| Objective:The systemic immune inflammation index(SII),neutrophil-to-lymphocyte ratio(NLR)and platelet-to-lymphocyte ratio(PLR)are serological markers that reflect the level of inflammation in the host organism.The purpose of this study was to investigate the predictive value of SII,NLR and PLR alone and in combination for gastric cancer.And to investigate the relationship between SII,NLR and PLR and clinicopathological features of gastric cancer.Methods:One hundred and twenty-five patients with gastric cancer initially diagnosed at Taiyuan Central Hospital,affiliated with the Ninth Clinical Medical College of Shanxi Medical University,from May 2017 to March 2022 were chosen as the observation group,and the control group consisted of 125 people without physical illness who visited our hospital for routine physical examinations during the same period.Information on age,gender,routine blood results and clinicopathological characteristics and postoperative TNM stage of malignant tumor in the stomach patients were collected from all subjects,and peripheral circulation inflammatory markers PLR,NLR and SII of all subjects were calculated from routine blood results.Comparison between groups by Mann-Whitney U-test or t-test.Chi-square tests were used to assess secondary categorical variables.The Kruskal-Wallis test was used for intercomparison of comprehensive inflammatory markers in venous blood between control group and patients with different stages of gastric cancer,and the Bonferroni correction was used for two-way comparisons.Receiver operating characteristic curve(ROC)and area under curve(AUC)were plotted to evaluate the predictive value of each indicator for gastric cancer.P<0.05 was considered statistically significant.Results:1.Comparison of the differences in SII,NLR and PLR levels between the two groups.Compared with the healthy people without diseases,gastric cancer patients had significantly higher SII,NLR,and PLR values,higher WBC platelet and neutrophil counts,and a lower lymphocyte count(all P < 0.05).2.We evaluated the predictive efficacy of SII,NLR and PLR when applied alone for gastric cancer.The AUC of SII was 0.831(95% confidence interval [CI]: 0.777-0.885),the AUC of NLR was 0.821(95% CI: 0.769-0.873)and the AUC of PLR was 0.783(95% CI: 0.726-0.840).The AUC of SII was significantly greater than that of NLR(P =0.017)and PLR(P = 0.020).the AUC of NLR was greater than that of PLR(P = 0.003).the sensitivity(Se)and specificity(Sp)of SII were the highest,68.80% and 94.40%,respectively.The optimal truncation values of SII,NLR and PLR for predicting gastric cancer were 438.7,2.1 and 139.5,respectively.3.We conducted a comprehensive evaluation of the predictive efficacy of SII,NLR and PLR when applied in combination for gastric cancer.the AUC for the combined index of SII,NLR and PLR was 0.843(95% CI: 0.791-0.885),the AUC for the combined index of SII and NLR was 0.837(95% CI: 0.785-0.880),and the AUC for the combined index of SII and The AUC of the combined index of SII and NLR was 0.835(95% CI:0.783-0.879).The AUC of the three combined indicators was significantly higher than that of the combination of SII and NLR and the combination of SII and PLR(all P <0.05).Compared with the single application of SII,NLR or PLR,the AUC of the three combined indexes increased significantly(all P < 0.05).4.We analyzed the differences between SII,NLR,and PLR among patients with different stages.Following TNM staging stratification,our research showed that SII,NLR,and PLR were significantly greater in patients with Ⅰ/Ⅱ stage and Ⅲ/Ⅳ stage gastric cancer compared to controls,and that all three markers were higher in the Ⅲ/Ⅳstage compared to the Ⅰ/Ⅱ stage(all P < 0.05).5.Separate analyses of SII,NLR,and PLR revealed that the levels of all three were obviously related with maximum diameter of malignant tumor,number of lymph node metastases,and serosa invasion(all P < 0.05).Elevated levels of the NLR or SII were linked to distant metastasis(all P < 0.001).There was no correlation between the levels of each of the three indices and the degree of tumor differentiation,tumor location,and the presence of lymphovascular or nerve infiltration(all P > 0.05).Conclusion:Preoperative SII,NLR and PLR can be used as predictors of gastric cancer.When applied alone,SII has the highest predictive value,while the combination of the three has the highest predictive value for gastric cancer.In addition,SII,NLR and PLR are significantly correlated with the clinical staging and clinicopathological features of gastric cancer,which can be used as the basis for preoperative assessment of biological behavior of gastric cancer. |
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