Toda Makoto, Musha Hiroaki, Suzuki Takefumi, Nomura Takashi, Motoi Fuyuhiko
Department of Surgery, Yamagata Prefectural Central Hospital, Yamagata, Japan.
First Department of Surgery, Yamagata University, Yamagata, Japan.
Front Nutr. 2025 Mar 12;12:1556062. doi: 10.3389/fnut.2025.1556062. eCollection 2025.
The significance of the C-reactive protein-albumin-lymphocyte index [CALLY index (CI)] as a prognostic factor in gastric cancer remains unexplored. Therefore, this study assessed the utility of the CI as a predictor of short-term postoperative outcomes and long-term prognosis after gastric cancer surgery.
This study consisted of two cohorts. Cohort 1 included 120 patients who underwent distal gastrectomy for clinical stages I-III primary gastric cancer between November 2022 and March 2024. Patients were categorized into high- and low-CI groups, and complications were classified accordingly. Propensity score matching was performed based on clinical stage, surgical approach, and lymph node dissection extent, yielding 40 matched cases. The relationship between preoperative CI and short-term postoperative outcomes was analyzed. Cohort 2 included 358 patients with pathological stages I-III gastric cancer who underwent distal gastrectomy between January 2014 and December 2017. Preoperative CI was assessed, and its association with long-term outcomes was evaluated. Prognostic factors were also analyzed.
In Cohort 1, the preoperative CI was associated with short-term postoperative outcomes. Compared with the high-CI group, the low-CI group developed significantly more complications, including postoperative pneumonia. In Cohort 2, the 5-year overall survival (OS) and recurrence-free survival (RFS) differed significantly between the high and low CI groups. CI was an independent prognostic factor for OS and RFS.
The CI reflects patients' overall systemic conditions and may be a valuable predictor of short-term outcomes and long-term prognosis following gastric cancer surgery.
C反应蛋白-白蛋白-淋巴细胞指数[CALLY指数（CI）]作为胃癌预后因素的意义仍未得到充分研究。因此，本研究评估了CI作为胃癌手术后短期预后和长期生存预测指标的效用。
本研究包括两个队列。队列1包括2022年11月至2024年3月期间因临床I-III期原发性胃癌接受远端胃切除术的120例患者。患者被分为高CI组和低CI组，并据此对并发症进行分类。根据临床分期、手术方式和淋巴结清扫范围进行倾向评分匹配，得到40对匹配病例。分析术前CI与术后短期预后的关系。队列2包括2014年1月至2017年12月期间因病理I-III期胃癌接受远端胃切除术的358例患者。评估术前CI，并评估其与长期预后的关联。同时分析预后因素。
在队列1中，术前CI与术后短期预后相关。与高CI组相比，低CI组发生的并发症明显更多，包括术后肺炎。在队列2中，高CI组和低CI组的5年总生存率（OS）和无复发生存率（RFS）存在显著差异。CI是OS和RFS的独立预后因素。
CI反映了患者的整体全身状况，可能是胃癌手术后短期预后和长期生存的重要预测指标。
