Pan-immune-inflammation value as a marker of gastric cancer recurrence and mortality

Öz

Aim: This study investigates whether the pan-immune-inflammation value (PIV) can serve as a novel prognostic marker for gastric cancer recurrence and mortality by assessing its interaction with the tumor microenvironment's immune-inflammatory status. Marerial and Methods: Between January 1, 2020, and January 1, 2023, a retrospective study was conducted on patients who had undergone total and subtotal gastrectomy for gastric adenocarcinoma (n:141). Peripheral Inflammation Value (PIV), calculated as 'PIV=Neutrophil x Platelet x Monocyte / Lymphocyte,' was assessed alongside clinical parameters, immune cell subsets, cytokines, and acute-phase reactants. Statistical analysis, employing multivariate regression models, aimed to explore the relationships between PIV and critical clinical outcomes, including disease recurrence, mortality, and various clinicopathological factors. Results: During the two-year follow-up, 48% of the patients experienced disease recurrence, while 50% faced mortality. A statistically significant correlation was observed, indicating that higher PIV values were associated with an increased risk of disease recurrence and mortality. Lymphovascular and perineural invasion (LVI, PNI) were identified as factors related to recurrence. Elevated levels of CA 19-9 and CEA were independent predictors of mortality. Furthermore, lower albumin levels were associated with an increased risk of mortality. Conclusion: This study highlights PIV's potential prognostic significance in gastric cancer. Elevated PIV reduced recurrence risk, emphasizing peritumoral immune response's role in progression and metastasis. Combining PIV with clinicopathological factors may enhance risk stratification and inform personalized treatments. Larger prospective studies are needed to validate PIV's clinical utility and its underlying mechanisms in gastric cancer.

Anahtar Kelimeler

• Pan-immune inflammation value
• gastric adenocarcinoma
• recurrence
• mortality

Mide kanseri nüksü ve mortalitesinin bir belirteci olarak pan-immün inflamasyon değeri

Öz

Amaç: Bu çalışma, pan-immün-inflamasyon değerinin (PIV), mide kanseri nüksü ve mortalitesi için yeni bir prognostik belirteç olarak hizmet edip etmediğini incelemekte ve bunun tümör mikroçevresinin immün-inflamatuar durumu ile etkileşimini değerlendirmektedir. Gereç ve Yöntemler: 1 Ocak 2020 ile 1 Ocak 2023 tarihleri arasında, mide adenokarsinomu için total ve subtotal gastrektomi uygulanan hastalar üzerinde geriye dönük bir çalışma yapılmıştır (n: 141). 'PIV = Nötrofil x Trombosit x Monosit / Lenfosit' olarak hesaplanan Periferik İnflamasyon Değeri (PIV), klinik parametreler, immün hücre alt grupları, sitokinler ve akut faz reaktanları ile birlikte değerlendirilmiştir. Çeşitli klinikopatolojik faktörler, hastalık nüksü, mortalite ve diğer kritik klinik sonuçlar arasındaki ilişkileri keşfetmeyi amaçlayan çok değişkenli regresyon modelleri kullanılarak istatistiksel analiz gerçekleştirilmiştir. Bulgular: İki yıllık takip süresince hastaların %48'i hastalık nüksü yaşamış, %50'si ise mortalite ile karşılaşmıştır. Yüksek PIV değerlerinin hastalık nüksü ve mortalite riskini artırdığını gösteren istatistiksel olarak anlamlı bir ilişki tespit edilmiştir. Lenfo-vasküler ve perinöral invazyon (LVI, PNI) nüksle ilişkili faktörler olarak belirlenmiştir. CA 19-9 ve CEA seviyelerinin yüksek olması mortalitenin bağımsız prediktörleri olarak tanımlanmıştır. Ayrıca, düşük albümin seviyeleri mortalite riski ile ilişkilendirilmiştir. Sonuçlar: Bu çalışma, mide kanserinde PIV'nin potansiyel prognostik önemini vurgulamaktadır. Yüksek PIV, nüks riskini arttırmış, peritümöral immün yanıtın ilerleme ve metastazdaki rolünü vurgulamıştır. PIV'yi klinikopatolojik faktörlerle birleştirmek, risk sınıflandırmasını artırabilir ve kişiselleştirilmiş tedavileri bilgilendirebilir. PIV'nin klinik kullanılabilirliğini ve mide kanserindeki temel mekanizmalarını doğrulamak için daha büyük prospektif çalışmalara ihtiyaç vardır.

Anahtar Kelimeler

• Pan-immün inflamasyon değeri
• mide adenokarsinomu
• nüks
• mortalite

Kaynakça

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