Zhang L, Chen YP, Ji M, Ying LQ, Huang CC, Zhou JY, Liu L. Inflammation-related markers and prognosis of alpha-fetoprotein producing gastric cancer. World J Gastrointest Oncol 2024; 16(9): 3875-3886 [DOI: 10.4251/wjgo.v16.i9.3875]
Corresponding Author of This Article
Lin Liu, MD, Chief Physician, Department of Oncology, Zhongda Hospital, Medical School of Southeast University, No. 87 Dingjiaqiao, Nanjing 210009, Jiangsu Province, China. 101012478@seu.edu.cn
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Retrospective Study
Open-Access Policy of This Article
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: http://creativecommons.org/licenses/by-nc/4.0/
World J Gastrointest Oncol. Sep 15, 2024; 16(9): 3875-3886 Published online Sep 15, 2024. doi: 10.4251/wjgo.v16.i9.3875
Inflammation-related markers and prognosis of alpha-fetoprotein producing gastric cancer
Lu Zhang, Yan-Ping Chen, Min Ji, Le-Qian Ying, Chun-Chun Huang, Jing-Yi Zhou, Lin Liu
Lu Zhang, Yan-Ping Chen, Min Ji, Le-Qian Ying, Chun-Chun Huang, Jing-Yi Zhou, Lin Liu, Department of Oncology, Zhongda Hospital, Medical School of Southeast University, Nanjing 210009, Jiangsu Province, China
Author contributions: Liu L designed and directed the study; Zhang L wrote the manuscript draft; Liu L and Chen YP critically reviewed the manuscript; Zhang L, Ji M, Ying LQ, Huang CC and Zhou JY collected the original data; All authors reviewed the manuscript.
Institutional review board statement: This study design was approved by the ethics board of Zhongda Hospital of Southeast University, No. 2019ZDSYLL067-P01.
Informed consent statement: Informed consent of the patients could be waived because it was retrospective, and all information was anonymous.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Data sharing statement: The data that support the findings of this study are available upon reasonable request at 101012478@seu.edu.cn.
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: Lin Liu, MD, Chief Physician, Department of Oncology, Zhongda Hospital, Medical School of Southeast University, No. 87 Dingjiaqiao, Nanjing 210009, Jiangsu Province, China. 101012478@seu.edu.cn
Received: May 4, 2024 Revised: June 20, 2024 Accepted: July 15, 2024 Published online: September 15, 2024 Processing time: 127 Days and 23.3 Hours
Abstract
BACKGROUND
Inflammation-related markers including neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), monocyte-to-lymphocyte ratio (MLR), systemic immune-inflammation index (SII), systemic inflammation response index (SIRI) and prognostic nutritional index (PNI) could reflect tumor immune microenvironment and predict prognosis of cancers. However, it had not been explored in alpha-fetoprotein (AFP) producing gastric cancer (GC).
AIM
To determine the predictive value of inflammation-related peripheral blood markers including as NLR, PLR, MLR, SII, SIRI and PNI in the prognosis of AFP- producing GC (AFPGC). Besides, this study would also compare the differences in tumor immune microenvironment, clinical characteristics and prognosis between AFPGC and AFP- GC patients to improve the understanding of this disease.
METHODS
573 patients enrolled were retrospectively studied. They were divided into AFP+ group (AFP ≥ 20 ng/mL) and AFP- group (AFP < 20 ng/mL), comparing the levels of NLR/PLR/MLR/SII/SIRI/PNI and prognosis. In AFP+ group, the impact of NLR/PLR/MLR/SII/SIRI/PNI and their dynamic changes on prognosis were further explored.
RESULTS
Compared with AFP- patients, AFP+ patients had higher NLR/PLR/MLR/SII/SIRI and lower PNI levels and poorer overall survival (OS). In the AFP+ group, mortality was significantly lower in the lower NLR/PLR/MLR/SII/SIRI group and higher PNI group. Moreover, the dynamic increase (NLR/PLR/MLR/SII/SIRI) or decrease (PNI) was associated with the rise of mortality within 1 year of follow-up.
CONCLUSION
Compared with AFP- patients, the level of inflammation-related peripheral blood markers significantly increased in AFP+ patients, which was correlated with OS of AFP+ patients. Also, the gradual increase of SII and SIRI was associated with the risk of death within one year in AFP+ patients. AFPGC should be considered as a separate type and distinguished from AFP- GC because of the difference in tumor immune microenvironment. It requires basic experiments and large clinical samples in the future.
Core Tip: Compared with alpha-fetoprotein (AFP)- patients, the level of inflammation-related peripheral blood markers significantly increased in AFP+ patients, which was correlated with overall survival of AFP+ patients. AFP- producing gastric cancer (AFPGC) should be considered as a separate type and distinguished from AFP- gastric cancer because of the difference in tumor immune microenviroment. It might have different response rates in immunotherapy, which provided basis for selection of immunotherapy for AFPGC.
