Prognostic Value of Inflammatory Indices in Papillary Gastric Carcinoma with Different Proportions of Papillary Components.

PURPOSE

To evaluate the prognostic significance of peripheral inflammatory indices in patients with advantage papillary gastric carcinoma (APGC) and non-advantage papillary gastric carcinoma (NAPGC).

METHODS

The study retrospectively analyzed 270 patients who underwent radical surgery. Patients were stratified into APGC (n=133) and NAPGC (n=137) cohorts based on papillary component proportion (≥50% papillary histology for APGC, <50% for NAPGC). Receiver operating characteristic curve analysis was performed to assess the sensitivity of inflammatory indices for prognostic prediction. Overall survival was analyzed using Kaplan‒Meier survival and Log rank tests. The relationship between inflammatory indicators and clinicopathological characteristics was examined. Independent prognostic risk factors were identified using the Cox regression model and integrated into a nomogram, with calibration plots and decision curves used to evaluate predictive performance.

RESULTS

Compared to NAPGC patients, APGC patients demonstrated higher pT stage and carcinoembryonic antigen (CEA) levels, with poorer survival outcomes. Stage III APGC patients showed higher peripheral blood neutrophil ratios than NAPGC patients. For APGC, neutrophil-to-lymphocyte ratio (NLR) and CEA were identified as independent prognostic factors, while for NAPGC, systemic immune-inflammatory index (SII), age, and pN stage were determined to be independent prognostic factors.

CONCLUSION

Significant differences exist in clinicopathological characteristics, peripheral blood inflammatory indices, and prognosis between APGC and NAPGC patients. The nomogram incorporating inflammatory indices NLR and SII effectively predicts prognosis in both APGC and NAPGC patients.