Retrospective Study
Copyright ©The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastrointest Oncol. Apr 15, 2022; 14(4): 897-919
Published online Apr 15, 2022. doi: 10.4251/wjgo.v14.i4.897
Prognostic significance of serum inflammation indices for different tumor infiltrative pattern types of gastric cancer
Yu-Fei Wang, Xin Yin, Tian-Yi Fang, Yi-Min Wang, Lei Zhang, Xing-Hai Zhang, Dao-Xu Zhang, Yao Zhang, Xi-Bo Wang, Hao Wang, Ying-Wei Xue
Yu-Fei Wang, Xin Yin, Tian-Yi Fang, Yi-Min Wang, Dao-Xu Zhang, Yao Zhang, Xi-Bo Wang, Hao Wang, Ying-Wei Xue, Department of Gastroenterological Surgery, Harbin Medical University Cancer Hospital, Harbin 150081, Heilongjiang Province, China
Lei Zhang, Xing-Hai Zhang, Department of Pathology, Harbin Medical University Cancer Hospital, Harbin 150081, Heilongjiang Province, China
Author contributions: Wang YF and Yin X designed and conceived this project, and they contributed equally to this work; Wang YF, Yin X, Fang TY and Wang YM, Zhang L, Zhang XH interpreted and analyzed the data; Xue YW revised the manuscript for important intellectual content; Wang YF, Yin X, Fang TY, Wang YM, Zhang L, Zhang XH, Zhang DX, Zhang Y, Wang XB, Wang H participated in the patient information collection; all authors read and approved the final manuscript.
Supported by the Harbin Science and Technology Bureau Research and Development Project of Applied Technology, No. 2017RAXXJ054; and Nn 10 Program of Harbin Medical University Cancer Hospital, No. Nn 10 PY 2017-03.
Institutional review board statement: The study was approved by the Ethics Committee of the Affiliated Tumor Hospital of Harbin Medical University.
Informed consent statement: All study participants or their legal guardian provided informed written consent about personal and medical data collection prior to study enrolment.
Conflict-of-interest statement: All the authors have no conflict of interest related to the manuscript.
Data sharing statement: Patients’ data were saved in the Gastric Cancer Information Management System v1.2 of Harbin Medical University Cancer Hospital (Copyright No. 2013SR087424, http://www.sgihmu.com).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (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: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Ying-Wei Xue, PhD, Chief Doctor, Professor, Department of Gastroenterological Surgery, Harbin Medical University Cancer Hospital, No. 150 Haping Road, Harbin 150081, Heilongjiang Province, China. xueyingwei@hrbmu.edu.cn
Received: August 7, 2021
Peer-review started: August 7, 2021
First decision: October 3, 2021
Revised: October 8, 2021
Accepted: February 22, 2022
Article in press: February 22, 2022
Published online: April 15, 2022
Abstract
BACKGROUND

Inflammatory indices are considered to be potential prognostic biomarkers for patients with gastric cancer (GC). However, there is no evidence defining the prognostic significance of inflammatory indices for GC with different tumor infiltrative pattern (INF) types.

AIM

To evaluate the significance of inflammatory indices and INF types in predicting the prognosis of patients with GC.

METHODS

A total of 962 patients who underwent radical gastrectomy were retrospectively selected for this study. Patients were categorized into the expansive growth type (INFa), the intermediate type (INFb), and the infiltrative growth type (INFc) groups. The cutoff values of inflammatory indices were analyzed by receiver operating characteristic curves. The Kaplan–Meier method and log-rank test were used to analyze overall survival (OS). The chi-square test was used to analyze the association between inflammatory indices and clinical characteristics. The independent risk factors for prognosis in each group were analyzed by univariate and multivariate analyses based on logistic regression. Nomogram models were constructed by R studio.

RESULTS

The INFc group had the worst OS (P < 0.001). The systemic immune-inflammation index (P = 0.039) and metastatic lymph node ratio (mLNR) (P = 0.003) were independent risk factors for prognosis in the INFa group. The platelet-lymphocyte ratio (PLR) (P = 0.018), age (P = 0.026), body mass index (P = 0.003), and postsurgical tumor node metastasis (pTNM) stage (P < 0.001) were independent risk factors for prognosis in the INFb group. The PLR (P = 0.021), pTNM stage (P = 0.028), age (P = 0.021), and mLNR (P = 0.002) were independent risk factors for prognosis in the INFc group. The area under the curve of the nomogram model for predicting 5-year survival in the INFa group, INFb group, and INFc group was 0.787, 0.823, and 0.781, respectively.

CONCLUSION

The outcome of different INF types GC patients could be assessed by nomograms based on different inflammatory indices and clinicopathologic features.

Keywords: Gastric cancer, Tumor infiltrative pattern, Systemic immune-inflammation index, Platelet-lymphocyte ratio, Prognosis, Nomogram

Core Tip: This is a retrospective study to analyze the relationship between peripheral circulating immune cells, inflammatory indices and the tumor infiltrative pattern (INF) types and to verify their ability to evaluate the outcome of gastric cancer (GC) patients. Our results showed that the systemic immune-inflammation index and platelet–lymphocyte ratio were independent prognostic factors for the expansive growth type, the intermediate type, and the infiltrative growth type groups. Based on different inflammatory indicators and clinicopathologic features, the nomogram models can predict the prognosis of different INF types GC patients, which deserve further testing and extension in clinical practice.