Yufei Wang,1,* Meng Zhu,2,* Yingwei Xue1 

1Department of Gastroenterological Surgery, Harbin Medical University Cancer Hospital, Harbin Medical University, Harbin, 150081, People’s Republic of China; 2Department of Pathology, Harbin Medical University, Harbin, 150081, People’s Republic of China

*These authors contributed equally to this work

Correspondence: Yingwei Xue, Department of Gastrointestinal Surgery, Harbin Medical University Cancer Hospital, Harbin Medical University, Harbin, 150081, People’s Republic of China, Tel +86-13115505316, Email xueyingwei@hrbmu.edu.cn

Purpose: To evaluate the prognostic significance of peripheral inflammatory indices in patients with advantage papillary gastric carcinoma (APGC) and non-advantage papillary gastric carcinoma (NAPGC).
Methods: The study retrospectively analyzed 270 patients who underwent radical surgery. Patients were stratified into APGC (n=133) and NAPGC (n=137) cohorts based on papillary component proportion (≥ 50% papillary histology for APGC, < 50% for NAPGC). Receiver operating characteristic curve analysis was performed to assess the sensitivity of inflammatory indices for prognostic prediction. Overall survival was analyzed using Kaplan‒Meier survival and Log rank tests. The relationship between inflammatory indicators and clinicopathological characteristics was examined. Independent prognostic risk factors were identified using the Cox regression model and integrated into a nomogram, with calibration plots and decision curves used to evaluate predictive performance.
Results: Compared to NAPGC patients, APGC patients demonstrated higher pT stage and carcinoembryonic antigen (CEA) levels, with poorer survival outcomes. Stage III APGC patients showed higher peripheral blood neutrophil ratios than NAPGC patients. For APGC, neutrophil-to-lymphocyte ratio (NLR) and CEA were identified as independent prognostic factors, while for NAPGC, systemic immune-inflammatory index (SII), age, and pN stage were determined to be independent prognostic factors.
Conclusion: Significant differences exist in clinicopathological characteristics, peripheral blood inflammatory indices, and prognosis between APGC and NAPGC patients. The nomogram incorporating inflammatory indices NLR and SII effectively predicts prognosis in both APGC and NAPGC patients.

Keywords: gastric cancer, papillary carcinoma, inflammatory index, prognosis, nomogram