Clinical value of geriatric nutritional risk index and pan-immune-inflammation value in locally advanced gastric cancer receiving neoadjuvant chemotherapy

Table 1 Patient characteristics and demographics in this study, n (%)/mean ± SD

Characteristics	Total (n = 147)	Mean (SD)	Range
Gender
Male	107 (72.79)
Female	40 (27.21)
Age, years		59.53 ± 9.91	26-82
< 65	101 (68.71)
≥ 65	46 (31.29)
BMI (kg/m2)		23.94 ± 3.09	15.04-32.39
Underweight	4 (2.72)
Normal	72 (48.98)
Overweight	56 (38.10)
Obese	15 (10.20)
Smoking history
No	67 (45.58)
Yes	80 (54.42)
Drinking history
No	85 (57.82)
Yes	62 (42.18)
NACT regimen
SOX	137 (93.20)
Others	10 (6.80)
Diabetes
No	122 (82.99)
Yes	25 (17.01)
Hypertension
No	103 (70.07)
Yes	44 (29.93)
Location
1/3 lower	89 (60.54)
1/3 middle	32 (21.77)
1/3 upper	11 (7.48)
Total	15 (10.20)
Clinical T stage
T2	15 (10.20)
T3	65 (44.22)
T4	67 (45.58)
Clinical N stage
N-	37 (25.17)
N+	110 (74.83)
Clinical stage
2	54 (36.73)
3	93 (63.27)
CEA, ng/mL		3.3 ± 3.52	0.56-33.31
CA19-9, U/mL		16.6 ± 20.63	0.6-159.5
hsCRP, mg/L		2.56 ± 4.75	0.14-28.43
GNRI		107.17 ± 10.56	56.23-162.83
PIV		170.35 ± 127.5	16.66-823.23
NRS2002 score
< 3	103 (70.07)
≥ 3	44 (29.93)
Vascular invasion
No	99 (67.35)
Yes	48 (32.65)
Perineural invasion
No	108 (73.47)
Yes	39 (26.53)
Pathological T stage
T0	22 (14.97)
T1	25 (17.01)
T2	35 (23.81)
T3	36 (24.49)
T4	29 (19.73)
Pathological N stage
N-	92 (62.59)
N+	55 (37.41)
Pathological stage
PCR	21 (14.29)
1	53 (36.05)
2	35 (23.81)
3	38 (25.85)
CAP
0	22 (14.97)
1	28 (19.05)
2	47 (31.97)
3	50 (34.01)
Complication
No	98 (66.67)
Yes	49 (33.33)

BMI: Body mass index; NACT: Neoadjuvant therapy; SOX: S-1 plus oxaliplatin; CEA: Carcinoembryonic antigen; CA: Carbohydrate antigen; hsCRP: High-sensitivity C-reactive protein; GNRI: Geriatric nutritional risk index; PIV: Pan-immune-inflammation value; NRS2002: Nutritional Risk Screening 2002; PCR: Pathological complete response; CAP: College of American Pathologists.

Table 2 Univariate and multivariate Cox regression analysis for overall survival of clinicopathologic characteristics in the cohorts, median (interquartile range)

Variables	Univariate analysis		Multivariate analysis
	HR (95%CI)	P value	HR (95%CI)	P value
Gender
Male vs female	0.752 (0.436-1.295)	0.304
Age (years)	1.014 (0.989-1.041)	0.280
BMI (kg/m2)
Underweight	1 (reference)	NA
Normal	0.387 (0.118-1.266)	0.116
Overweight	0.308 (0.092-1.040)	0.058
Obese	0.316 (0.079-1.267)	0.104
Smoking history
No vs yes	0.693 (0.417-1.150)	0.156
Drinking history
No vs yes	0.564 (0.327-0.973)	0.039	0.504 (0.270-0.939)	0.031
Diabetes
Yes vs no	1.238 (0.643-2.385)	0.522
Hypertension
Yes vs no	1.293 (0.760-2.198)	0.343
Location
1/3 lower	1 (reference)	NA
1/3 middle	1.373 (0.746-2.528)	0.309
1/3 upper	1.011 (0.358-2.854)	0.984
Total	1.655 (0.764-3.584)	0.201
Nutrition supplement
Yes vs no	1.153 (0.664-2.003)	0.613
Clinical T stage
T2	1 (reference)	NA
T3	0.648 (0.257-1.633)	0.358
T4	1.533 (0.646-3.639)	0.333
Clinical N stage
Positive vs negative	1.166 (0.641-2.121)	0.615
Clinical stage
Stage 3 vs stage 2	1.836 (1.036-3.255)	0.038	0.868 (0.432-1.741)	0.690
CEA, ng/mL	1.048 (0.984-1.115)	0.145
CA19-9, U/mL	1.011 (1.002-1.019)	0.016	1.004 (0.992-1.015)	0.536
hsCRP, mg/L	1.022 (0.970-1.078)	0.407
GNRI	0.953 (0.927-0.980)	< 0.001	0.956 (0.923-0.991)	0.013
PIV	1.002 (1.000-1.004)	0.019	1.002 (1-1.005)	0.041
NRS2002 score
≥ 3 vs < 3	1.768 (1.055-2.964)	0.031	0.745 (0.358-1.55)	0.431
Vascular invasion
Yes vs no	2.096 (1.259-3.489)	0.004	1.32 (0.732-2.38)	0.356
Perineural invasion
Yes vs no	2.122 (1.253-3.593)	0.005	1.058 (0.568-1.968)	0.860
Pathological T stage
T0	1 (reference)	NA	1 (reference)	NA
T1	2.750 (0.555-13.626)	0.215	2.957 (0.575-15.202)	0.194
T2	3.871 (0.866-17.296)	0.076	2.061 (0.421-10.086)	0.372
T3	7.216 (1.673-31.133)	0.008	2.082 (0.353-12.265)	0.418
T4	15.956 (3.738-68.105)	< 0.001	2.888 (0.475-17.565)	0.250
Pathological N stage
Positive vs negative	3.849 (2.279-6.500)	< 0.001	1.154 (0.519-2.565)
pathological stage
Stage 2-3 vs stage 1-0	5.459 (2.941-10.132)	< 0.001	3.720 (1.061-13.044)	0.040
Complication
Yes vs no	1.823 (1.096-3.033)	0.021	1.450 (0.823-2.551)	0.198

BMI: Body mass index; CEA: Carcinoembryonic antigen; CA: Carbohydrate antigen; hsCRP: High-sensitivity C-reactive protein; GNRI: Geriatric nutritional risk index; PIV: Pan-immune-inflammation value; NRS2002: Nutritional Risk Screening 2002; HR: Hazard ratio; CI: Confidence interval; NA: Not available.

Table 3 Univariate and multivariate Cox regression analysis for disease-free survival of clinicopathologic characteristics in the cohorts, median (interquartile range)

Variables	Univariate analysis		Multivariate analysis
	HR (95%CI)	P value	HR (95%CI)	P value
Gender
Male vs female	0.717 (0.414-1.24)	0.234
Age (years)	1.008 (0.983-1.035)	0.522
BMI (kg/m2)
Underweight	1 (reference)	NA
Normal	0.367 (0.112-1.207)	0.099
Overweight	0.312 (0.093-1.052)	0.060
Obese	0.322 (0.08-1.29)	0.110
Smoking history
No vs yes	0.758 (0.453-1.268)	0.291
Drinking history
No vs yes	0.642 (0.373-1.104)	0.109
Diabetes
Yes vs no	1.09 (0.551-2.156)	0.804
Hypertension
Yes vs no	1.174 (0.678-2.032)	0.567
Location
1/3 lower	1 (reference)	NA
1/3 middle	1.455 (0.785-2.697)	0.233
1/3 upper	1.056 (0.373-2.993)	0.918
Total	1.823 (0.838-3.967)	0.130
Nutrition supplement
No vs yes	1.097 (0.629-1.914)	0.743
Clinical T stage
T2	1 (reference)	NA
T3	0.586 (0.229-1.497)	0.264
T4	1.553 (0.654-3.686)	0.319
Clinical N stage
Positive vs negative	1.259 (0.679-2.335)	0.464
Clinical stage
Stage 3 vs stage 2	2.086 (1.143-3.809)	0.017	0.821 (0.394-1.71)	0.599
CEA, ng/mL	1.052 (0.985-1.123)	0.132
CA19-9, U/mL	1.010 (1.002-1.019)	0.018	1.005 (0.994-1.016)	0.374
hsCRP, mg/L	1.022 (0.968-1.08)	0.424
GNRI	0.955 (0.929-0.981)	0.001	0.962 (0.928-0.997)	0.035
PIV	1.002 (1.000-1.004)	0.040	1.001 (0.999-1.004)	0.209
NRS2002 score
≥ 3 vs < 3	1.904 (1.129-3.212)	0.016	0.872 (0.417-1.825)	0.717
Vascular invasion
Yes vs no	2.426 (1.448-4.064)	0.001	1.258 (0.699-2.264)	0.444
Perineural invasion
Yes vs no	2.148 (1.262-3.655)	0.005	0.977 (0.534-1.79)	0.941
Pathological T stage
T0	1 (reference)	NA	1 (reference)	NA
T1	4.619 (0.54-39.542)	0.162	5.224 (0.597-45.681)	0.135
T2	7.987 (1.038-61.429)	0.046	4.727 (0.583-38.327)	0.146
T3	13.694 (1.821-102.995)	0.011	3.158 (0.344-28.949)	0.309
T4	33.792 (4.55-250.976)	0.001	6.105 (0.655-56.896)	0.112
Pathological N stage
Positive vs negative	4.632 (2.685-7.992)	< 0.001	1.21 (0.544-2.691)	0.640
pathological stage
Stage 2-3 vs stage 1-0	6.459 (3.336-12.506)	< 0.001	4.257 (1.242-14.596)	0.021
Complication
Yes vs no	1.952 (1.165-3.272)	0.011	1.642 (0.92-2.93)	0.094

BMI: Body mass index; CEA: Carcinoembryonic antigen; CA: Carbohydrate antigen; hsCRP: High-sensitivity C-reactive protein; GNRI: Geriatric nutritional risk index; PIV: Pan-immune-inflammation value; NRS2002: Nutritional Risk Screening 2002; HR: Hazard ratio; CI: Confidence interval; NA: Not available.

Table 4 Univariate and multivariate logistic regression analysis for pathological response of clinicopathologic characteristics in the cohorts, median (interquartile range)

Variables	Univariate analysis		Multivariate analysis
	OR (95%CI)	P value	OR (95%CI)	P value
Gender
Male vs female	1.098 (0.507-2.376)	0.813
Age (years)	0.999 (0.965-1.034)	0.964
Smoking history
Yes vs no	0.764 (0.385-1.514)	0.440
Drinking history
Yes vs no	1.267 (0.636-2.522)	0.501
Diabetes
Yes vs no	1.672 (0.696-4.018)	0.250
Hypertension
Yes vs no	1.005 (0.477-2.117)	0.990
Location
1/3 lower	1 (reference)	NA
1/3 middle	1.28 (0.559-2.934)	0.559
1/3 upper	0.702 (0.174-2.836)	0.619
Total	0.468 (0.123-1.783)	0.266
Nutrition supplement
Yes vs no	1.788 (0.828-3.861)	0.139
Clinical T stage
T2	1 (reference)	NA	1 (reference)	NA
T3	0.662 (0.215-2.044)	0.473	1.071 (0.313-3.662)	0.913
T4	0.231 (0.072-0.747)	0.014	0.520 (0.132-2.051)	0.350
Clinical N stage
Positive vs negative	1.1 (0.498-2.429)	0.814
Clinical stage
Stage 3 vs stage 2	0.288 (0.141-0.589)	0.001	0.419 (0.178-0.986)	0.046
CEA, ng/mL	1 (0.907-1.102)	0.997
CA19-9, U/mL	0.997 (0.979-1.015)	0.714
hsCRP, mg/L	0.905 (0.795-1.03)	0.132
NRS2002 score
≥ 3 vs < 3	0.641 (0.296-1.392)	0.261
GNRI-PIV score
0	1 (reference)	NA	1 (reference)	NA
1	0.393 (0.181-0.856)	0.019	0.501 (0.221-1.137)	0.098
2	0.448 (0.113-1.776)	0.253	0.446 (0.104-1.909)	0.277

CEA: Carcinoembryonic antigen; CA: Carbohydrate antigen; hsCRP: High-sensitivity C-reactive protein; NRS2002: Nutritional Risk Screening 2002; GNRI: Geriatric nutritional risk index; PIV: Pan-immune-inflammation value; OR: Odds ratio; CI: Confidence interval; NA: Not available.

Table 5 Relationship between clinical characteristics and the different score group, n (%)/mean ± SD

Clinical characteristics	GNRI-PIV score				P value
	Total (n = 147)	0 (n = 82)	1 (n = 53)	2 (n = 12)
Gender					0.274
Male	107 (72.79)	64 (78.05)	35 (66.04)	8 (66.67)
Female	40 (27.21)	18 (21.95)	18 (33.96)	4 (33.33)
Age					0.555
< 65	101 (68.71)	59 (71.95)	35 (66.04)	7 (58.33)
≥ 65	46 (31.29)	23 (28.05)	18 (33.96)	5 (41.67)
BMI					< 0.001
< 25	97 (65.99)	40 (48.78)	46 (86.79)	11 (91.67)
≥ 25	50 (34.01)	42 (51.22)	7 (13.21)	1 (8.33)
Smoking history					0.935
No	67 (45.58)	37 (45.12)	25 (47.17)	5 (41.67)
Yes	80 (54.42)	45 (54.88)	28 (52.83)	7 (58.33)
Drinking history					0.295
No	85 (57.82)	43 (52.44)	35 (66.04)	7 (58.33)
Yes	62 (42.18)	39 (47.56)	18 (33.96)	5 (41.67)
Diabetes					0.635
No	122 (82.99)	66 (80.49)	46 (86.79)	10 (83.33)
Yes	25 (17.01)	16 (19.51)	7 (13.21)	2 (16.67)
Hypertension					0.285
No	103 (70.07)	59 (71.95)	38 (71.7)	6 (50)
Yes	44 (29.93)	23 (28.05)	15 (28.3)	6 (50)
Location					0.64
1/3 lower	89 (60.54)	46 (56.1)	35 (66.04)	8 (66.67)
1/3 middle	32 (21.77)	19 (23.17)	10 (18.87)	3 (25)
1/3 upper	11 (7.48)	9 (10.98)	2 (3.77)	0 (0)
Total	15 (10.2)	8 (9.76)	6 (11.32)	1 (8.33)
Clinical T stage					0.489
T2	15 (10.2)	10 (12.2)	4 (7.55)	1 (8.33)
T3	65 (44.22)	40 (48.78)	20 (37.74)	5 (41.67)
T4	67 (45.58)	32 (39.02)	29 (54.72)	6 (50)
Clinical N stage					0.744
N-	37 (25.17)	22 (26.83)	13 (24.53)	2 (16.67)
N+	110 (74.83)	60 (73.17)	40 (75.47)	10 (83.33)
Clinical stage					0.028
Stage 2	54 (36.73)	37 (45.12)	12 (22.64)	5 (41.67)
Stage 3	93 (63.27)	45 (54.88)	41 (77.36)	7 (58.33)
CEA, ng/mL	3.30 (3.52)	3.05 (2.62)	3.70 (4.79)	3.20 (2.10)	0.883
CA19-9, U/mL	16.59 (20.63)	15.11 (18.56)	19.56 (24.91)	13.62 (10.52)	0.807
hsCRP, mg/L	2.56 (4.75)	2.48 (4.92)	2.94 (4.97)	1.36 (1.12)	0.416
NRS2002 score					0.002
< 3	103 (70.07)	67 (81.71)	30 (56.6)	6 (50)
≥ 3	44 (29.93)	15 (18.29)	23 (43.4)	6 (50)
Vascular invasion					0.223
No	99 (67.35)	59 (71.95)	31 (58.49)	9 (75)
Yes	48 (32.65)	23 (28.05)	22 (41.51)	3 (25)
Perineural invasion					0.401
No	108 (73.47)	60 (73.17)	41 (77.36)	7 (58.33)
Yes	39 (26.53)	22 (26.83)	12 (22.64)	5 (41.67)
Pathological stage					0.347
PCR	21 (14.29)	12 (14.63)	8 (15.09)	1 (8.33)
1	53 (36.05)	35 (42.68)	16 (30.19)	2 (16.67)
2	35 (23.81)	18 (21.95)	12 (22.64)	5 (41.67)
3	38 (25.85)	17 (20.73)	17 (32.08)	4 (33.33)
CAP					0.044
CAP 0-1	50 (34.01)	35 (42.68)	12 (22.64)	3 (25)
CAP 2-3	97 (65.99)	47 (57.32)	41 (77.36)	9 (75)
Complication					0.035
No	98 (66.67)	62 (75.61)	29 (54.72)	7 (58.33)
Yes	49 (33.33)	20 (24.39)	24 (45.28)	5 (41.67)

BMI: Body mass index; CEA: Carcinoembryonic antigen; CA: Carbohydrate antigen; hsCRP: High-sensitivity C-reactive protein; NRS2002: Nutritional Risk Screening 2002; PCR: Pathological complete response; CAP: College of American Pathologists; GNRI: Geriatric nutritional risk index; PIV: Pan-immune-inflammation value.