Gender differences in systemic inflammatory and nutritional index following radical surgery for advanced gastric cancer.

Q3 Medicine 中南大学学报(医学版) Pub Date : 2024-08-28 DOI:10.11817/j.issn.1672-7347.2024.240120

Jincong Min, Ting Liu, Mimi Tang, Xuan Li, Xiang Feng, Heli Liu, Jie Ge

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引用次数: 0

Abstract

Objectives: Albumin-globulin ratio (AGR), prognostic nutritional index (PNI), and platelet-to-lymphocyte ratio (PLR) have been validated as prognostic factors for gastric cancer (GC). However, significant gender differences exist in albumin levels and inflammatory cell counts, and further research is required to understand how these differences influence GC prognosis. This study aims to investigate the prognostic impact of nutritional and inflammatory indicators on GC patients undergoing radical surgery, as well as the influence of gender on these indicators' prognostic value.

Methods: The study included 596 patients with advanced GC hospitalized in the Department of Gastrointestinal Surgery, General Surgery, Xiangya Hospital of Central South University from January 2012 to December 2016. Receiver operating characteristic (ROC) analysis was performed to determine cutoff values for nutritional and inflammatory factors. Univariate analysis was used to identify factors significantly affecting survival in GC patients, while multivariate and Kaplan-Meier analyses determined independent prognostic factors for GC.

Results: Multivariate analysis revealed that postsurgical tumor node metastasis (pTNM) stage [stage II: hazard ratio (HR)=3.284, P=0.012; stage III: HR: 8.062, P<0.001], low preoperative AGR (HR=1.499, P=0.012), and postoperative PNI (HR=1.503, P=0.008) were risk factors for overall survival in male patients after radical GC surgery. For female patients, pN2-3 (HR=3.185, P<0.001), total gastrectomy (HR=2.286, P=0.004), low preoperative PLR (HR=1.702, P=0.027), and postoperative PNI (HR=1.943, P=0.011) were identified as risk factors for overall survival.

Conclusions: Postoperative PNI is an independent risk factor for all advanced GC patients. Preoperative PLR is an independent prognostic factor only for female patients, while preoperative AGR is an independent prognostic factor only for male patients. Further research is warranted to investigate the gender-specific differences in GC prognosis.

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晚期胃癌根治术后全身炎症和营养指数的性别差异。

目的：白蛋白-球蛋白比（AGR）、预后营养指数（PNI）和血小板-淋巴细胞比（PLR）已被证实是胃癌（GC）的预后因素。然而，白蛋白水平和炎症细胞计数存在显著的性别差异，需要进一步研究这些差异如何影响GC预后。本研究旨在探讨营养和炎症指标对胃癌根治性手术患者预后的影响，以及性别对这些指标预后价值的影响。方法：选取2012年1月至2016年12月在中南大学湘雅医院普通外科胃肠外科住院的596例晚期胃癌患者。进行受试者工作特征（ROC）分析以确定营养和炎症因子的临界值。单因素分析用于确定显著影响胃癌患者生存的因素，而多因素和Kaplan-Meier分析用于确定胃癌的独立预后因素。结果：多因素分析显示，术后肿瘤淋巴结转移（pTNM）分期[II期：风险比(HR)=3.284， P=0.012；III期：HR: 8.062， PHR=1.499， P=0.012)和术后PNI （HR=1.503， P=0.008）是男性根治性胃癌术后总生存的危险因素。对于女性患者，pN2-3 （HR=3.185， PHR=2.286， P=0.004）、术前低PLR （HR=1.702， P=0.027）和术后低PNI （HR=1.943， P=0.011）是影响总生存的危险因素。结论：术后PNI是所有晚期胃癌患者的独立危险因素。术前PLR仅为女性患者的独立预后因素，而术前AGR仅为男性患者的独立预后因素。进一步研究GC预后的性别差异是有必要的。

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来源期刊

中南大学学报(医学版) Medicine-Medicine (all)

CiteScore

1.00

自引率

0.00%

发文量

8237

期刊介绍： Journal of Central South University (Medical Sciences), founded in 1958, is a comprehensive academic journal of medicine and health sponsored by the Ministry of Education and Central South University. The journal has been included in many important databases and authoritative abstract journals at home and abroad, such as the American Medline, Pubmed and its Index Medicus (IM), the Netherlands Medical Abstracts (EM), the American Chemical Abstracts (CA), the WHO Western Pacific Region Medical Index (WPRIM), and the Chinese Science Citation Database (Core Database) (CSCD); it is a statistical source journal of Chinese scientific and technological papers, a Chinese core journal, and a "double-effect" journal of the Chinese Journal Matrix; it is the "2nd, 3rd, and 4th China University Excellent Science and Technology Journal", "2008 China Excellent Science and Technology Journal", "RCCSE China Authoritative Academic Journal (A+)" and Hunan Province's "Top Ten Science and Technology Journals". The purpose of the journal is to reflect the new achievements, new technologies, and new experiences in medical research, medical treatment, and teaching, report new medical trends at home and abroad, promote academic exchanges, improve academic standards, and promote scientific and technological progress.