Zhang Jingliang, Zhang Li, Duan Shusheng, Li Zhi, Li Guodong, Yu Haiyan
1The First Clinical Medical School, Shanxi Medical University, Taiyuan, China.
Department of Gastroenterology, Taiyuan Central Hospital of Shanxi Medical University, Taiyuan, China.
Front Oncol. 2023 Mar 30;13:1143154. doi: 10.3389/fonc.2023.1143154. eCollection 2023.
The platelet-lymphocyte ratio (PLR), neutrophil-lymphocyte ratio (NLR), and systemic immune-inflammation index (SII) are markers for systemic inflammatory responses and have been shown by numerous studies to correlate with the prognosis of gastric cancer (GC). However, the diagnostic value of these three markers in GC is unclear, and no research has examined them in combination. In this study, we investigated the value of the PLR, NLR, and SII individually or in combination for GC diagnosis and elucidated the connection of these three markers with GC patients' clinicopathological features.
This retrospective study was conducted on 125 patients diagnosed with GC and 125 healthy individuals, whose peripheral blood samples were obtained for analysis. The preoperative PLR, NLR, and SII values were subsequently calculated.
The results suggest that the PLR, NLR, and SII values of the GC group were considerably higher than those of the healthy group (all P ≤ 0.001); moreover, all three parameters were notably higher in early GC patients (stage I/II) than in the healthy population. The diagnostic value of each index for GC was analyzed using receiver operating characteristic (ROC) curve analysis and area under the curve (AUC) calculation. The diagnostic efficacy of the SII alone (AUC: 0.831; 95% confidence interval [CI], 0.777-0.885) was expressively better than those of the NLR (AUC: 0.821; 95% CI: 0.769-0.873, P = 0.017) and PLR (AUC: 0.783; 95% CI: 0.726-0.840; P = 0.020). The AUC value of the combination of the PLR, NLR, and SII (AUC: 0.843; 95% CI: 0.791-0.885) was significantly higher than that of the combination of the SII and NLR (0.837, 95% CI: 0.785-0.880, P≤0.05), PLR (P = 0.020), NLR (P = 0.017), or SII alone (P ≤ 0.001). The optimal cut-off values were determined for the PLR, NLR, and SII using ROC analysis (SII: 438.7; NLR: 2.1; PLR: 139.5). Additionally, the PLR, NLR, and SII values were all meaningfully connected with the tumor size, TNM stage, lymph node metastasis, and serosa invasion (all P ≤ 0.05). Elevated levels of the NLR and SII were linked to distant metastasis (all P ≤ 0.001).
These data suggest that the preoperative PLR, NLR, and SII could thus be utilized as diagnostic markers for GC or even early GC. Among these three indicators, the SII had the best diagnostic efficacy for GC, and the combination of the three could further improve diagnostic efficiency.
血小板与淋巴细胞比值（PLR）、中性粒细胞与淋巴细胞比值（NLR）以及全身免疫炎症指数（SII）是全身炎症反应的标志物，大量研究表明它们与胃癌（GC）的预后相关。然而，这三种标志物在胃癌中的诊断价值尚不清楚，且尚无研究对它们进行联合检测。在本研究中，我们分别或联合研究了PLR、NLR和SII在胃癌诊断中的价值，并阐明了这三种标志物与胃癌患者临床病理特征的关系。
本回顾性研究对125例确诊为胃癌的患者和125名健康个体进行，采集他们的外周血样本进行分析。随后计算术前PLR、NLR和SII值。
结果表明，胃癌组的PLR、NLR和SII值显著高于健康组（所有P≤0.001）；此外，所有这三个参数在早期胃癌患者（I/II期）中也显著高于健康人群。使用受试者工作特征（ROC）曲线分析和曲线下面积（AUC）计算来分析每个指标对胃癌的诊断价值。单独SII的诊断效能（AUC：0.831；95%置信区间[CI]，0.777 - 0.885）明显优于NLR（AUC：0.821；95%CI：0.769 - 0.873，P = 0.017）和PLR（AUC：0.783；95%CI：0.726 - 0.840；P = 0.020）。PLR、NLR和SII联合的AUC值（AUC：0.843；95%CI：0.791 - 0.885）显著高于SII和NLR联合（0.837，95%CI：0.785 - 0.880，P≤0.05）、PLR（P = 0.020）、NLR（P = 0.017）或单独SII（P≤0.001）。使用ROC分析确定PLR、NLR和SII的最佳截断值（SII：438.7；NLR：2.1；PLR：139.5）。此外，PLR、NLR和SII值均与肿瘤大小、TNM分期、淋巴结转移和浆膜侵犯有显著关联（所有P≤0.05）。NLR和SII水平升高与远处转移相关（所有P≤0.001）。
这些数据表明，术前PLR、NLR和SII可作为胃癌甚至早期胃癌的诊断标志物。在这三个指标中，SII对胃癌的诊断效能最佳，三者联合可进一步提高诊断效率。
