Importance of hematological and inflammatory markers in the localization of gastric cancer

Table 1 Comparison of features between cardia and non-cardia gastric adenocarcinoma, mean ± SD/n (%)

Characteristic	PGC (n = 84)	DGC (n = 66)	Total (n = 150)	P value
Age	65.3 ± 11.0	67.7 ± 9.5	66.4 ± 10.4	0.164
Gender				0.005
Female	39 (46)	16 (24)	55 (37)
Male	45 (54)	50 (76)	95 (63)
Observation duration (mo)	23.8 ± 14.4	22.7 ± 12.9	23.3 ± 13.7	0.916
Complaint at admission
Dyspepsia	47 (56)	44 (67)	91 (61)	0.182
Bleeding	19 (23)	15 (23)	34 (23)	0.987
Constitutional	7 (8)	7 (11)	14 (9)	0.935
Dysphagia	21 (25)	0 (0)	21 (14)	< 0.001
Anemia	10 (12)	16 (24)	26 (17)	0.048
Comorbidities
HT	30 (36)	22 (33)	52 (35)	0.761
DM	13 (16)	8 (12)	21 (14)	0.556
Cardiovascular	20 (24)	11 (17)	31 (21)	0.284
AF	3 (4)	0 (0)	3 (2)	0.256
CRD	10 (12)	9 (14)	19 (13)	0.752
CVD	2 (2)	4 (6)	6 (4)	0.406
CRF	3 (4)	1 (2)	4 (3)	0.631
Hypothyroidism	4 (5)	0 (0)	4 (3)	0.131
Stage				0.525
1	6 (8)	5 (9)	11 (8)
2	5 (7)	8 (14)	3 (10)
3	33 (45)	21 (36)	54 (41)
4	29 (40)	24 (41)	53 (41)
Metastasis	31 (40)	24 (36)	55 (37)	0.946
Laboratory tests
WBC, 103/UL	8.6 ± 3.3	8.1 ± 3.4	8.3 ± 3.4	0.246
Neutrophils, 103/UL	5.6 ± 2.2	5.6 ± 3.2	5.6 ± 2.7	0.473
Lym, 103/UL	2.1 ± 0.9	1.8 ± 0.7	1.9 ± 0.8	0.084
Monocytes, 103/UL	0.5 ± 0.2	0.5 ± 0.2	0.5 ± 0.2	0.454
Hemoglobin, g/dL	12.5 ± 2.7	11.9 ± 2.9	12.2 ± 2.8	0.192
RDW, %	15.2 ± 3.7	15.9 ± 3.4	15.5 ± 3.6	0.134
Platelet, 103/UL	293 ± 113	308 ± 125	299 ± 117	0.429
MPV, fL	9.5 ± 1.1	9.5 ± 1.1	9.5 ± 1.1	0.892
PDW, %	16.1 ± 0.4	15.9 ± 0.4	16.0 ± 0.4	0.623
CRP, mg/L	18.7 ± 26.8	18.1 ± 29.1	18.4 ± 27.8	0.920
Albumin, g/dL	3.8 ± 0.5	3.7 ± 5.7	3.7 ± 5.3	0.486
AST, IU/L	22.8 ± 15.2	19.6 ± 11.6	21.4 ± 13.7	0.177
ALT, IU/L	18.6 ± 15.9	17.1 ± 14.9	17.9 ± 15.5	0.539
Total bilirubin, mg/dL	0.6 ± 0.4	0.6 ± 0.5	0.6 ± 0.4	0.442
Creatinine, mg/dL	0.82 ± 0.28	0.83 ± 0.24	0.83 ± 0.26	0.589
BUN, mg/dL	40.9 ± 17.9	43.5 ± 28.5	42.1 ± 23.1	0.768
Sodium, mEq/L	138.2 ± 3.4	138.1 ± 2.9	138.1 ± 3.2	0.953
Potassium, mEq/L	4.2 ± 0.5	4.3 ± 0.5	4.2 ± 0.5	0.457
Index
NLR	2.9 ± 2.1	3.8 ± 3.7	3.3 ± 2.9	0.413
PLR	157.3 ± 91.5	191.2 ± 115.2	172.2 ± 103.6	0.031
LMR	8.8 ± 39.5	4.1 ± 2.1	6.7 ± 29.6	0.311
SII	897 ± 705	1316 ± 1856	1081 ± 1350	0.401
Death	15 (18)	12 (18)	27 (18)	0.959

PGC: Proximal gastric cancer; DGC: Distal gastric cancer; HT: Hypertension; DM: Diabetes mellitus; AF: Atrial fibrillation; CRD: Chronic respiratory disease; CVD: Cerebrovascular disease; CRF: Chronic renal failure; WBC: White blood cell; RDW: Red cell distribution width; MPV: Mean platelet volume; PDW: Platelet distribution width; CRP: C-reactive protein; ALT: Alanine transferase; AST: Aspartate transferase; Lym: Lymphocyte; BUN: Blood urea nitrogen; NLR: Neutrophil/lymphocyte ratio; PLR: Platelet/lymphocyte ratio; LMR: Lymphocyte/monocyte ratio; SII: Systemic immune-inflammation index.

Table 2 Comparison of features between elderly (> 65) and non-elderly (< 65) patients with gastric adenocarcinoma, mean ± SD/n (%)

Characteristic	Non-elderly (n = 59)	Elderly (n = 91)	Total (n = 150)	P value
Age	56.1 ± 5.9	73.1 ± 6.6	66.4 ± 10.4	< 0.001
Gender				0.571
Female	20 (34)	35 (39)	55 (37)
Male	39 (54)	56 (61)	95 (63)
Observation duration (mo)	22.1 ± 12.7	24.1 ± 14.4	23.3 ± 13.7	0.406
Complaint at admission
Dyspepsia	40 (68)	51 (56)	91 (61)	0.150
Bleeding	10 (17)	24 (26)	34 (23)	0.178
Constitutional	7 (12)	7 (8)	14 (9)	0.391
Dysphagia	8 (14)	13 (14)	21 (14)	0.900
Anemia	7 (12)	19 (21)	26 (17)	0.154
Comorbidities
HT	10 (17)	42 (46)	52 (35)	< 0.001
DM	7 (12)	14 (15)	21 (14)	0.392
Cardiovascular	7 (12)	24 (26)	31 (21)	0.032
AF	0 (0)	3 (3)	3 (2)	0.279
CRD	6 (10)	13 (14)	19 (13)	0.459
CVD	4 (2)	5 (6)	6 (4)	0.404
CRF	1 (2)	3 (3)	4 (3)	0.999
Hypothyroidism	4 (7)	0 (0)	4 (3)	0.022
Stage				0.064
1	3 (5)	8 (10)	11 (8)
2	5 (9)	8 (10)	3 (10)
3	30 (55)	24 (32)	54 (41)
4	17 (31)	36 (48)	53 (41)
Metastasis	17 (29)	38 (42)	55 (37)	0.108
Localization				0.319
Cardia	36 (61)	48 (53)	84 (56)
Non-cardia	23 (39)	43 (47)	66 (44)
Laboratory tests
WBC, 103/UL	8.3 ± 2.8	8.4 ± 3.7	8.3 ± 3.4	0.905
Neutrophils, 103/UL	5.5 ± 2.5	5.7 ± 2.8	5.6 ± 2.7	0.492
Lym, 103/UL	2.1 ± 0.8	1.9 ± 0.7	1.9 ± 0.8	0.125
Monocytes, 103/UL	0.5 ± 0.2	0.5 ± 0.1	0.5 ± 0.2	0.837
Hemoglobin, g/dL	12.8 ± 2.3	11.7 ± 2.9	12.8 ± 7.4	0.028
RDW, %	14.9 ± 2.3	15.8 ± 4.1	15.5 ± 3.6	0.101
Platelet, 103/UL	304 ± 116	295 ± 119	299 ± 117	0.662
MPV, fL	9.6 ± 1.1	9.4 ± 1.1	9.5 ± 1.1	0.386
PDW, %	16.1 ± 0.4	15.9 ± 0.4	16.0 ± 0.4	0.468
CRP, mg/L	15.9 ± 23.5	19.9 ± 30.1	18.4 ± 27.8	0.556
Albumin, g/dL	3.8 ± 0.5	3.6 ± 0.5	3.7 ± 0.5	0.014
AST, IU/L	23.8 ± 17.8	19.9 ± 10.1	21.4 ± 13.7	0.560
ALT, IU/L	22.1 ± 21.6	15.2 ± 8.9	17.9 ± 15.5	0.068
Total bilirubin, mg/dL	0.6 ± 0.4	0.6 ± 0.5	0.6 ± 0.4	0.822
Creatinine, mg/dL	0.82 ± 0.29	0.83 ± 0.25	0.83 ± 0.26	0.551
BUN, mg/dL	38.4 ± 22.3	44.4 ± 23.4	42.1 ± 23.1	0.009
Sodium, mEq/L	138.3 ± 3.1	138.1 ± 3.3	138.1 ± 3.2	0.373
Potassium, mEq/L	4.3 ± 0.4	4.2 ± 0.5	4.2 ± 0.5	0.607
Indexes
NLR	3.1 ± 2.7	3.5 ± 3.1	3.3 ± 2.9	0.133
PLR	168.4 ± 97.9	174.7 ± 107.6	172.2 ± 103.6	0.560
LMR	4.4 ± 1.8	8.3 ± 37.9	6.7 ± 29.6	0.313
SII	1023 ± 1022	1119 ± 1530	1081 ± 1350	0.294
Death	13 (22)	14 (15)	27 (18)	0.300

HT: Hypertension; DM: Diabetes mellitus; AF: Atrial fibrillation; CRD: Chronic respiratory disease; CVD: Cerebrovascular disease; CRF: Chronic renal failure; WBC: White blood cell; RDW: Red cell distribution width; MPV: Mean platelet volume; PDW: Platelet distribution width; CRP: C-reactive protein; ALT: Alanine transferase; AST: Aspartate transferase; Lym: Lymphocyte; BUN: Blood urea nitrogen; NLR: Neutrophil/lymphocyte ratio; PLR: Platelet/lymphocyte ratio; LMR: Lymphocyte/monocyte ratio; SII: Systemic immune-inflammation index.

Table 3 Analysis with Cox-regression model all causes mortality

Characteristic	Univariate			Multivariate
	HR	95%CI	P value	HR	95%CI	P value
Age	1.002	0.966-1.040	0.897	1.010	0.968-1.054	0.639
Gender (female)	1.471	0.688-3.145	0.319	1.551	0.701-3.434	0.279
Cardiovascular disease	1.985	0.891-4.420	0.093	1.326	0.534-3.291	0.534
Stage (per one stage increase)	2.020	1.137-3.590	0.017	1.905	1.039-3.492	0.037
NLR	1.194	1.086-1.313	< 0.001	1.205	1.091-1.332	< 0.001
PLR	1.003	1.000-1.006	0.057
LMR	0.803	0.632-1.019	0.072
SII	1.001	1.000-1.002	< 0.001

CI: Confidence interval; HR: Hazard ratio; NLR: Neutrophil/lymphocyte ratio; PLR: Platelet/lymphocyte ratio; LMR: Lymphocyte/monocyte ratio; SII: Systemic immune-inflammation index.