Potential biomarkers for the prognosis of gastrointestinal stromal tumors

Table 1 Relationship between systemic inflammatory markers and the prognosis of gastrointestinal stromal tumors

Inflammatory markers	Impact	Mechanism	Threshold value	Ref.
NLR	High preoperative NLR is associated with decreased DFS and is an independent prognostic factor	Higher NLR may reflect the inflammatory state and immunosuppressive state of the body, which may be related to tumor progression and response to treatment	1.92-6	Kumarasamy et al[14], Bigot et al[20], Malietzis et al[21]
SII	A promising predictor for RFS and effect of neoadjuvant therapy	A high level of SII indicates an enhanced systemic inflammatory state and a weakened immune response, while a high level of SII may indicate that the inflammatory microenvironment promotes tumor invasion and metastasis	544.6-820.0	Goh et al[16], Lu et al[17]
PLR	High PLR is an independent prognostic factor for RFS in patients with GIST	High PLR may indicate the immune surveillance ability is decreased, which may be related to tumor progression	275
PENK	High expression of PENK was associated with superior OS and RFS in patients with GIST	PENK is a neuropeptide precursor, which may affect the proliferation and apoptosis of tumor cells through its interaction with opioid receptors. The high expression of PENK may be related to the tumor inhibition pathway	IHC score ≥ 4: PENK positive. IHC score < 4: PENK negative
GNRI	A promising predictor for RFS	GNRI is an objective nutritional assessment method based on serum albumin levels and body weight ratios, reflecting the nutritional status of patients to influence prognosis	98.3	Lu et al[17]
PNI	A promising predictor for effect of neoadjuvant therapy	PNI reflects the nutritional status and immune function of patients. Low PNI may indicate decreased immune function and poor nutritional status, further promoting the formation of an inflammatory microenvironment	47.2
MLR	As a prognostic indicator for the recurrence of GIST, with elevated MLR correlating with an increased risk of postoperative recurrence	Monocytes and lymphocytes play crucial roles in the immune modulation within the tumor microenvironment. A high MLR may signify underlying chronic inflammation, which could facilitate tumor progression and recurrence. Furthermore, an elevated MLR might reflect compromised immune surveillance capabilities	/
SLITRK3	SLITRK3 expression is closely associated with OS and DFS in GIST patients	Elevated levels of SLITRK3 may be linked to the aggressiveness and unfavorable prognosis of GIST; however, the precise mechanisms underlying its action and the critical pathways involved in GIST remain to be elucidated	IHC score ≥ 4: SLITRK3 positive. IHC score < 4: SLITRK3 negative

DFS: Disease-free survival; GNRI: Geriatric nutritional risk index; IHC: Immunohistochemical; MLR: Monocyte-to-lymphocyte ratio; NLR: Neutrophil-to-lymphocyte ratio; OS: Overall survival; PENK: Proenkephalin; PLR: Platelet-to-lymphocyte ratio; PNI: Prognostic nutritional index; RFS: Recurrence-free survival; SII: Systemic immune-to-inflammation index.