Correlation of systemic immune-inflammation and prognostic nutritional indices with pathological characteristics and prognosis in gastric cancer

doi:10.4240/wjgs.v18.i5.116701

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Publication Name

World Journal of Gastrointestinal Surgery

ISSN

1948-9366

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Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA

Retrospective Study

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 Surg. May 27, 2026; 18(5): 116701
Published online May 27, 2026. doi: 10.4240/wjgs.v18.i5.116701

Correlation of systemic immune-inflammation and prognostic nutritional indices with pathological characteristics and prognosis in gastric cancer

Qiang Song, Hao-Shu Niu

Qiang Song, Clinical Laboratory, Inner Mongolia Baogang Hospital, Baotou 014010, Inner Mongolia Autonomous Region, China

Hao-Shu Niu, Department of Gastroenterology, Inner Mongolia Baogang Hospital, Baotou 014010, Inner Mongolia Autonomous Region, China

Author contributions: Song Q designed the study, wrote the manuscript, and revised the manuscript; Song Q and Niu HS collected and analyzed the data, participated in collection of the data. All authors approved the final version of the manuscript.

Institutional review board statement: Given the retrospective design and data anonymization, approval from the Ethics Review Committee is waived.

Informed consent statement: As the study used anonymous and pre-existing data, the requirement for the informed consent from patients was waived.

Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.

Data sharing statement: No additional data are available.

Corresponding author: Hao-Shu Niu, MD, Department of Gastroenterology, Inner Mongolia Baogang Hospital, No. 20 Shaoxian Road, Kundulun District, Baotou 014010, Inner Mongolia Autonomous Region, China. niuhaoshu1982@163.com

Received: January 16, 2026
Revised: February 4, 2026
Accepted: March 10, 2026
Published online: May 27, 2026
Processing time: 131 Days and 5.2 Hours

Abstract

BACKGROUND

An ongoing need persists to identify reliable biological markers for gastric cancer (GC) prognosis, clinicopathological stratification, and survival prediction.

AIM

To determine the correlation of the Systemic Immune-Inflammation Index (SII) and Prognostic Nutritional Index (PNI) with clinicopathological characteristics and prognosis in patients with GC.

METHODS

This study included 107 patients with GC admitted to Inner Mongolia Baogang Hospital between February 2020 and February 2022. Clinical data including SII, PNI, and three-year prognosis were collected to evaluate the potential correlation of SII and PNI with the clinicopathological characteristics in patients with GC. Among the studied patients, receiver operating characteristic curve analysis assessed the prognostic predictive value of SII and PNI, and univariate and Cox multivariate regression analyses identified independent prognostic factors.

RESULTS

In patients with GC, SII levels were closely associated with maximum tumor diameter, invasion depth, metastases to lymph nodes, distant metastasis, tumor-node-metastasis staging, and carbohydrate antigen 199, and PNI levels were closely associated with differentiation degree, invasion depth, distant metastasis, tumor-node-metastasis staging, and carbohydrate antigen 199. The poor prognosis group (n = 37) exhibited notably higher SII levels and lower PNI levels relative to the good prognosis group (n = 70). Survival curve analysis revealed that in GC patients, high SII levels (≥ 607) were significantly correlated with lower three-year overall survival, while low PNI levels (< 44.5) were significantly correlated with lower three-year overall survival. According to the receiver operating characteristic curve, the area under the curve values for predicting GC prognosis using SII and PNI were 0.816 and 0.768, respectively, and the area under the curve of the two combined indices reached 0.866. Univariate and multivariate analyses showed that metastases to lymph nodes, distant metastasis, SII, and PNI were independent factors influencing three-year prognosis in patients with GC.

CONCLUSION

SII and PNI were effective biomarkers for predicting GC prognosis, and the two combined markedly improved predictive efficacy.

Keywords: Systemic Immune-Inflammation Index; Prognostic Nutritional Index; Gastric cancer; Clinical pathological characteristics; Prognosis; Correlation analysis

Core Tip: This study validated the correlation of the Systemic Immune-Inflammation Index and Prognostic Nutritional Index with clinicopathological characteristics and prognosis in patients with gastric cancer (GC). Analysis of the collected clinical data from patients with GC revealed that Systemic Immune-Inflammation Index and Prognostic Nutritional Index are effective biological markers for predicting GC prognosis, as they reflect patients’ clinicopathological characteristics and prognosis. The combination of the two further enhances prognostic and diagnostic efficacy, and both are also independent predictors for three-year overall survival in such patients.