Objective To investigate the efficacy of thromboelastography (TEG) combined with D-dimer (D-D) and fibrinogen (Fib) in predicting venous thromboembolism (VTE) in patients with gastric cancer.

Methods Based on the inclusion and exclusion criteria, clinical data from 150 patients with gastric cancer in the Tumor Hospital Affiliated to Xinjiang Medical University from January 2022 to December 2023 were collected. The patients were divided into thrombus group (n=29) and non-thrombus group (n=121) according to their thrombotic status. TEG parameters reaction time (R value), coagulation time (K value), clot angle (α angle), and maximum amplitude (MA) value as well as Fib and D-D levels were compared between the two groups. Logistic regression analysis and receiver operating characteristic (ROC) curve were used to evaluate the predictive value of each indicator alone and their combination for VTE.

Results No significant differences were observed between the thrombus and non-thrombus groups in terms of age, gender, ethnicity, pathological type, degree of infiltration, lymph node metastasis, distant metastasis, and Khorana score (P>0.05). Significant differences were observed in TEG parameters (R value, K value, α angle, and MA value) and conventional coagulation indicators (Fib and D-D levels) between the two groups (P < 0.05). Logistic regression model analysis revealed that R value, K value, α angle, MA value, Fib and D-D were relevant risk factors for thrombosis in patients with gastric cancer (P < 0.05). The area under the curve (AUC) for MA value in predicting VTE was 0.931, with a sensitivity of 0.909 and a specificity of 0.862, making it the optimal single indicator. The AUC for the combined prediction of all indicatorswas 0.940, with a sensitivity of 0.759 and a specificity of 0.967.

Conclusion TEG combined with D-D and Fib exhibits a synergistic effect in predicting VTE in patients with gastric cancer, and MA value can serve as a high-precision independent predictive marker.