Introduction

Gastric cancer (GC) is the fourth leading cause of cancer-related death worldwide. Our study aimed to investigate the prognostic value of preoperative inflammatory, nutritional and tumor markers and develop an effective prognostic score system to predict the prognosis of GC patients.

Methods

We retrospectively analyzed 1587 consecutive GC patients who received curative gastrectomy from two medical centers. A novel prognostic score system was proposed based on independently preoperative markers associated with overall survival (OS) of GC patients. A nomogram based on prognostic score system was further established and validated internally and externally.

Results

Based on multivariate analysis in the training set, a novel BLC (body mass index-lymphocyte-carbohydrate antigen 19-9) score system was proposed, which showed an effective predictability of OS in GC patients (log-rank P < 0.001). Moreover, receiver-operating characteristic (ROC) analysis showed that BLC had better performance in predicting OS than the traditional prognostic markers. The C-index of the BLC based-nomogram was 0.710 (95% CI 0.686–0.734), and the areas under ROC curves for predicting 3- and 5-year OS were 0.781 (95% CI 0.750–0.813) and 0.755 (95% CI 0.723–0.786), respectively, which were higher than those of tumor node metastasis (TNM) staging system alone. The calibration curve for probability of 3- and 5-year OS rate showed a good fitting effect between prediction by nomogram and actual observation. Verification in the internal and external validation sets showed results consistent with those in the training set.

Conclusions

The BLC combining inflammatory, nutritional and tumor markers was an independent prognostic predictor for GC patients, and the nomogram based on BLC could accurately predict the personalized survival of patients with GC.

中文翻译：

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使用术前炎症、营养和肿瘤标志物预测胃癌预后的预后评分系统：一项两中心队列研究

介绍

胃癌 (GC) 是全球癌症相关死亡的第四大原因。我们的研究旨在调查术前炎症、营养和肿瘤标志物的预后价值，并开发有效的预后评分系统来预测 GC 患者的预后。

方法

我们回顾性分析了来自两个医疗中心的 1587 名接受根治性胃切除术的连续 GC 患者。基于与 GC 患者总生存期 (OS) 相关的独立术前标志物，提出了一种新的预后评分系统。进一步建立了基于预后评分系统的列线图，并在内部和外部进行了验证。

结果

基于训练集中的多变量分析，提出了一种新的 BLC（体重指数-淋巴细胞-碳水化合物抗原 19-9）评分系统，该评分系统显示出 GC 患者 OS 的有效预测性（log-rank P < 0.001)。此外，接受者操作特征（ROC）分析表明，BLC 在预测 OS 方面比传统预后标志物具有更好的性能。基于 BLC 的列线图的 C 指数为 0.710（95% CI 0.686-0.734），预测 3 年和 5 年 OS 的 ROC 曲线下面积分别为 0.781（95% CI 0.750-0.813）和 0.755（95 % CI 0.723–0.786)，分别高于单独的肿瘤淋巴结转移 (TNM) 分期系统。3 年和 5 年 OS 率概率的校准曲线显示诺模图预测与实际观察之间具有良好的拟合效果。内部和外部验证集中的验证显示结果与训练集中的结果一致。

结论

结合炎症、营养和肿瘤标志物的 BLC 是 GC 患者的独立预后预测因子，基于 BLC 的列线图可以准确预测 GC 患者的个性化生存。