Abstract / Summary
Background:Systemic inflammatory indices are widely investigated as accessible biomarkers in gastric cancer, primarily for prognostic assessment.Their ability to discriminate tumor stage before treatment remains uncertain.This study evaluated the diagnostic performance of preoperative systemic inflammatory indices for distinguishing early-stage from advanced-stage gastric cancer. Material/Methods:This retrospective study included 151 patients with histologically confirmed gastric cancer treated between January 2018 and December 2023.Patients were classified as having early-stage (stage I-II, n = 38) or advancedstage (stage III-IV, n = 113) gastric cancer according to the American Joint Committee on Cancer 8th edition tumor-node-metastasis classification.Preoperative neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), lymphocyte-to-monocyte ratio (LMR), mean platelet volume (MPV), systemic immune-inflammation index (SII), and systemic inflammation response index (SIRI) were calculated from routine laboratory tests.Group comparisons, receiver operating characteristic (ROC) analysis, univariable logistic regression, Spearman correlation, and multicollinearity analyses were performed. Results:None of the inflammatory indices differed significantly between stage groups (all P > 0.05).ROC analysis demonstrated limited discrimination, with areas under the ROC curve ranging from 0.474 to 0.570.Univariable logistic regression identified no significant association between any inflammatory index and advanced-stage disease.Strong correlations were observed among NLR, SII, and SIRI, while multicollinearity analysis demonstrated substantial overlap among several composite indices. Conclusions:Preoperative systemic inflammatory indices showed limited ability to discriminate between early-stage and advanced-stage gastric cancer.They should therefore be considered complementary rather than stand-alone tools for preoperative tumor stage assessment.Prospective multicenter studies integrating inflammatory indices with radiological, pathological, and molecular biomarkers are warranted.