Clinical association between coagulation indicators and bone metastasis in patients with gastric cancer

Table 1 Demographic and baseline characteristics of patients

Characteristic	Overall, n = 454	No bone metastasis, n = 263	Bone metastasis, n = 191	P value
Male sex	335 (73.8)	196 (74.5)	139 (72.8)	0.676
Age, yr	59 (50-67)	61 (51-67)	57 (49-66)	0.046
CEA, ng/mL	3.53 (1.73-14.65)	2.43 (1.35-4.89)	5.29 (2.90-38.31)	< 0.001
CA19-9, U/mL	12.25 (6.30-46.88)	9.89 (4.92-20.20)	22.62 (9.73-113.35)	< 0.001
CA72-4, U/mL	3.39 (1.60-12.00)	2.58 (1.57-6.78)	7.09 (1.96-21.68)	< 0.001
Erythrocyte, × 1012/L	4.14 (3.65-4.57)	4.27 (3.78-4.68)	4.00 (3.50-4.39)	< 0.001
Hemoglobin, g/L	124 (106-139)	127 (109-143)	119 (103-133)	< 0.001
Leukocyte, × 109/L	5.69 (4.51-7.12)	5.51 (4.43-6.76)	6.20 (4.69-7.86)	0.002
Neutrophil, × 109/L	3.54 (2.64-4.88)	3.23 (2.51-4.33)	4.04 (2.83-5.97)	< 0.001
Lymphocyte, × 109/L	1.37 (1.08-1.81)	1.48 (1.12-1.95)	1.30 (1.02-1.63)	0.001
Platelet, × 109/L	196 (150-253)	204 (160-260)	180 (140-235)	0.001
Monocyte, × 109/L	0.41 (0.30-0.54)	0.42 (0.31-0.54)	0.40 (0.30-0.55)	0.713
Glucose, mmol/L	4.54 (4.17-5.07)	4.40 (4.04-4.83)	4.84 (4.39-5.55)	< 0.001
Albumin, g/L	38.11 ± 4.96	37.80 ± 4.71	38.55 ± 5.26	0.113
Globulin, g/L	26.4 (23.7-29.8)	25.5 (22.8-28.2)	28.8 (25.1-31.6)	< 0.001
PT, s	13.1 (12.5-13.8)	12.8 (12.3-13.4)	13.5 (13.0-14.4)	< 0.001
PTR	1.05 (0.99-1.10)	1.03 (0.98-1.08)	1.06 (1.01-1.12)	< 0.001
INR	1.05 (0.99-1.10)	1.03 (0.98-1.08)	1.07 (1.01-1.13)	< 0.001
aPTT, s	35.0 (31.5-38.1)	33.5 (30.8-36.8)	36.3 (33.7-39.1)	< 0.001
TT, s	16.3 (15.6-16.9)	16.4 (15.7-17.0)	16.0 (15.3-16.8)	< 0.001
FIB, g/L	3.32 (2.76-4.16)	3.21 (2.62-3.82)	3.63 (2.93-4.59)	< 0.001
D-dimer, mg/L	0.9 (0.3-2.5)	0.5 (0.1-1.1)	2.0 (0.8-6.6)	< 0.001
FDP, mg/L	1.9 (0.9-4.9)	1.2 (0.7-2.5)	4.5 (1.7-16.2)	< 0.001

Data are shown as number of cases and percentage or median and interquartile range. aPTT: Activated partial prothrombin time; CA19-9: Carbohydrate antigen 19-9; CA72-4: Carbohydrate antigen 72-4; CEA: Carcinoembryonic antigen; FDP: Fibrin degradation products; FIB: Fibrinogen; INR: International normalized ratio; PT: Prothrombin time; PTR: Prothrombin ratio; TT: Thrombin time.

Table 2 Area under the receiver operating characteristic curves and cutoff values of diagnostic indicators at the maximum Youden index for bone metastasis

Parameter	AUC	95%CI	Cutoff	Sen	Spe	Youden index	PPV	NPV	P value
Age	0.558	0.501-0.616	59.5	0.546	0.583	0.129	0.433	0.546	0.046
CEA	0.694	0.639-0.748	3.97	0.649	0.711	0.36	0.665	0.711	< 0.001
CA19-9	0.673	0.617-0.729	12.81	0.655	0.649	0.304	0.614	0.649	< 0.001
CA72-4	0.624	0.560-0.688	6.71	0.518	0.747	0.265	0.603	0.747	< 0.001
Erythrocyte	0.623	0.571-0.675	4.43	0.423	0.797	0.220	0.498	0.423	< 0.001
Hemoglobin	0.599	0.547-0.651	133.50	0.427	0.759	0.186	0.488	0.427	< 0.001
Leukocyte	0.587	0.532-0.641	6.28	0.492	0.685	0.177	0.529	0.685	0.002
Neutrophil	0.63	0.576-0.683	4.23	0.484	0.749	0.233	0.581	0.749	< 0.001
Lymphocyte	0.591	0.539-0.644	1.43	0.552	0.642	0.194	0.508	0.552	0.001
Platelet	0.591	0.538-0.645	167.50	0.731	0.449	0.180	0.545	0.731	0.001
Glucose	0.664	0.613-0.716	4.82	0.524	0.748	0.272	0.595	0.748	< 0.001
Globulin	0.675	0.624-0.726	28.75	0.500	0.814	0.314	0.655	0.814	< 0.001
PT	0.738	0.692-0.784	13.25	0.651	0.709	0.360	0.618	0.709	< 0.001
PTR	0.622	0.570-0.675	1.09	0.407	0.785	0.193	0.579	0.785	< 0.001
INR	0.627	0.574-0.680	1.10	0.376	0.819	0.195	0.602	0.819	< 0.001
aPTT	0.678	0.629-0.727	35.15	0.640	0.640	0.280	0.563	0.640	< 0.001
TT	0.598	0.545-0.652	15.95	0.697	0.487	0.184	0.538	0.816	< 0.001
FIB	0.616	0.562-0.669	4.06	0.423	0.820	0.243	0.630	0.820	< 0.001
D-dimer	0.756	0.710-0.801	1.03	0.690	0.728	0.418	0.645	0.728	< 0.001
FDP	0.768	0.722-0.814	2.75	0.668	0.801	0.469	0.706	0.801	< 0.001
PP	0.879	0.841-0.917	0.364	0.831	0.806	0.637	0.745	0.806	< 0.001

aPTT: Activated partial prothrombin time; AUC: Area under receiver operating characteristic curve; CA19-9: Carbohydrate antigen 19-9; CA72-4: Carbohydrate antigen 72-4; CEA: Carcinoembryonic antigen; CI: Confidence interval; FDP: Fibrin degradation products; FIB: Fibrinogen; INR: International normalized ratio; NPV: Negative predictive value; PP: Prediction probability; PPV: Positive predictive value; PT: Prothrombin time; PTR: Prothrombin ratio; Sen: Sensitivity; Spe: Specificity; TT: Thrombin time.

Table 3 Univariate and multivariate binary logistic regression analyses of variables for bone metastasis

	Univariate analysis			Multivariate analysis
Parameter	Odds ratio	95%CI	P value	Odds ratio	95%CI	P value
Age	0.594	0.398-0.887	0.011	0.392	0.203-0.756	0.005
CEA	4.559	2.931-7.090	< 0.001	2.847	1.496-5.418	0.001
CA19-9	3.511	2.271-5.429	< 0.001			0.352
CA72-4	3.176	1.995-5.056	< 0.001			0.086
Erythrocyte	0.348	0.226-0.536	< 0.001	0.482	0.240-0.966	0.040
Hemoglobin	0.425	0.281-0.645	< 0.001			0.852
Leukocyte	2.102	1.426-3.099	< 0.001			0.693
Neutrophil	2.798	1.872-4.183	< 0.001			0.601
Lymphocyte	0.453	0.308-0.667	< 0.001			0.575
Platelet	0.452	0.304-0.672	< 0.001			0.066
Glucose	3.273	2.191-4.890	< 0.001			0.087
Globulin	4.367	2.861-6.667	< 0.001	4.253	2.114-8.558	< 0.001
PT	4.536	3.038-6.774	< 0.001	3.16	1.612-6.194	0.001
PTR	2.517	1.663-3.808	< 0.001			0.145
INR	2.727	1.771-4.199	< 0.001			0.072
aPTT	3.161	2.140-4.669	< 0.001	2.234	1.157-4.313	0.017
TT	0.535	0.344-0.833	0.006			0.842
FIB	3.342	2.179-5.125	< 0.001			0.193
D-dimer	5.952	3.939-8.993	< 0.001			0.956
FDP	8.103	5.271-12.457	< 0.001	3.17	1.637-6.139	0.001

The reference of parameters was set to be less than their cutoff values. aPTT: Activated partial prothrombin time; CA19-9: Carbohydrate antigen 19-9; CA72-4: Carbohydrate antigen 72-4; CEA: Carcinoembryonic antigen; CI: Confidence interval; FDP: Fibrin degradation products; FIB: Fibrinogen; INR: International normalized ratio; PT: Prothrombin time; PTR: Prothrombin ratio; TT: Thrombin time.