全身免疫炎症指数（SII）、全身炎症反应指数（SIRI）及预后营养指数（PNI）联合检测在胃癌早期诊断中的临床价值

The Clinical Value of the Combined Detection of Systemic Immune-Inflammation Index (SII), Systemic Inflammation Response Index (SIRI), and Prognostic Nutritional Index (PNI) in Early Diagnosis of Gastric Cancer.

作者信息

Zheng Junyu, Zheng Lijun, Wang Xiao, Mao Xuelian, Wang Qin, Yang Yining, Mo Dongping

机构信息

Department of Clinical Laboratory, Jiangsu Cancer Hospital & Nanjing Medical University Affiliated Cancer Hospital & Jiangsu Institute of Cancer Research, Nanjing, People's Republic of China.

Department of Clinical Laboratory, Nanjing Lishui District Hospital of Traditional Chinese Medicine, Nanjing, People's Republic of China.

出版信息

J Inflamm Res. 2025 Jan 18;18:813-826. doi: 10.2147/JIR.S496703. eCollection 2025.

OBJECTIVE

Gastric cancer (GC) is a common malignant tumor of the digestive tract. Accumulating studies suggest that inflammation is linked with the pathogenesis of GC. The study delves into novel hematological inflammatory markers, such as systemic immune-inflammation index (SII), systemic inflammation response index (SIRI), and prognostic nutritional index (PNI), to explore their potential applications in early diagnosis of GC.

METHODS

From October 2020 and August 2024, 1339 GC patients admitted to our hospital were enrolled in this study. The pre-treatment SII, SIRI, and PNI was calculated from peripheral blood samples. Univariate and multivariate logistic regression analyses were utilized to verify independent risk factors for patients, and constructed the nomograms. The correlation between hematological indicators and tumor-node-metastasis (TNM) stage was assessed through Spearman's analysis.

RESULTS

Eligible patients and healthy controls were grouped by gender. The diagnostic ability of PNI was significantly superior to other indicators to diagnose male GC (area under the curve [AUC]=0.908, 95% CI: 0.892-0.925) and female GC (AUC=0.890, 95% CI: 0.865-0.914). Besides, the combination of hematological indicators is more effective in diagnosing GC patients, especially for male patients (AUC=0.916, 95% CI: 0.901-0.932, sensitivity: 84.98%, specificity: 84.29%). The C-statistic of Nomogram model was 0.917 for males and 0.875 for females. In both male and female cohorts, CEA, SII, and SIRI were positively correlated with TNM stage, while PNI was negatively correlated. The AUC of CEA, SII, SIRI, and PNI combined for the diagnosis in the early stage of male GC patients was 0.897 (95% CI: 0.875-0.918, sensitivity: 86.57%, specificity: 80.30%) is higher than that of in the advanced stage (AUC: 0.745, 95% CI: 0.710-0.780, sensitivity: 56.53%, specificity: 82.86%).

CONCLUSION

The combined CEA, SII, PNI, and SIRI could be used as screening biomarkers in diagnosing GC, especially in the early stage of male GC patients.

目的

胃癌（GC）是常见的消化道恶性肿瘤。越来越多的研究表明，炎症与胃癌的发病机制有关。本研究深入探讨了新型血液学炎症标志物，如全身免疫炎症指数（SII）、全身炎症反应指数（SIRI）和预后营养指数（PNI），以探索它们在胃癌早期诊断中的潜在应用。

方法

2020年10月至2024年8月，我院收治的1339例GC患者纳入本研究。从外周血样本中计算治疗前的SII、SIRI和PNI。采用单因素和多因素逻辑回归分析验证患者的独立危险因素，并构建列线图。通过Spearman分析评估血液学指标与肿瘤-淋巴结-转移（TNM）分期之间的相关性。

结果

符合条件的患者和健康对照按性别分组。PNI诊断男性GC的能力显著优于其他指标（曲线下面积[AUC]=0.908，95%CI：0.892-0.925）和女性GC（AUC=0.890，95%CI：0.865-0.914）。此外，血液学指标联合诊断GC患者更有效，尤其是男性患者（AUC=0.916，95%CI：0.901-0.932，敏感性：84.98%，特异性：84.29%）。列线图模型的C统计量男性为0.917，女性为0.875。在男性和女性队列中，癌胚抗原（CEA）、SII和SIRI与TNM分期呈正相关，而PNI与TNM分期呈负相关。男性GC患者早期诊断中CEA、SII、SIRI和PNI联合的AUC为0.897（95%CI：0.875-0.918，敏感性：86.57%，特异性：80.30%）高于晚期（AUC：0.745，95%CI：0.710-0.780，敏感性：56.53%，特异性：82.86%）。