Zhang JW. Systemic inflammatory markers in gastric ulcer: Leveraging routine blood tests. World J Gastroenterol 2026; 32(1): 114172 [DOI: 10.3748/wjg.v32.i1.114172]
Corresponding Author of This Article
Jin-Wei Zhang, MD, Doctor, Institute of Biomedical and Clinical Sciences, Medical School, Faculty of Health and Life Sciences, University of Exeter, Hatherly Laboratories, Streatham Campus, Stocker Road, Exeter EX4 4PS, United Kingdom. j.zhang5@exeter.ac.uk
Research Domain of This Article
Biology
Article-Type of This Article
Editorial
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 Gastroenterol. Jan 7, 2026; 32(1): 114172 Published online Jan 7, 2026. doi: 10.3748/wjg.v32.i1.114172
Systemic inflammatory markers in gastric ulcer: Leveraging routine blood tests
Jin-Wei Zhang
Jin-Wei Zhang, Institute of Biomedical and Clinical Sciences, Medical School, Faculty of Health and Life Sciences, University of Exeter, Hatherly Laboratories, Streatham Campus, Exeter EX4 4PS, United Kingdom
Jin-Wei Zhang, State Key Laboratory of Chemical Biology, Research Center of Chemical Kinomics, Shanghai Institute of Organic Chemistry, Chinese Academy of Sciences, Shanghai 200032, China
Author contributions: Zhang JW designed the overall concept and outline of the manuscript, contributed to the discussion and design of the manuscript, the writing and editing of the manuscript, illustrations, and review of the literature.
Supported by the National Natural Science Foundation of China, No. 82170406 and No. 81970238.
Conflict-of-interest statement: The authors declare that they have no conflict of interest.
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: Jin-Wei Zhang, MD, Doctor, Institute of Biomedical and Clinical Sciences, Medical School, Faculty of Health and Life Sciences, University of Exeter, Hatherly Laboratories, Streatham Campus, Stocker Road, Exeter EX4 4PS, United Kingdom. j.zhang5@exeter.ac.uk
Received: September 15, 2025 Revised: November 7, 2025 Accepted: November 17, 2025 Published online: January 7, 2026 Processing time: 114 Days and 16.9 Hours
Abstract
Gastric ulcer (GU) represents a clinically significant manifestation of peptic ulcer disease, driven by a complex interplay of microbial, environmental, and immune-inflammatory factors. A recent cross-sectional study by Shen et al systematically evaluated six complete blood count-derived inflammatory indices: Neutrophil-to-lymphocyte ratio, monocyte-to-lymphocyte ratio, platelet-to-lymphocyte ratio, systemic immune-inflammation index, systemic inflammatory response index (SIRI), and aggregate index of systemic inflammation and demonstrated their positive associations with GU prevalence, identifying SIRI as the strongest predictor. This editorial contextualizes these findings within the broader literature, clarifies that these indices reflect systemic rather than GU-specific inflammation, highlights methodological strengths and major limitations, and proposes a conceptual clinical algorithm for integrating SIRI into GU risk assessment. Future multicenter studies incorporating Helicobacter pylori infection, non-steroidal anti-inflammatory drug exposure, and prospective design are essential to validate and translate these findings into clinical practice.
Core Tip: This editorial provides a critical analysis and appraisal of Shen et al’s study, which links six complete blood count-derived inflammatory indices (systemic inflammation markers) with gastric ulcer (GU) and demonstrates that systemic inflammatory response index (SIRI) exhibits the highest predictive value (area under the curve = 0.868) among these indices. While these inexpensive and accessible markers particularly SIRI may serve as practical tools for GU risk stratification, the editorial introduces a refined clinical framework for their application in this context and emphasizes the essential need for confirmation in prospective multicenter studies that account for Helicobacter pylori and non-steroidal anti-inflammatory drug confounders.
