Copyright: ©Author(s) 2026. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution-NonCommercial (CC BY-NC 4.0) license. No commercial re-use. See permissions. Published by Baishideng Publishing Group Inc.
World J Gastrointest Oncol. Jul 15, 2026; 18(7): 120785
Published online Jul 15, 2026. doi: 10.4251/wjgo.v18.i7.120785
Published online Jul 15, 2026. doi: 10.4251/wjgo.v18.i7.120785
Synergistic value of systemic inflammatory and tumor markers in predicting pretreatment distant metastasis of gastric cancer
Yu-Meng Shen, Xiao-Yu Hong, Hao-Chun Gao, Qiu-Lin Hao, Zheng-Yu Li, Zhi-Yuan Yao, Chao Gao, Department of Oncology, The Affiliated Hospital of Xuzhou Medical University, Xuzhou 221000, Jiangsu Province, China
Co-first authors: Yu-Meng Shen and Xiao-Yu Hong.
Co-corresponding authors: Zhi-Yuan Yao and Chao Gao.
Author contributions: Shen YM, Hong XY, Yao ZY, and Gao C contributed to the study conceptualization, manuscript review and editing, as well as project administration and overall supervision; Shen YM and Gao C were responsible for the methodology of this study; Shen YM and Hong XY contributed to the study through formal analysis, visualization, and validation and they contributed equally to this manuscript as co-first authors; Shen YM, Hong XY, and Hao QL were involved in investigation and original draft preparation; Hao QL and Li ZY took part in the data curation of this study; Gao HC took part in the resources; Yao ZY and Gao C were involved in the supervision of this study and they contributed equally to this manuscript as co-corresponding authors. All authors have read and approved the final manuscript.
AI contribution statement: Only DeepL was appropriately used strictly for translation from Chinese to English to improve readability. Subsequently, the manuscript was sent to a professional language editing service for further comprehensive human editing and language polishing. The manuscript content, study protocol, research results, and figures/tables were all created without the use of AI software.
Institutional review board statement: This research was carried out following the Declaration of Helsinki and received approval from the Ethics Committee at the Affiliated Hospital of Xuzhou Medical University (approval No. XYFY2025-KL581-01).
Informed consent statement: Patients were not required to give informed consent to the study because the analysis used anonymous clinical data that were obtained after each patient agreed to treatment by written consent.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Data sharing statement: Technical appendix, statistical code, and dataset available from the corresponding author at
Corresponding author: Chao Gao, MD, Department of Oncology, The Affiliated Hospital of Xuzhou Medical University, No. 99 Huaihai West Road, Xuzhou 221000, Jiangsu Province, China. gaochaoly@sina.com
Received: March 9, 2026
Revised: March 27, 2026
Accepted: April 16, 2026
Published online: July 15, 2026
Processing time: 122 Days and 10.8 Hours
Revised: March 27, 2026
Accepted: April 16, 2026
Published online: July 15, 2026
Processing time: 122 Days and 10.8 Hours
Core Tip
Core Tip: Early and accurate identification of distant metastasis before treatment remains a clinical challenge in gastric cancer. This study developed and internally validated a practical predictive model integrating routinely available inflammatory markers and tumor markers. By combining carbohydrate antigen 19-9, neutrophil count, lymphocyte count, and tumor location, the model demonstrated good discrimination, calibration, and clinical net benefit. The proposed model provides a convenient and cost-effective tool for pre-treatment risk stratification, which may assist clinicians in optimizing diagnostic strategies and individualized management for patients with gastric cancer.