< 0.001^a
Mitotic index as/50 HPF: ≤ 5/6-10/> 10/unknown	2.071 (1.686-2.545)	< 0.001^a		< 0.001^a		< 0.001^a		0.001^a
≤ 5 vs 6-10			5.659 (2.151-14.887)	0.002^a	5.442 (2.067-14.323)	0.001^a	5.444 (1.955-15.162)	0.001^a
≤ 5 vs > 10			8.259 (3.140-21.720)	< 0.001^a	14.722 (6.037-35.904)	< 0.001^a	7.675 (2.759-21.348)	< 0.001^a
≤ 5 vs unknown			5.299 (2.041-13.757)	< 0.001^a	9.851 (3.843-25.251)	< 0.001^a	5.107 (1.873-13.923)	0.001^a
CD117: +/-	1.231 (0.300-5.059)	0.773		NA	1.291 (0.314-5.313)	0.723	-	NA
DOG1: +/-/unknown	1.464 (0.773-2.774)	0.242		NA	1.626 (0.853-3.102)	0.140	-	NA
Ki67: ≤ 10/> 10/unknown	1.919 (1.453-2.533)	< 0.001^a		0.001^a		< 0.001^a		0.001^a
< 10 vs ≤ 10			3.579 (1.771-7.233)	< 0.001^a	8.625 (4.750-15.660)	< 0.001^a	3.710 (1.811-7.599)	< 0.001^a
Unknown vs ≤ 10			2.844 (1.290-6.270)	0.024^a	3.310 (1.528-7.169)	0.002^a	3.050 (1.365-6.816)	0.007
Histologic subtypes: Spindle/epithelioid/mixed	1.361 (0.981-1.889)	0.065		NS	1.236 (0.891-1.715)	0.204	-	NA
NIH risk category: Very low/low/intermediate/high	3.218 (2.180-4.751)	< 0.001^a		NS	2.892 (1.865-4.484)	< 0.001^a	-	NS
Adjuvant therapy: Yes/no	1.289 (0.768-2.162)	0.336	0.445 (0.257-0.769)	0.004^a	0.923 (0.549-1.551)	0.761		0.003^a
NLR: < 2.60/≥ 2.60	2.025 (1.229-3.337)	0.006^a		NS	1.746 (1.055-2.890)	0.030^a		NS
PLR: < 134.8/≥ 134.8	2.925 (1.673-5.112)	< 0.001^a		NS	1.991 (1.137-3.486)	0.016^a		NS
LMR: < 4.0/≥ 4.0	1.296 (0.777-2.163)	0.321		NA	1.088 (0.650-1.821)	0.749	-	NA
PNI: < 48.6/≥ 48.6	0.291 (0.171-0.496)	< 0.001^a		NS	1.991 (1.137-3.486)	0.016^a		NS
HALP: < 31.5/≥ 31.5	0.341 (0.197-0.590)	< 0.001^a	0.506 (0.291-0.879)	0.016^a	0.457 (0.265-0.785)	0.005^a	0.558 (0.319-0.976)	0.041^a

^aP < 0.05 was considered statistically significant.

CI: Confidence interval; HALP: Combination index of hemoglobin, albumin, lymphocyte, and platelet; HPF: High-power field; HR: Hazard ratio; NA: Not adopted; LMR: Lymphocyte-to-monocyte ratio; NIH: National Institutes of Health; NLR: Neutrophil-to-lymphocyte ratio; NS: Not significant; PLR: Platelet-to-lymphocyte ratio; PNI: Prognostic nutritional index; PSM: Propensity scores matching.

Citation: Zhao Z, Yin XN, Wang J, Chen X, Cai ZL, Zhang B. Prognostic significance of hemoglobin, albumin, lymphocyte, platelet in gastrointestinal stromal tumors: A propensity matched retrospective cohort study. World J Gastroenterol 2022; 28(27): 3476-3487
URL: https://www.wjgnet.com/1007-9327/full/v28/i27/3476.htm
DOI: https://dx.doi.org/10.3748/wjg.v28.i27.3476