Association of Systemic Inflammatory Response Index and Prognostic Nutritional Index Scores with Sarcopenia in Patients with Metastatic Gastric Cancer
Abstract
1. Introduction
2. Materials and Methods
2.1. Patient Selection and Data Collection
2.2. Assessment of Sarcopenia
2.3. Assessment of Inflammatory Biomarkers
2.4. Statistical Analysis
3. Results
3.1. Patient Characteristics
3.2. Demographic and Clinical Characteristics of Patients According to the Presence of Sarcopenia
3.3. Sarcopenia Risk Factors
3.4. Factors Determining General Survival
4. Discussion
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
Abbreviations
BMI | Body Mass Index |
CAR | CRP Albumin Ratio |
CT | Computed Tomography |
DEUFM | Dokuz Eylül University Faculty of Medicine |
EWGSOP | European Working Group on Sarcopenia in Older People |
GLOBOCAN | Global Cancer Observatory |
dNLR | Derivative Neutrophil to Lymphocyte Rate |
LAR | LDH to Albumin Ratio |
MLR | Monocyte to Lymphocyte Ratio |
NLR | Neutrophil to Lymphocyte Ratio |
PIV | Pan-Immune Inflammatory Value |
PLR | Platelet to Lymphocyte Ratio |
PNI | Prognostic Nutritional Index |
SII | Systemic Inflammatory Index |
SIRI | Systemic Inflammatory Response Index |
SMI | Skeletal Muscle Index |
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Parameters | n (%) | |
---|---|---|
Median age, years (min–max) | 58 (26–84) | |
Age group | <60 years | 72 (40.7) |
>60 years | 105 (59.3) | |
Sex | Woman | 53 (29.9) |
Man | 124 (70.1) | |
ECOG | 0–1 | 148 (83.6) |
2–3 | 29 (16.4) | |
Histopathological type | Adenocarcinoma | 118 (66.7) |
Signet ring | 58 (32.8) | |
Adenosquamous | 1 (0.6) | |
BMI groups | Underweight (<18.5 kg/m2) | 16 (9) |
Normal (≥18.5 and <25 kg/m2) | 106 (59.9) | |
Overweight (≥25 and <30 kg/m2) | 43 (24.3) | |
Obese (≥30 kg/m2) | 12 (6.8) | |
Sarcopenia | Yes | 127 (71.8) |
No | 50 (28.2) | |
Metastasis at diagnosis | Yes | 125 (70.6) |
No | 52 (29.4) | |
Liver metastasis | 75 (42.4) | |
Lung metastasis | 43 (24.3) | |
Bone metastasis | 38 (21.5) | |
Peritoneal metastasis | 126 (71.2) | |
Distant lymph node metastasis | 82 (46.3) | |
Other metastasis | 70 (39.5) |
Sarcopenia (n = 127) | No Sarcopenia (n = 50) | p | ||
---|---|---|---|---|
Median age, years (min–max) | 63 (31–84) | 59 (26–84) | 0.074 | |
Age group | ≥60.0 years | 46 (36.2) | 26 (52) | 0.054 |
<60.0 years | 81 (63.8) | 24 (48) | ||
Sex | Man | 98 (77.2) | 26 (52.0) | 0.001 |
Woman | 29 (22.8) | 24 (48.0) | ||
ECOG | 2–3 | 106 (83.5) 106 (83.5) | 42 (84) 42 (84) | 0.931 |
0–1 | 21 (16.5) | 8 (16) | ||
BMI | 22.3 (12.5–53.2) | 24.4 (13.7–35.1) | <0.001 | |
BMI group | Normal | 80 (63) | 26 (52) | 0.023 |
Underweight | 15 (11.8) | 1 (2) | ||
Overweight | 25 (19.7) | 18 (36) | ||
Obese | 7 (5.5) | 5 (10) | ||
Metastasis at diagnosis | Yes | 90 (70.9) | 35 (70) | 0.909 |
No | 37 (29.1) | 15 (30) | ||
Liver metastasis | 57 (44.9) | 18 (36) | 0.282 | |
Lung metastasis | 36 (28.3) | 7 (14) | 0.045 | |
Bone metastasis | 25 (19.7) | 13 (26) | 0.347 | |
Peritoneal metastasis | 91 (71.7) | 35 (70) | 0.827 | |
Distant lymph node metastasis | 59 (46.5) | 23 (46) | 0.956 | |
Other metastasis | 56 (44.1) | 14 (28) | 0.06 | |
SIRI | 2.4 (0.3–21.9) | 1.7 (0.5–20.3) | 0.008 | |
PIV | 637 (30.1–8580.9) | 495.6 (62.4–3587.7) | 0.051 | |
NLR | 3.6 (0.8–39.7) | 2.7 (1.0–12) | 0.004 | |
MLR | 0.5 (0.1–1.9) | 0.3 (0.1–2) | <0.001 | |
PLR | 206.0 (34.1–912.9) | 160.7 (65.8–675) | 0.025 | |
SII | 1150 (100.4–8580.9) | 874.9 (208–3800) | 0.046 | |
PNI | 44.4 (21.7–61.7) | 47.1 (34.9–65.2) | 0.004 | |
dNLR | 2.4 (0.6–23.8) | 1.7 (0.8–7.8) | 0.007 | |
LAR | 52.8 (27.8–2074.3) | 49.2 (29.1–468.2) | 0.343 | |
CAR | 2.9 (0.1–80.6) | 2.2 (0.2–107.5) | 0.327 |
Univariate Analysis | Multivariate Analysis | |||||
---|---|---|---|---|---|---|
OR | CI 95% | p | OR | CI 95% | p | |
Age | ||||||
<60 years vs. ≥60 years | 1.9 | 1.0–3.7 | 0.056 | |||
Sex | ||||||
Woman vs. man | 3.1 1.63.1 | 1.6–6.2 1.6–6.2 | 0.001 0.001 | |||
BMI | 0.040 | |||||
Obese vs. normal | 2.2 | 0.6–7.5 | 0.210 | |||
Obese vs. underweight | 10.7 | 1.0–109.8 | 0.046 | |||
Obese vs. overweight | 1.0 | 0.3–3.6 | 0.990 | |||
Lung metastasis | ||||||
None vs. present | 2.4 | 1.0–5.9 | 0.050 | |||
SIRI | ||||||
≤1.14 vs. >1.14 | 3.9 | 1.9–8.1 | <0.001 | 2.4 | 1.0–5.9 | 0.044 |
PIV | ||||||
≤630.41 vs. >630.41 | 2.1 | 1.1–4.1 | 0.033 | |||
NLR | ||||||
≤2.18 vs. >2.18 | 5.5 | 2.5–11.7 | <0.001 | |||
MLR | ||||||
≤0.43 vs. >0.43 | 3.5 | 1.7–7.1 | 0.001 | |||
PLR | ||||||
≤155.65 vs. >155.65 | 3.1 | 1.6–6 | 0.001 | |||
SII | ||||||
≤1227.50 vs. >1227.50 | 2.6 | 1.3–5.3 | 0.010 | 1.0 | 0.4–2.5 | 0.979 |
PNI | ||||||
≥50.35 vs. <50.35 | 3.4 | 1.6–7.0 | 0.001 | 2.4 | 1.1–5.4 | 0.034 |
dNLR | ||||||
≤1.70 vs. >1.70 | 3.5 | 1.8–7.0 | <0.001 | 1.8 | 0.7–4.6 | 0.194 |
mOS | 95% CI | p Value | |
---|---|---|---|
Sarcopenia | 0.010 | ||
Yes | 11.5 ± 0.8 | 9.8–13.3 | |
No | 17.5 ± 4.6 | 8.5–26.4 | |
SIRI | <0.001 | ||
≤1.77 | 18.5 ± 2.1 | 14.3–22.6 | |
>1.77 | 9.7 ± 1.2 | 7.3–12.1 | |
NLR | <0.001 | ||
≤2.18 | 23.0 ± 2.3 | 18.5–27.5 | |
>2.18 | 10.8 ± 1.2 | 8.5–13.0 | |
SII | 0.016 | ||
≤621.73 | 18.0 ± 4.1 | 10.0–26.1 | |
>621.73 | 11.5 ± 1.0 | 9.6–13.4 | |
PNI | <0.001 | ||
≥46.95 | 16.2 ± 2.5 | 11.3–21.1 | |
<46.95 | 10.4 ± 1.3 | 7.9–13.0 | |
LAR | <0.001 | ||
≤45.98 | 19.5 ± 1.2 | 17.3–21.8 | |
>45.98 | 9.4 ± 1.1 | 7.2–11.6 | |
CAR | <0.001 | ||
≤1.89 | 22.4 ± 2.2 | 18.1–26.6 | |
>1.89 | 9.7 ± 1.2 | 7.5–12.0 |
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Kanbur, B.; Unek, I.T.; Uzun, M.; Ozturk, C.; Yarol, R.C.; Balci, A. Association of Systemic Inflammatory Response Index and Prognostic Nutritional Index Scores with Sarcopenia in Patients with Metastatic Gastric Cancer. Medicina 2025, 61, 785. https://doi.org/10.3390/medicina61050785
Kanbur B, Unek IT, Uzun M, Ozturk C, Yarol RC, Balci A. Association of Systemic Inflammatory Response Index and Prognostic Nutritional Index Scores with Sarcopenia in Patients with Metastatic Gastric Cancer. Medicina. 2025; 61(5):785. https://doi.org/10.3390/medicina61050785
Chicago/Turabian StyleKanbur, Busra, Ilkay Tugba Unek, Mehmet Uzun, Caner Ozturk, Raif Can Yarol, and Ali Balci. 2025. "Association of Systemic Inflammatory Response Index and Prognostic Nutritional Index Scores with Sarcopenia in Patients with Metastatic Gastric Cancer" Medicina 61, no. 5: 785. https://doi.org/10.3390/medicina61050785
APA StyleKanbur, B., Unek, I. T., Uzun, M., Ozturk, C., Yarol, R. C., & Balci, A. (2025). Association of Systemic Inflammatory Response Index and Prognostic Nutritional Index Scores with Sarcopenia in Patients with Metastatic Gastric Cancer. Medicina, 61(5), 785. https://doi.org/10.3390/medicina61050785