Single and combined use of the platelet-lymphocyte ratio, neutrophil-lymphocyte ratio, and systemic immune-inflammation index in gastric cancer diagnosis
IntroductionThe platelet-lymphocyte ratio (PLR), neutrophil-lymphocyte ratio (NLR), and systemic immune-inflammation index (SII) are markers for systemic inflammatory responses and have been shown by numerous studies to correlate with the prognosis of gastric cancer (GC). However, the diagnostic val...
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Frontiers Media S.A.
2023-03-01
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| Series: | Frontiers in Oncology |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fonc.2023.1143154/full |
| _version_ | 1797785204588281856 |
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| author | Jingliang Zhang Li Zhang Shusheng Duan Zhi Li Guodong Li Haiyan Yu |
| author_facet | Jingliang Zhang Li Zhang Shusheng Duan Zhi Li Guodong Li Haiyan Yu |
| author_sort | Jingliang Zhang |
| collection | DOAJ |
| description | IntroductionThe platelet-lymphocyte ratio (PLR), neutrophil-lymphocyte ratio (NLR), and systemic immune-inflammation index (SII) are markers for systemic inflammatory responses and have been shown by numerous studies to correlate with the prognosis of gastric cancer (GC). However, the diagnostic value of these three markers in GC is unclear, and no research has examined them in combination. In this study, we investigated the value of the PLR, NLR, and SII individually or in combination for GC diagnosis and elucidated the connection of these three markers with GC patients’ clinicopathological features.MethodsThis retrospective study was conducted on 125 patients diagnosed with GC and 125 healthy individuals, whose peripheral blood samples were obtained for analysis. The preoperative PLR, NLR, and SII values were subsequently calculated.ResultsThe results suggest that the PLR, NLR, and SII values of the GC group were considerably higher than those of the healthy group (all P ≤ 0.001); moreover, all three parameters were notably higher in early GC patients (stage I/II) than in the healthy population. The diagnostic value of each index for GC was analyzed using receiver operating characteristic (ROC) curve analysis and area under the curve (AUC) calculation. The diagnostic efficacy of the SII alone (AUC: 0.831; 95% confidence interval [CI], 0.777–0.885) was expressively better than those of the NLR (AUC: 0.821; 95% CI: 0.769–0.873, P = 0.017) and PLR (AUC: 0.783; 95% CI: 0.726–0.840; P = 0.020). The AUC value of the combination of the PLR, NLR, and SII (AUC: 0.843; 95% CI: 0.791–0.885) was significantly higher than that of the combination of the SII and NLR (0.837, 95% CI: 0.785–0.880, P≤0.05), PLR (P = 0.020), NLR (P = 0.017), or SII alone (P ≤ 0.001). The optimal cut-off values were determined for the PLR, NLR, and SII using ROC analysis (SII: 438.7; NLR: 2.1; PLR: 139.5). Additionally, the PLR, NLR, and SII values were all meaningfully connected with the tumor size, TNM stage, lymph node metastasis, and serosa invasion (all P ≤ 0.05). Elevated levels of the NLR and SII were linked to distant metastasis (all P ≤ 0.001).DiscussionThese data suggest that the preoperative PLR, NLR, and SII could thus be utilized as diagnostic markers for GC or even early GC. Among these three indicators, the SII had the best diagnostic efficacy for GC, and the combination of the three could further improve diagnostic efficiency. |
| first_indexed | 2024-03-13T00:50:46Z |
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| institution | Directory Open Access Journal |
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| language | English |
| last_indexed | 2024-03-13T00:50:46Z |
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| series | Frontiers in Oncology |
| spelling | doaj.art-dce85fdf7b804ec4840008c4d91ce83f2023-07-07T18:41:50ZengFrontiers Media S.A.Frontiers in Oncology2234-943X2023-03-011310.3389/fonc.2023.11431541143154Single and combined use of the platelet-lymphocyte ratio, neutrophil-lymphocyte ratio, and systemic immune-inflammation index in gastric cancer diagnosisJingliang Zhang0Li Zhang1Shusheng Duan2Zhi Li3Guodong Li4Haiyan Yu5The First Clinical Medical School, Shanxi Medical University, Taiyuan, ChinaDepartment of Gastroenterology, Taiyuan Central Hospital of Shanxi Medical University, Taiyuan, ChinaDepartment of Hematology, Taiyuan Central Hospital of Shanxi Medical University, Taiyuan, ChinaDepartment of Gastroenterology Surgery, Taiyuan Central Hospital of Shanxi Medical University, Taiyuan, ChinaDepartment of Gastroenterology Surgery, Taiyuan Central Hospital of Shanxi Medical University, Taiyuan, ChinaDepartment of Gastroenterology, Taiyuan Central Hospital of Shanxi Medical University, Taiyuan, ChinaIntroductionThe platelet-lymphocyte ratio (PLR), neutrophil-lymphocyte ratio (NLR), and systemic immune-inflammation index (SII) are markers for systemic inflammatory responses and have been shown by numerous studies to correlate with the prognosis of gastric cancer (GC). However, the diagnostic value of these three markers in GC is unclear, and no research has examined them in combination. In this study, we investigated the value of the PLR, NLR, and SII individually or in combination for GC diagnosis and elucidated the connection of these three markers with GC patients’ clinicopathological features.MethodsThis retrospective study was conducted on 125 patients diagnosed with GC and 125 healthy individuals, whose peripheral blood samples were obtained for analysis. The preoperative PLR, NLR, and SII values were subsequently calculated.ResultsThe results suggest that the PLR, NLR, and SII values of the GC group were considerably higher than those of the healthy group (all P ≤ 0.001); moreover, all three parameters were notably higher in early GC patients (stage I/II) than in the healthy population. The diagnostic value of each index for GC was analyzed using receiver operating characteristic (ROC) curve analysis and area under the curve (AUC) calculation. The diagnostic efficacy of the SII alone (AUC: 0.831; 95% confidence interval [CI], 0.777–0.885) was expressively better than those of the NLR (AUC: 0.821; 95% CI: 0.769–0.873, P = 0.017) and PLR (AUC: 0.783; 95% CI: 0.726–0.840; P = 0.020). The AUC value of the combination of the PLR, NLR, and SII (AUC: 0.843; 95% CI: 0.791–0.885) was significantly higher than that of the combination of the SII and NLR (0.837, 95% CI: 0.785–0.880, P≤0.05), PLR (P = 0.020), NLR (P = 0.017), or SII alone (P ≤ 0.001). The optimal cut-off values were determined for the PLR, NLR, and SII using ROC analysis (SII: 438.7; NLR: 2.1; PLR: 139.5). Additionally, the PLR, NLR, and SII values were all meaningfully connected with the tumor size, TNM stage, lymph node metastasis, and serosa invasion (all P ≤ 0.05). Elevated levels of the NLR and SII were linked to distant metastasis (all P ≤ 0.001).DiscussionThese data suggest that the preoperative PLR, NLR, and SII could thus be utilized as diagnostic markers for GC or even early GC. Among these three indicators, the SII had the best diagnostic efficacy for GC, and the combination of the three could further improve diagnostic efficiency.https://www.frontiersin.org/articles/10.3389/fonc.2023.1143154/fullgastric cancerdiagnosissystemic immune-inflammation indexneutrophil-lymphocyte ratioplatelet-lymphocyte ratio |
| spellingShingle | Jingliang Zhang Li Zhang Shusheng Duan Zhi Li Guodong Li Haiyan Yu Single and combined use of the platelet-lymphocyte ratio, neutrophil-lymphocyte ratio, and systemic immune-inflammation index in gastric cancer diagnosis Frontiers in Oncology gastric cancer diagnosis systemic immune-inflammation index neutrophil-lymphocyte ratio platelet-lymphocyte ratio |
| title | Single and combined use of the platelet-lymphocyte ratio, neutrophil-lymphocyte ratio, and systemic immune-inflammation index in gastric cancer diagnosis |
| title_full | Single and combined use of the platelet-lymphocyte ratio, neutrophil-lymphocyte ratio, and systemic immune-inflammation index in gastric cancer diagnosis |
| title_fullStr | Single and combined use of the platelet-lymphocyte ratio, neutrophil-lymphocyte ratio, and systemic immune-inflammation index in gastric cancer diagnosis |
| title_full_unstemmed | Single and combined use of the platelet-lymphocyte ratio, neutrophil-lymphocyte ratio, and systemic immune-inflammation index in gastric cancer diagnosis |
| title_short | Single and combined use of the platelet-lymphocyte ratio, neutrophil-lymphocyte ratio, and systemic immune-inflammation index in gastric cancer diagnosis |
| title_sort | single and combined use of the platelet lymphocyte ratio neutrophil lymphocyte ratio and systemic immune inflammation index in gastric cancer diagnosis |
| topic | gastric cancer diagnosis systemic immune-inflammation index neutrophil-lymphocyte ratio platelet-lymphocyte ratio |
| url | https://www.frontiersin.org/articles/10.3389/fonc.2023.1143154/full |
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