Guo R, Gao M. Prognostic value of systemic immune-inflammation index in patients with gastric cancer treated with immune checkpoint inhibitors. World J Gastroenterol 2026; 32(34): 119567 [DOI: 10.3748/wjg.v32.i34.119567]
Corresponding Author of This Article
Rui Guo, Department of Laboratory Medicine, Henan Provincial People’s Hospital, People’s Hospital of Zhengzhou University, No. 7 Weiwu Road, Jinshui District, Zhengzhou 462000, Henan Province, China. guorui2460@163.com
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Oncology
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Guo R, Gao M. Prognostic value of systemic immune-inflammation index in patients with gastric cancer treated with immune checkpoint inhibitors. World J Gastroenterol 2026; 32(34): 119567 [DOI: 10.3748/wjg.v32.i34.119567]
World J Gastroenterol. Sep 14, 2026; 32(34): 119567 Published online Sep 14, 2026. doi: 10.3748/wjg.v32.i34.119567
Prognostic value of systemic immune-inflammation index in patients with gastric cancer treated with immune checkpoint inhibitors
Rui Guo, Meng Gao
Rui Guo, Department of Laboratory Medicine, Henan Provincial People’s Hospital, People’s Hospital of Zhengzhou University, Zhengzhou 462000, Henan Province, China
Meng Gao, Department of Anesthesiology and Perioperative Medicine, Henan Cancer Hospital, Affiliated Cancer Hospital of Zhengzhou University, Zhengzhou 450000, Henan Province, China
Author contributions: Guo R initiated research, conducted the collation and statistical analysis, wrote the original manuscript and revised the paper; Gao M designed the experiments, conducted clinical data collection, performed postoperative follow-up and recorded the data; all authors read and approved the final manuscript.
AI contribution statement: We confirm that no AI tools were used at any stage, including in the preparation of the response to reviewers. All content of the manuscript and the rebuttal letter was fully written, reviewed, and approved by the authors.
Institutional review board statement: This study was approved by the Ethics Committee of Henan Provincial People’s Hospital, No. 2024-1-112.
Informed consent statement: The Ethics Committee agrees to waive informed consent.
Conflict-of-interest statement: All authors declare no conflict of interest in publishing the manuscript.
Data sharing statement: All data generated or analyzed during this study are included in this published article.
Corresponding author: Rui Guo, Department of Laboratory Medicine, Henan Provincial People’s Hospital, People’s Hospital of Zhengzhou University, No. 7 Weiwu Road, Jinshui District, Zhengzhou 462000, Henan Province, China. guorui2460@163.com
Received: March 3, 2026 Revised: March 25, 2026 Accepted: May 11, 2026 Published online: September 14, 2026 Processing time: 168 Days and 18.3 Hours
Abstract
BACKGROUND
Immune checkpoint inhibitors (ICIs) have improved the overall survival rates of advanced gastric cancer patients to some extent, but individuals respond differently; thus, an urgent need exists for precise predictive models. Systemic immune-inflammation index (SII) score, integrating peripheral blood neutrophils, T cells and platelets counts can comprehensively reflect changes in immunity and inflammation of human body. The prediction results of it are all quite accurate.
AIM
To research on the prediction capability of SII in patients with gastric cancer receiving immunotherapy.
METHODS
A total of 238 advanced gastric cancer patients who received ICIs have been retrospectively studied. Based on whether there was a deterioration in condition over six months (good prognostic group/poor prognostic group), as well as preoperative score II levels, patients were divided into low/high groups; cutoff: 593.995. Aneutropia, leucomasia and blood counts need to be tested weekly during this stage to assess the level of SII. Primary indicators are progression-free survival (PFS), etc.
RESULTS
The poor prognosis group was significantly higher in SII than the normal control group (673.42 ± 152.91 and 503.83 ± 138.74, respectively, P < 0.001). SII showed the best prediction accuracy in predicting progressive disease within 6 months [area under the curve (AUC) = 0.788]. The high SII group had a lower disease control rate (49.09% vs 69.53%, P = 0.001) and shorter PFS (7.83 months vs 8.52 months, P = 0.013). Based on multivariate analysis, a high SII was identified as an independent predictor of shortened PFS (hazard ratio: 1.896, P < 0.05). In receiver operating characteristic analysis, SII alone (AUC = 0.788) had a higher discriminative ability than other single clinical indicators; In addition, the highest prediction accuracy was obtained in combination mode (AUC = 0.856).
CONCLUSION
High SII scores have been confirmed to be necessary risk indicators, and by adding other clinical parameters, the diagnostic accuracy of progressive disease in ICIs-treated stomach cancer patients was improved significantly.
Core Tip: The systemic immune-inflammation index (SII), calculated from routine blood counts, integrates neutrophils, lymphocytes, and platelets to reflect the host immune-inflammatory balance. This retrospective study of 238 advanced gastric cancer patients treated with immune checkpoint inhibitors demonstrates that a high baseline SII (≥ 593.995) independently predicts poor progression-free survival and lower disease control rates. Combining SII with clinical parameters significantly improves predictive accuracy for early progressive disease, suggesting SII as a practical and accessible biomarker for risk stratification in immune checkpoint inhibitors-treated gastric cancer.
