Prognostic significance of serum inflammation indices for different tumor infiltrative pattern types of gastric cancer

Table 1 Baseline characteristics of the patients

Characteristics	INFa (n = 183)	INFb (n = 331)	INFc (n = 448)
Sex
Male	133 (72.7)	248 (74.9)	308 (68.8)
Female	50 (27.3)	83 (25.1)	140 (31.2)
Age (yr)	58.81 ± 9.59	59.30 ± 9.73	57.06 ± 10.55
Borrmann type
0-1	31 (16.9)	51 (15.4)	21 (4.7)
2	62 (33.9)	105 (31.7)	104 (23.2)
3	74 (40.4)	138 (41.7)	242 (54.0)
4-5	16 (8.8)	37 (11.2)	81 (18.1)
Tumor location
Lower third	156 (85.2)	227 (68.6)	329 (73.4)
Middle third	21 (11.5)	64 (19.3)	75 (16.8)
Upper third	4 (2.2)	33 (10.0)	31 (6.9)
Entire stomach	2 (1.1)	7 (2.1)	13 (2.9)
Tumor size (mm)	44.40 ± 24.85	53.06 ± 25.78	56.31 ± 27.38
pTNM stage
I	72 (39.3)	70 (21.1)	36 (8.0)
II	60 (32.8)	127 (38.4)	137 (30.6)
III	51 (27.9)	134 (40.5)	275 (61.4)
Histological type
Well and medium differentiation	112 (61.2)	149 (45.0)	126 (28.1)
Poor differentiation	46 (25.1)	88 (26.6)	207 (46.2)
Others	25 (13.7)	94 (28.4)	115 (25.7)
mLNR	0.09 ± 0.16	0.12 ± 0.17	0.19 ± 0.22
Vascular infiltration
No	137 (74.9)	231 (69.8)	317 (70.8)
Yes	46 (25.1)	100 (30.2)	131 (29.2)
Nerve infiltration
No	123 (67.2)	198 (59.8)	251 (56.0)
Yes	60 (32.8)	133 (40.2)	197 (44.0)
Postoperative chemotherapy
Yes	58 (31.7)	90 (27.2)	167 (37.3)
No	125 (68.3)	241 (72.8)	281 (62.7)

Tumor infiltrative pattern, tumor location, postsurgical tumor node metastasis stage, histological type, mLNR, vascular infiltration and nerve infiltration were according to the postoperative pathology report. INF: Tumor infiltrative pattern; INFa: Expansive growth type; INFb: Intermediate type; INFc: Infiltrative growth type; mLNR: Metastatic lymph node ratio; pTNM: Postsurgical tumor node metastasis.

Table 2 Chi-square test analysis of the associations between the inflammation index and clinicopathological features

Characteristics	INFa			INFb			INFc
	SII ≤ 523.01 (119)	SII > 523.01 (64)	P value	PLR ≤ 134.02 (195)	PLR > 134.02 (136)	P value	PLR ≤ 134.02 (273)	PLR > 134.02 (175)	P value
Sex			0.443			0.979			0.489
Male	84 (70.6)	49 (76.6)		146 (74.9)	102 (75.0)		191 (70.0)	117 (66.9)
Female	35 (29.4)	15 (23.4)		49 (25.1)	34 (25.0)		82 (30.0)	58 (33.1)
Age (yr)			0.126			0.878			< 0.001
≤ 60	68 (57.1)	29 (45.3)		103 (52.8)	73 (53.7)		191 (70.0)	86 (49.1)
> 60	51 (42.9)	35 (54.7)		92 (47.2)	63 (46.3)		82 (30.0)	89 (50.9)
BMI			0.105			0.038			0.592
≤ 22.49	52 (43.7)	36 (56.3)		85 (43.6)	75 (55.1)		138 (50.5)	93 (53.1)
> 22.49	67 (56.3)	28 (43.7)		110 (56.4)	61 (44.9)		135 (49.5)	82 (46.9)
CEA			0.064			0.608			0.782
≤ 5 ng/mL	108 (90.8)	52 (81.2)		162 (83.1)	110 (80.9)		235 (86.1)	149 (85.1)
> 5 ng/mL	11 (9.2)	12 (18.8)		33 (16.9)	26 (19.1)		38 (13.9)	26 (14.9)
CA19-9			0.014			0.198			0.156
≤ 37 U/mL	112 (94.1)	53 (82.8)		168 (86.2)	110 (83.7)		246 (90.1)	150 (85.7)
> 37 U/mL	7 (5.9)	11 (17.2)		27 (13.8)	26 (16.3)		27 (9.9)	25 (14.3)
Borrmann type			0.005			0.051			0.454
0-2	71 (59.7)	22 (34.4)		84 (43.1)	72 (53.0)		80 (29.3)	45 (25.7)
3	40 (33.6)	34 (53.1)		92 (47.2)	46 (33.8)		141 (51.6)	101 (57.7)
4	8 (6.7)	8 (12.5)		19 (9.7)	18 (13.2)		52 (19.1)	29 (16.6)
Tumor diameter (mm)			< 0.001			< 0.001			< 0.001
≤ 50	95 (79.8)	31 (48.4)		131 (67.2)	63 (46.3)		172 (63.0)	75 (42.9)
> 50	24 (20.2)	33 (51.6)		64 (32.8)	73 (53.7)		101 (37.0)	100 (57.1)
Tumor location			0.992			0.051			0.423
Middle and upper third	16 (13.4)	9 (14.0)		57 (29.2)	40 (29.4)		62 (22.7)	44 (25.1)
Lower third	102 (85.7)	54 (84.4)		137 (70.3)	90 (66.2)		205 (75.1)	124 (70.9)
Entire stomach	1 (0.9)	1 (1.6)		1 (0.5)	6 (4.4)		6 (2.2)	7 (4.0)
Histological type			< 0.001			0.041			< 0.001
Well and medium differentiation	74 (62.2)	38 (59.4)		99 (50.8)	50 (36.8)		78 (28.6)	48 (27.4)
Poor differentiation	2 (1.7)	19 (30.0)		47 (24.1)	41 (30.1)		120 (43.9)	87 (49.7)
Others	18 (15.1)	7 (10.9)		49 (25.1)	45 (33.1)		75 (27.5)	40 (22.9)
pTNM stage			< 0.001			0.022			< 0.001
I	61 (51.3)	11 (17.2)		51 (26.2)	19 (14.0)		29 (10.6)	7 (4.0)
II	36 (30.2)	24 (37.5)		73 (37.4)	54 (39.7)		96 (35.2)	41 (23.4)
III	22 (18.5)	29 (45.3)		71 (36.4)	63 (46.3)		148 (54.2)	127 (72.6)
mLNR			0.019			0.290			0.001
≤ 0.07	84 (70.6)	34 (53.1)		109 (55.9)	68 (50.0)		131 (48.0)	56 (32.0)
> 0.07	35 (29.4)	30 (46.9)		86 (44.1)	68 (50.0)		142 (52.0)	119 (68.0)
Vascular infiltration			0.494			0.030			0.146
No	91 (76.5)	46 (71.9)		145 (74.4)	86 (63.2)		200 (73.3)	117 (66.9)
Yes	28 (23.5)	18 (28.1)		50 (25.6)	50 (36.8)		73 (26.7)	58 (33.1)
Nerve infiltration			0.098			0.592			0.238
No	85 (71.4)	38 (59.4)		119 (61.0)	79 (58.1)		159 (58.2)	92 (52.6)
Yes	34 (28.6)	26 (40.6)		76 (39.0)	57 (41.9)		114 (41.8)	83 (47.4)

Carcino-embryonic antigen and carbohydrate antigen 19-9 were according to the tumor marker examination. Tumor infiltrative pattern, tumor location, postsurgical tumor node metastasis stage, histological type, mLNR, vascular infiltration and nerve infiltration were according to the postoperative pathology report. Statistically significant P values are in bold (P < 0.05). INF: Tumor infiltrative pattern; INFa: Expansive growth type; INFb: Intermediate type; INFc: Infiltrative growth type; BMI: body mass index; CEA: Carcino-embryonic antigen; CA19-9: Carbohydrate antigen 19-9; mLNR: Metastatic lymph node ratio; pTNM: Postsurgical tumor node metastasis.

Table 3 Prognostic factors of patients with gastric cancer by univariate and multivariate analyses based on logistic regression analysis in the expansive growth type group

Characteristics	INFa
	Univariate analysis		Multivariate analysis
	HR (95%CI)	P value	HR (95%CI)	P value
Sex		0.584
Male	1
Female	1.261 (0.550-2.894)
Age (yr)	1.019 (0.979-1.061)	0.349
BMI	0.880 (0.772-1.003)	0.055
SII	1.002 (1.001-1.003)	0.001	1.001 (1.000-1.003)	0.039
ALT	0.988 (0.954-1.023)	0.491
Total protein	0.968 (0.916-1.023)	0.251
CEA	1.030 (0.996-1.065)	0.087
CA19-9	1.002 (0.998-1.006)	0.278
Borrmann type		0.007		0.272
0-1	1		1
2	3.818 (0.448-32.517)	0.220	5.312 (0.450-62.711)	0.185
3	8.947 (1.135-70.530)	0.038	5.450 (0.496-59.870)	0.166
4-5	23.333 (2.525-215.647)	0.005	14.134 (0.944-211.701)	0.055
Tumor location		0.691
Lower third	1
Middle third	1.176 (0.366-3.782)	0.785
Upper third	1.667 (0.167-16.657)	0.664
Entire stomach	5.000 (0.303-82.520)	0.261
Tumor size (mm)	1.032 (1.016-1.049)	< 0.001	1.012 (0.989-1.034)	0.310
pTNM stage		< 0.001		0.796
I	1		1
II	2.615 (0.747-9.159)	0.133	0.660 (0.154-2.830)	0.576
III	10.968 (3.457-34.794)	< 0.001	0.532 (0.080-3.525)	0.513
Histological type		0.160
Well and medium differentiation	1
Poor differentiation	2.282 (0.972-5.360)	0.058
Others	1.617 (0.527-4.959)	0.401
mLNR	438.799 (38.101-5053.535)	< 0.001	471.355 (8.218-27035.275)	0.003
Vascular infiltration		0.080
No	1
Yes	2.065 (0.917-4.647)
Nerve infiltration		0.025		0.621
No	1		1
Yes	2.432 (1.118-5.288)		1.286 (0.474-3.490)
Postoperative chemotherapy		0.720
Yes	1
No	1.159 (0.517-2.597)

Carcinoembryonic antigen and carbohydrate antigen 19-9 were according to the tumor marker examination. Tumor infiltrative pattern, tumor location, postsurgical tumor node metastasis stage, histological type, metastatic lymph node ratio, vascular infiltration and nerve infiltration were according to the postoperative pathology report. Statistically significant P values are in bold (P < 0.05). INF: Tumor infiltrative pattern; INFa: Expansive growth type; INFb: Intermediate type; INFc: Infiltrative growth type; HR: Hazard ratio; BMI: Body mass index; SII: Systemic immune-inflammation index; ALT: Alanine transaminase; CEA: Carcinoembryonic antigen; CA19-9: Carbohydrate antigen 19-9; mLNR: Metastatic lymph node ratio; pTNM: Postsurgical tumor node metastasis.

Table 4 Prognostic factors of patients with gastric cancer by univariate and multivariate analyses based on logistic regression analysis in the intermediate type group

Characteristics	INFb
	Univariate analysis		Multivariate analysis
	HR (95%CI)	P value	HR (95%CI)	P value
Sex		0.115
Male	1
Female	0.617 (0.339-1.124)
Age (yr)	1.033 (1.007-1.061)	0.014	1.036 (1.004-1.069)	0.026
BMI	0.814 (0.746-0.888)	< 0.001	0.861 (0.781-0.950)	0.003
PLR	1.008 (1.003-1.012)	< 0.001	1.006 (1.001-1.012)	0.018
ALT	0.976 (0.949-1.004)	0.094
Total protein	0.975 (0.946-1.004)	0.092
CEA	1.004 (0.995-1.014)	0.338
CA19-9	1.003 (1.001-1.006)	0.012	1.000 (0.998-1.003)	0.650
Borrmann type		0.005		0.226
0-1	1		1
2	1.031 (0.430-2.473)	0.945	0.715 (0.246-2.079)	0.538
3	2.410 (1.081-5.372)	0.031	1.530 (0.554-4.223)	0.412
4-5	3.182 (1.201-8.429)	0.020	1.339 (0.374-4.797)	0.654
Tumor location		0.088	-	-
Lower third	1
Middle third	1.195 (0.641-2.228)	0.575
Upper third	1.527 (0.697-3.345)	0.290
Entire stomach	7.634 (1.441-40.446)	0.017
Tumor size (mm)	1.021 (1.012-1.032)	< 0.001	1.007 (0.994-1.021)	0.302
pTNM stage		< 0.001		< 0.001
I	1		1
II	3.929 (1.120-13.785)	0.033	2.036 (0.528-7.856)	0.302
III	23.010 (6.895-76.795)	< 0.001	8.306 (2.053-33.597)	0.003
Histological types		0.739
Well and medium differentiation	1
Poor differentiation	1.105 (0.617-1.977)	0.738
Others	0.853 (0.472-1.542)	0.599
mLNR	87.343 (18.612-409.881)	< 0.001	2.267 (0.291-17.641)	0.434
Vascular infiltration		< 0.001		0.149
No	1		1
Yes	3.160 (1.897-5.263)		1.585 (0.848-2.963)
Nerve infiltration		0.003		0.859
No	1		1
Yes	2.097 (1.283-3.428)		1.057 (0.573-1.951)
Postoperative chemotherapy		0.493
Yes	1
No	0.823 (0.472-1.436)

Carcinoembryonic antigen and carbohydrate antigen 19-9 were according to the tumor marker examination. Tumor infiltrative pattern, tumor location, postsurgical tumor node metastasis stage, histological type, metastatic lymph node ratio, vascular infiltration and nerve infiltration were according to the postoperative pathology report. Statistically significant P values are in bold (P < 0.05). INF: Tumor infiltrative pattern; INFa: Expansive growth type; INFb: Intermediate type; INFc: Infiltrative growth type; HR: Hazard ratio; BMI: Body mass index; PLR: Platelet–lymphocyte ratio; ALT: Alanine transaminase; CEA: Carcinoembryonic antigen; CA19-9: Carbohydrate antigen 19-9; mLNR: Metastatic lymph node ratio; pTNM: Postsurgical tumor node metastasis.

Table 5 Prognostic factors of patients with gastric cancer by univariate and multivariate analyses based on logistic regression analysis in the infiltrative growth type group

Characteristics	INFc
	Univariate analysis		Multivariate analysis
	HR (95%CI)	P value	HR (95%CI)	P value
Sex		0.570
Male	1
Female	0.889 (0.592-1.335)
Age (yr)	1.028 (1.009-1.047)	0.003	1.026 (1.004-1.049)	0.021
BMI	0.965 (0.915-1.017)	0.184
PLR	1.007 (1.004-1.010)	< 0.001	1.004 (1.001-1.008)	0.021
ALT	0.984 (0.966-1.003)	0.096
Total protein	0.995 (0.973-1.018)	0.683
CEA	1.006 (0.998-1.014)	0.161
CA19-9	1.000 (1.000-1.006)	0.020	1.001 (0.999-1.004)	0.387
Borrmann type		< 0.001		0.055
0-1	1		1
2	2.104 (0.574-7.708)	0.262	1.193 (0.290-4.903)	0.807
3	4.298 (1.233-14.981)	0.022	1.781 (0.460-6.891)	0.403
4-5	14.250 (3.837-52.919)	< 0.001	3.735 (0.835-16.696)	0.085
Tumor location		< 0.001		0.059
Lower third	1		1
Middle third	2.791 (1.669-4.670)	< 0.001	1.952 (1.052-3.622)	0.034
Upper third	1.985 (0.947-4.160)	0.069	1.955 (0.820-4.658)	0.130
Entire stomach	22.330 (2.867-173.902)	0.003	4.687 (0.523-41.965)	0.167
Tumor size (mm)	1.028 (1.020-1.037)	< 0.001	1.004 (0.993-1.016)	0.433
pTNM stage		< 0.001		0.028
I	1		1
II	10.667 (1.405-80.956)	0.022	8.549 (1.073-68.125)	0.043
III	45.208 (6.106-334.716)	< 0.001	13.795 (1.693-112.382)	0.014
Histological types		0.643
Well and medium differentiation	1
Poor differentiation	1.026 (0.656-1.604)	0.912
Others	0.826 (0.493-1.384)	0.468
mLNR	93.645 (30.921-283.603)	< 0.001	11.042 (2.407-50.664)	0.002
Vascular infiltration		< 0.001		0.783
No	1		1
Yes	2.899 (1.905-4.411)		1.080 (0.623-1.874)
Nerve infiltration		0.029		0.471
No	1		1
Yes	1.524 (1.044-2.226)		1.187 (0.745-1.892)
Postoperative chemotherapy		0.315
Yes	1
No	0.891 (0.554-1.209)

Carcinoembryonic antigen and carbohydrate antigen 19-9 were according to the tumor marker examination. Tumor infiltrative pattern, tumor location, postsurgical tumor node metastasis stage, histological type, metastatic lymph node ratio, vascular infiltration and nerve infiltration were according to the postoperative pathology report. Statistically significant P values are in bold (P < 0.05). INF: Tumor infiltrative pattern; INFa: Expansive growth type; INFb: Intermediate type; INFc: Infiltrative growth type; HR: Hazard ratio; BMI: Body mass index; PLR: Platelet–lymphocyte ratio; ALT: Alanine transaminase; CEA: Carcinoembryonic antigen; CA19-9: Carbohydrate antigen 19-9; mLNR: Metastatic lymph node ratio; pTNM: Postsurgical tumor node metastasis.