ASSOCIATION BETWEEN HEMATOLOGICAL INFLAMMATORY INDICES AND CLINICAL OUTCOMES IN NEWLY DIAGNOSED GASTRIC CANCER: A PROSPECTIVE COHORT STUDY
- 1Faculdade de Medicina da PUC-Campinas, Campinas, SP, Brazil
- 2Faculdade de Ciências Médicas da Universidade Estadual de Campinas (Unicamp), Campinas, SP, Brazil
Abstract
Introduction: Gastric cancer is a leading cause of cancer mortality worldwide and is associated with chronic systemic inflammation and cachexia. Hematological inflammatory indices derived from routine blood counts are accessible biomarkers that may reflect nutritional status and prognosis. This study evaluated their association with clinical outcomes in newly diagnosed gastric cancer. Methods: Prospective observational study with newly diagnosed patients with gastric cancer at the University of Campinas (UNICAMP), Brazil. Nine hematological parameters were analyzed from complete blood count (CBC) at the time of the diagnosis: neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), monocyte-to-lymphocyte ratio (MLR), systemic immune-inflammation index (SII), systemic inflammation response index (SIRI), pan-immune-inflammation value (PIV), mean platelet volume (MPV), platelet count, and the MPV-to-platelet ratio. Patients were stratified according to GLIM-defined cachexia, sarcopenia, myosteatosis, performance status (ECOG), clinical staging, metabolic tumor activity (FDG uptake), ethnicity, sex, age, body mass index (BMI), percentage weight loss and skeletal muscle index (SMI), H. pylori status, recurrence and mortality. Mann-Whitney and Spearman tests were used. Results: The cohort comprised 85 patients (54.1% male; median age 62.98-years, IQR 53.14‒70.02; 60% Caucasian, 38.82% Afro-descendant, 1.18% Asian), with H. pylori, sarcopenia, myosteatosis, and cachexia present in 38.82%, 36.47%, 35.29%, and 35.29%, respectively. The median values from CBC were: hemoglobin 12.0 g/dL, hematocrit 35.5%, MCV 82.7 fL, MCH 27.9 pg, leukocytes 7.05 × 10³/µL (neutrophils 4.17, lymphocytes 1.72, monocytes 0.53), platelets 243 × 10³/µL, and MPV 10.3 fL. Advanced stage tumor (III/IV) showed increased PLR (p = 0.02) and SII (p = 0.04) and decreased MPV (p = 0.03) and MPV-to-platelet ratio (p = 0.02). Positive FDG uptake also showed increased SII (p = 0.03), PIV (p = 0.04), and platelet count (p = 0.002) and a decreased MPV-to-platelet ratio (p = 0.01). Poorer performance status (ECOG 1/2) was associated with increased NLR (p = 0.01), PLR (p = 0.009), SII (p = 0.01), and PIV (p = 0.03). Increased NLR, SII, SIRI, PIV (p < 0.0001), PLR (p = 0.001), MLR (p = 0.01), and platelet count (p = 0.006), as well as decreased MPV-to-platelet ratio (p = 0.01) were associated with GLIM-defined cachexia. NLR (p = 0.02), SII (p = 0.009), SIRI (p = 0.0005), PIV (p = 0.0002), and MLR (p = 0.0005) were higher among patients who died during follow-up, whereas disease recurrence was associated with increased platelet count (p = 0.03) and decreased MPV-to-platelet ratio (p = 0.03). On correlation, PLR ( r = 0.32, p = 0.009), SII ( r = 0.33, p = 0.007) and platelet count (p = 0.05) increased with weight loss. SII decreased with age ( r = -0.22, p = 0.05), while PLR showed a borderline inverse correlation with BMI (p = 0.06). No significant associations were found with sarcopenia, myosteatosis, sex, ethnicity, H. pylori, BMI, or SMI. Conclusion: Using CBC-derived inflammatory indices, this study shows that platelet activation is associated with advanced clinical stage, increased metabolic tumor activity, and disease recurrence. In contrast, cachexia and mortality are related to a broader inflammatory response involving platelets, neutrophils, and monocytes. These findings support the potential role of these indices in baseline risk stratification and the participation of blood cells in adverse outcomes in gastric cancer.
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BibTeX
@article{kopacheski2026association,
title = {{ASSOCIATION BETWEEN HEMATOLOGICAL INFLAMMATORY INDICES AND CLINICAL OUTCOMES IN NEWLY DIAGNOSED GASTRIC CANCER: A PROSPECTIVE COHORT STUDY}},
author = {Maria Sofia KOPACHESKI and Jose Diogo OLIVEIRA and Renata ERBERT CONTRICIANI and Leo Victor KIM and Larissa Ariel OLIVEIRA CARRILHO and Sandra Regina BRANBILLA and Barbara ZANETTE CIPRIANO and Bruna CARDOSO ROBISON and Fabiana DA SILVA and Nicole NOVAIS and Fabíola FURTUOSO ZARPELÃO and Juliana TAQUINI PEZZUTTI and Ananda Giovana CABRAL SILVA and Luiz Roberto LOPES and Nelson ADAMI ANDREOLLO and Maria Carolina SANTOS MENDES and José BARRETO CAMPELLO CARVALHEIRA and Fernanda ANDRADE ORSI},
journal = {Hematology, Transfusion and Cell Therapy},
year = {2026},
month = oct,
doi = {10.1016/j.htct.2026.108448},
url = {https://doi.org/10.1016/j.htct.2026.108448},
note = {CC BY},
}
RIS
TY - JOUR
TI - ASSOCIATION BETWEEN HEMATOLOGICAL INFLAMMATORY INDICES AND CLINICAL OUTCOMES IN NEWLY DIAGNOSED GASTRIC CANCER: A PROSPECTIVE COHORT STUDY
AU - Maria Sofia KOPACHESKI
AU - Jose Diogo OLIVEIRA
AU - Renata ERBERT CONTRICIANI
AU - Leo Victor KIM
AU - Larissa Ariel OLIVEIRA CARRILHO
AU - Sandra Regina BRANBILLA
AU - Barbara ZANETTE CIPRIANO
AU - Bruna CARDOSO ROBISON
AU - Fabiana DA SILVA
AU - Nicole NOVAIS
AU - Fabíola FURTUOSO ZARPELÃO
AU - Juliana TAQUINI PEZZUTTI
AU - Ananda Giovana CABRAL SILVA
AU - Luiz Roberto LOPES
AU - Nelson ADAMI ANDREOLLO
AU - Maria Carolina SANTOS MENDES
AU - José BARRETO CAMPELLO CARVALHEIRA
AU - Fernanda ANDRADE ORSI
PY - 2026
DA - 2026/10/23
JO - Hematology, Transfusion and Cell Therapy
DO - 10.1016/j.htct.2026.108448
UR - https://doi.org/10.1016/j.htct.2026.108448
AB - Introduction: Gastric cancer is a leading cause of cancer mortality worldwide and is associated with chronic systemic inflammation and cachexia. Hematological inflammatory indices derived from routine blood counts are accessible biomarkers that may reflect nutritional status and prognosis. This study evaluated their association with clinical outcomes in newly diagnosed gastric cancer. Methods: Prospective observational study with newly diagnosed patients with gastric cancer at the University of Campinas (UNICAMP), Brazil. Nine hematological parameters were analyzed from complete blood count (CBC) at the time of the diagnosis: neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), monocyte-to-lymphocyte ratio (MLR), systemic immune-inflammation index (SII), systemic inflammation response index (SIRI), pan-immune-inflammation value (PIV), mean platelet volume (MPV), platelet count, and the MPV-to-platelet ratio. Patients were stratified according to GLIM-defined cachexia, sarcopenia, myosteatosis, performance status (ECOG), clinical staging, metabolic tumor activity (FDG uptake), ethnicity, sex, age, body mass index (BMI), percentage weight loss and skeletal muscle index (SMI), H. pylori status, recurrence and mortality. Mann-Whitney and Spearman tests were used. Results: The cohort comprised 85 patients (54.1% male; median age 62.98-years, IQR 53.14‒70.02; 60% Caucasian, 38.82% Afro-descendant, 1.18% Asian), with H. pylori, sarcopenia, myosteatosis, and cachexia present in 38.82%, 36.47%, 35.29%, and 35.29%, respectively. The median values from CBC were: hemoglobin 12.0 g/dL, hematocrit 35.5%, MCV 82.7 fL, MCH 27.9 pg, leukocytes 7.05 × 10³/µL (neutrophils 4.17, lymphocytes 1.72, monocytes 0.53), platelets 243 × 10³/µL, and MPV 10.3 fL. Advanced stage tumor (III/IV) showed increased PLR (p = 0.02) and SII (p = 0.04) and decreased MPV (p = 0.03) and MPV-to-platelet ratio (p = 0.02). Positive FDG uptake also showed increased SII (p = 0.03), PIV (p = 0.04), and platelet count (p = 0.002) and a decreased MPV-to-platelet ratio (p = 0.01). Poorer performance status (ECOG 1/2) was associated with increased NLR (p = 0.01), PLR (p = 0.009), SII (p = 0.01), and PIV (p = 0.03). Increased NLR, SII, SIRI, PIV (p < 0.0001), PLR (p = 0.001), MLR (p = 0.01), and platelet count (p = 0.006), as well as decreased MPV-to-platelet ratio (p = 0.01) were associated with GLIM-defined cachexia. NLR (p = 0.02), SII (p = 0.009), SIRI (p = 0.0005), PIV (p = 0.0002), and MLR (p = 0.0005) were higher among patients who died during follow-up, whereas disease recurrence was associated with increased platelet count (p = 0.03) and decreased MPV-to-platelet ratio (p = 0.03). On correlation, PLR ( r = 0.32, p = 0.009), SII ( r = 0.33, p = 0.007) and platelet count (p = 0.05) increased with weight loss. SII decreased with age ( r = -0.22, p = 0.05), while PLR showed a borderline inverse correlation with BMI (p = 0.06). No significant associations were found with sarcopenia, myosteatosis, sex, ethnicity, H. pylori, BMI, or SMI. Conclusion: Using CBC-derived inflammatory indices, this study shows that platelet activation is associated with advanced clinical stage, increased metabolic tumor activity, and disease recurrence. In contrast, cachexia and mortality are related to a broader inflammatory response involving platelets, neutrophils, and monocytes. These findings support the potential role of these indices in baseline risk stratification and the participation of blood cells in adverse outcomes in gastric cancer.
SN - 2531-1379
SN - 2531-1387
ER -