ORIGINAL RESEARCH article
Front. Nutr.
Sec. Clinical Nutrition
Volume 12 - 2025 | doi: 10.3389/fnut.2025.1562202
This article is part of the Research TopicNutritional Impacts on Human Tumor Development and Immune SystemView all 5 articles
Prognostic Value of Combining Preoperative Immune-Inflammatory-Nutritional Index and Tumor Biomarkers in Gastric Cancer Patients Undergoing Radical Resection
Provisionally accepted
Yongtao Du
Yunlong LiZhaobang Tan
Jiawei SongYu JiangShuai LiuYajie Guo
Yihuan Qiao
Jun ZhuShisen Li
Jipeng Li*- Air Force Medical University, Xi'an, China
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Background: Gastric cancer (GC) patients frequently face the debilitating comorbidity of malignant cachexia, a condition that consistently forecasts a dismal prognosis. Early diagnosis of cachexia and timely prediction of survival outcomes are essential for them. Here, we aimed to construct an immune-inflammatory-nutritional-tumor-marker (IINTM) prognostic score for GC, and further scrutinize its clinical relevance in early forecasting the cachexia.Method: A total of 1101 GC patients underwent curative surgical were incorporated in our study, and they were evaluated by the Computed Tomography (CT) of skeletal muscle mass at third lumbar spine plane levels (SMI-L3). Using restricted cubic spline (RCS) analysis, we examined associations between prognosis and nutritional indices, including the Prognostic Nutritional Index (PNI) and Systemic Immune-Inflammation Index (SII). The IINTM score was constructed by the multivariate Cox analysis and evaluated by the Receiver Operating Characteristic (ROC) and area under the ROC (AUC).We identified striking discrepancies in immunonutrition profiles and prognoses between cachexia and non-cachexia GC patients. Patients with cachexia had worse prognosis and lower SMI-L3 scores than those without cachexia. The IINTM score, incorporating PNI, SII, body mass index (BMI), NRS2002, serum albumin, platelet, D-dimer, CEA, and CA199, exhibited a high concordance index (C-index) of 0.784, underscoring its robust predictive efficacy. Most crucially, IINTM score demonstrated substantial diagnostic value for cachexia, with an AUC of 0.858, denoting its high degree of accuracy.The IINTM score could be a reliable tool and precisely predict the cachexia and prognosis for GC patients. Our findings provide novel insights into the role of immune-inflammatory-nutrition, tumor marker and cachexia in GC patients.
Keywords: gastric cancer, Cachexia, Prognostic nutritional index, systemic immune inflammation index, Prognostic model, nomogram, calibration curve
Received: 17 Jan 2025; Accepted: 22 May 2025.
Copyright: © 2025 Du, Li, Tan, Song, Jiang, Liu, Guo, Qiao, Zhu, Li and Li. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Jipeng Li, Air Force Medical University, Xi'an, China
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