Development and validation of a novel nomogram for predicting overall survival in gastric cancer based on inflammatory markers

Table 1 Baseline demographics and clinical characteristics of patients in the training and validation cohorts, n (%)

Variables	Training cohort (n = 543)	Validation cohort (n = 361)	P value
Pathological types			0.369
Adenocarcinoma	96 (91.3)	336 (93.1)
Signet-ring cell	25 (4.6)	14 (3.9)
Adenosquamous	1 (0.2)	2 (0.6)
Squamous carcinoma	4 (0.7)	4 (1.1)
Mucinous cell	17 (3.1)	5 (1.4)
Macroscopic type			0.932
Borrmann I	22 (4.1)	15 (4.2)
Borrmann II	391 (72.0)	260 (72.0)
Borrmann III	113 (20.8)	72 (19.9)
Borrmann IV	17 (3.1)	14 (3.9)
Tumor location			0.415
Upper	250 (46.1)	156 (43.3)
Middle	123 (22.7)	85 (23.6)
Lower	169 (31.2)	119 (33.1)
Surgery selection			0.344
Distal gastrectomy	117 (21.5)	88 (24.4)
Total gastrectomy	401 (73.8)	261 (72.6)
Proximal gastric resection	25 (4.6)	11 (3.0)
Differentiated grade			0.662
High	25 (4.6)	16 (4.4)
Middle	268 (49.5)	181 (50.2)
Poor	248 (45.9.3)	164 (45.4)
Sex			0.669
Male
Female	142 (26.2)	89 (24.7)
Age			0.925
< 60
≥ 60	334 (61.5)	224 (62)
Neutrophil count	3.17 ± 4.49	2.89 ± 4.06	0.326
Platelet count	196.5 ± 71.70	205.48 ± 84.35	0.086
Lymphocyte count	1.64 ± 1.68	1.58 ± 0.59	0.491

Table 2 Univariate analysis of the training cohort

Characteristics	β	HR (95%CI)	P value
Sex (male/female)	-0.305	0.737 (0.546, 0.995)	0.046
Age (< 60 / ≥ 60 yr)	0.333	1.395 (1.071, 1.818)	0.014
NLR (< 2 / ≥ 2)	0.406	1.502 (1.163, 1.940)	0.001
Tumor size (< 5 / ≥ 5 cm)	0.810	2.248 (1.746, 2.894)	< 0.001
TNM stage	1.062	2.892 (1.897, 4.409)	< 0.001
Histologic type	-0.788	0.455 (0.140, 1.478)	0.190
Neutrophil count	0.007	0.992 (0.963, 1.023)	0.622
Platelet count	0.001	0.999 (0.997, 1.000)	0.247
Lymphocyte count	0.048	1.049 (0.966, 1.139)	0.259
PLR (< 120/> 120)	0.482	1.619 (1.251, 2.096)	< 0.001
Pathological types	-0.614	0.541 (0.255, 1.148)	1.148
Macroscopic type	-0.114	0.893 (0.486, 1.640)	0.714
Tumor location	-0.102	0.903 (0.543, 1.502)	0.695
Surgery selection	0.098	0.903 (0.806, 1.508)	0.540
CEA (5 g/L)	1.238	3.449 (2.679, 4.440)	< 0.001
SII (< 475.6/ > 475.6)	0.632	1.881 (1.464, 2.417)	< 0.001
NLR-PLR	0.286	1.331 (1.194, 1.483)	< 0.001
NLR-PLT	0.269	1.308 (1.158, 1.477)	< 0.001
Hemoglobin	-0.350	0.705 (0.549, 0.905)	0.006

HR: Hazard ratio; TNM: Tumor node metastasis; CEA: Carcinoembryonic antigen; SII: Systemic immune-inflammation index; NLR: Neutrophil-to-lymphocyte ratio; PLR: Platelet-to-lymphocyte ratio; PLT: Platelet; CI: Confidence interval.

Table 3 Multivariate analysis of the training cohort

Characteristic	Beta	HR (95%CI)	P value
TNM	0.888	2.429 (1.588, 3.716)	< 0.001
CEA	0.839	2.313 (1.774, 3.015)	< 0.001
SII	0.405	1.499 (1.165, 1.930)	0.002
Age	0.303	1.354 (1.034, 1.771)	0.028

HR: Hazard ratio; TNM: Tumor node metastasis; CEA: Carcinoembryonic antigen; SII: Systemic immune-inflammation index; CI: Confidence interval.

Table 4 Nomogram scoring system

SII	Points	Age	Points	CEA	Points	TNM	Points
1	0	1	0	1	0	I	0
2	26	2	20	2	55	II	58
						III	100

1: Low group; 2: High group; TNM: Tumor-Node-Metastasis; CEA: Carcinoembryonic antigen; SII: Systemic immune-inflammation index.