Clinical usefulness of nutritional and immunological indices to distinguish gallbladder carcinoma from benign disease.

BACKGROUND

It is challenging to accurately and preoperatively diagnose gallbladder carcinoma (GBC) because patients are often asymptomatic or present with nonspecific symptoms that mimic common benign diseases in radiological findings. In this study, we evaluated the clinical usefulness of nutritional and immunological indices to distinguish GBC from benign disease.

METHODS

This study included 113 patients who underwent surgical resection for suspected GBC (37 benign and 76 GBC cases by pathological diagnosis). As the nutritional and immunological indices, the geriatric nutritional risk index (GNRI), modified Glasgow prognostic score (mGPS), neutrophil/lymphocyte ratio (NLR), platelet/lymphocyte ratio (PLR), and prognostic nutrition index (PNI) were examined, and their usefulness in distinguishing GBC from benign disease was determined using logistic regression analyses.

RESULTS

GBC cases displayed significantly worse nutritional and immunological status in the GNRI, mGPS, NLR, PLR, and PNI compared with those of the benign cases. As the predictive factors to distinguish GBC from benign disease, age > 75 years, GNRI < 101.7, and PLR ≥ 1.76 were identified by multivariate logistic regression analyses.

CONCLUSION

Patients with GBC showed poor nutritional or immunological status compared with patients with benign disease, and a low GNRI and high PLR may be noninvasive predictors of GBC.