Abstract
BACKGROUND: Neoadjuvant chemotherapy is the primary treatment for locally advanced gastric cancer, and the efficacy of neoadjuvant chemotherapy has an important impact on the long-term prognosis of patients with gastric cancer. Accurately predicting the efficacy of neoadjuvant chemotherapy in patients with gastric cancer is critical to treatment planning, so it is necessary to identify the biological indicators of treatment efficacy. This study aimed to analyze the value of the systemic immune inflammation index in predicting the efficacy of neoadjuvant chemotherapy in patients with gastric cancer. METHODS: From January 2020 to December 2021, a total of 182 patients with locally advanced gastric cancer admitted to The Fifth Hospital of Shijiazhuang Hebei Province and Yangxin County People's Hospital and who received neoadjuvant chemotherapy were retrospectively enrolled. The patients were divided into an objective remission group (n=112) and a control group (no objective remission; n=70) according to the efficacy of neoadjuvant chemotherapy. Multivariate logistics regression was used to analyze the influencing factors of efficacy in patients with gastric cancer treated with neoadjuvant chemotherapy. Finally, the patients of the two groups were followed up for 3 years, and the recurrence, metastasis, and mortality of the two groups were observed. RESULTS: There were significant differences in the systemic immune inflammatory index, Ki-67 expression, lymph node metastasis, and tumor cell differentiation between the two groups (P<0.05). A high systemic immune inflammatory index score and poorly differentiated cancer were unfavorable factors for objective remission in patients treated with neoadjuvant chemotherapy, with relative risks of 0.974 (95% confidence interval: 0.965-0.982) and 0.086 (95% confidence interval: 0.022-0.338), respectively. Meanwhile, a high Ki-67 expression was a favorable factor for objective remission in patients with gastric cancer treated with neoadjuvant chemotherapy, with a relative risk of 1.090 (95% confidence interval: 1.034-1.148). The systemic immune inflammation index demonstrated high value in predicting objective remission in patients with gastric cancer treated with neoadjuvant chemotherapy, with an area under the curve of 0.947 (95% confidence interval: 0.914-0.981). Compared with that in the control group, the radical resection rate in the objective remission group was significantly higher (P>0.05). The 3-year recurrence rate, metastasis rate, and mortality rate were significantly lower in the objective remission group than in the control group (P<0.05). CONCLUSIONS: The efficacy of neoadjuvant chemotherapy in patients with locally advanced gastric cancer has an important impact on prognosis, and the systemic immune inflammation index is a reliable biological indicator for the efficacy of this treatment.