Wang H, Bao SS. Inflammation, immunity, and gastric ulcer — clinical insights from routine haematology. World J Gastroenterol 2026; 32(3): 114347 [DOI: 10.3748/wjg.v32.i3.114347]
Corresponding Author of This Article
Shi-San Bao, Additional Professor, Department of Pathology, Faculty of Medicine and Health, University of Sydney, D06, New South Wales 2006, Australia. profbao@hotmail.com
Research Domain of This Article
Gastroenterology & Hepatology
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Letter to the Editor
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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/
Jan 21, 2026 (publication date) through Jan 16, 2026
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Publication Name
World Journal of Gastroenterology
ISSN
1007-9327
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Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA
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Wang H, Bao SS. Inflammation, immunity, and gastric ulcer — clinical insights from routine haematology. World J Gastroenterol 2026; 32(3): 114347 [DOI: 10.3748/wjg.v32.i3.114347]
World J Gastroenterol. Jan 21, 2026; 32(3): 114347 Published online Jan 21, 2026. doi: 10.3748/wjg.v32.i3.114347
Inflammation, immunity, and gastric ulcer — clinical insights from routine haematology
Hui Wang, Shi-San Bao
Hui Wang, Department of Infectious Diseases, Ruijin Hospital, Shanghai 200025, China
Shi-San Bao, Department of Pathology, Faculty of Medicine and Health, University of Sydney, New South Wales 2006, Australia
Author contributions: Wang H and Bao SS both wrote and edited the letter.
Conflict-of-interest statement: There is no conflict of interest associated with any of the senior author or other coauthors contributed their efforts in this manuscript.
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: Shi-San Bao, Additional Professor, Department of Pathology, Faculty of Medicine and Health, University of Sydney, D06, New South Wales 2006, Australia. profbao@hotmail.com
Received: September 16, 2025 Revised: November 24, 2025 Accepted: December 5, 2025 Published online: January 21, 2026 Processing time: 121 Days and 15.9 Hours
Abstract
Gastric ulcer remains a common cause of morbidity, yet marked clinical variability suggests contributors beyond established risk factors such as Helicobacter pylori, non-steroidal anti-inflammatory drug exposure, and excess gastric acid. To clarify the role of systemic inflammation, Shen et al evaluated six complete blood count (CBC)-derived inflammatory indices in patients with gastric ulcer. All indices showed significant associations, with the systemic inflammatory response index demonstrating the strongest discriminatory value. Given that CBC testing is routine, inexpensive, and widely accessible, these indices may offer practical adjunctive markers for identifying individuals at increased risk. However, the cross-sectional design and lack of adjustment for major confounders limit causal interpretation. Prospective validation is required to determine whether these indices predict ulcer development, recurrence, or clinical outcomes, and to assess their potential integration with established risk factors.
Core Tip: Gastric ulcer remains a significant health concern with serious complications. This study shows that six complete blood count (CBC)-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—are associated with gastric ulcer, with SIRI demonstrating the strongest predictive value (area under the curve = 0.868). As CBC is widely available, inexpensive, and reproducible, these indices may serve as practical, non-invasive tools for identifying at-risk patients and supplementing traditional risk factors. The findings emphasise the role of systemic inflammation in gastric ulcer pathogenesis and warrant prospective validation.
