Prognostic value of the prognostic immune-inflammatory-nutritional score in patients with advanced gastric cancer treated with immunochemotherapy

doi:10.4251/wjgo.122724

Advanced Search

BPG is committed to discovery and dissemination of knowledge

Home / Archive / Volume 18, Issue 10

This Article

(10)

(8)

(0)

(15)

Peer-Review Report of This Article

CrossCheck and Google Search of This Article

Academic Rules and Norms of This Article

Citation of this article

Corresponding Author of This Article

Research Domain of This Article

Article-Type of This Article

Open-Access Policy of This Article

Times Cited Counts in Google of This Article

Journal Information of This Article

Publication Name

World Journal of Gastrointestinal Oncology

ISSN

1948-5204

Publisher of This Article

Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA

Retrospective Study

Copyright: ©Author(s) 2026. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution-NonCommercial (CC BY-NC 4.0) license. No commercial re-use. See permissions. Published by Baishideng Publishing Group Inc.

World J Gastrointest Oncol. Oct 15, 2026; 18(10): 122724
Published online Oct 15, 2026. doi: 10.4251/wjgo.122724

Table 1 Baseline characteristics stratified by prognostic immune-inflammatory-nutritional score (< 25.69 vs ≥ 25.69), mean ± SD/n (%)

Variables	Total (n = 200)	Low (n = 68)	High (n = 132)	t /χ²	P value
ALBI	-2.38 ± 0.54	-2.48 ± 0.49	-2.33 ± 0.56	-1.88	0.061
NLR	3.21 ± 2.01	2.01 ± 0.91	3.83 ± 2.14	-8.38	< 0.001
SII	748.17 ± 528.33	433.34 ± 234.34	910.35 ± 563.89	-8.41	< 0.001
PNI	42.49 ± 6.61	44.21 ± 5.64	41.61 ± 6.92	2.68	0.008
FIB	2.85 ± 0.82	2.36 ± 0.46	3.10 ± 0.86	-7.89	< 0.001
Gender				0.21	0.644
Female	75 (37.50)	24 (35.29)	51 (38.64)
Male	125 (62.50)	44 (64.71)	81 (61.36)
Age (years)				0.06	0.801
< 60 years	78 (39.00)	28 (41.18)	50 (37.88)
≥ 60 years	122 (61.00)	40 (58.82)	82 (62.12)
BMI (kg/m²)				3.11	0.078
< 25	166 (83.00)	52 (76.47)	114 (86.36)
≥ 25	34 (17.00)	16 (23.53)	18 (13.64)
CEA (ng/mL)				0.76	0.382
≥ 3	121 (60.50)	44 (64.71)	77 (58.33)
< 3	79 (39.50)	24 (35.29)	55 (41.67)
CA199 (ng/mL)				0.76	0.382
< 37	127 (63.50)	46 (67.65)	81 (61.36)
≥ 37	73 (36.50)	22 (32.35)	51 (38.64)
ECOG				3.34	0.068
0	71 (35.50)	30 (44.12)	41 (31.06)
1	129 (64.50)	38 (55.88)	91 (68.94)
TNM staging				0.14	0.705
III	89 (44.50)	29 (42.65)	60 (45.45)
IV	111 (55.50)	39 (57.35)	72 (54.55)
Differentiation				4.37	0.037
Poorly/undifferentiated	180 (90.00)	57 (83.82)	123 (93.18)
Medium/high	20 (10.00)	11 (16.18)	9 (6.82)
Peritoneal metastasis				3.54	0.060
No	113 (56.50)	45 (66.18)	68 (51.52)
Yes	87 (43.50)	23 (33.82)	64 (48.48)
Liver metastasis				2.82	0.093
No	157 (78.50)	58 (85.29)	99 (75.00)
Yes	43 (21.50)	10 (14.71)	33 (25.00)
PD-L1 expression				3.55	0.060
CPS < 5	95 (47.50)	26 (38.24)	69 (52.27)
CPS ≥ 5	105 (52.50)	42 (61.76)	63 (47.73)
MMR status				0.99	0.319
pMMR	158 (79.00)	51 (75.00)	107 (81.06)
dMMR	42 (21.00)	17 (25.00)	25 (18.94)

ALBI: Albumin-bilirubin; NLR: Neutrophil-to-lymphocyte ratio; SII: Systemic immune-inflammation index; PNI: Prognostic nutritional index; FIB: Fibrinogen; BMI: Body mass index; CEA: Carcinoembryonic-antigen; CA199: Carbohydrate antigen 199; ECOG: Eastern Cooperative Oncology Group; PD-L1: Programmed death-ligand 1; CPS: Combined positive score; MMR: Mismatch repair; pMMR: Proficient mismatch repair; dMMR: Deficient mismatch repair.

Full Size Table

Table 2 Comparison of features between the training and validation sets, n (%)

Variables	Total (n = 200)	Test (n = 60)	Train (n = 140)	χ²	P value
Gender				0.63	0.426
Female	75 (37.50)	20 (33.33)	55 (39.29)
Male	125 (62.50)	40 (66.67)	85 (60.71)
Age (years)				3.14	0.076
< 60 years	78 (39.00)	29 (48.33)	49 (35.00)
≥ 60 years	122 (61.00)	31 (51.67)	91 (65.00)
BMI (kg/m²)				0.55	0.46
< 25	166 (83.00)	48 (80.00)	118 (84.29)
≥ 25	34 (17.00)	12 (20.00)	22 (15.71)
CEA (ng/mL)				0.17	0.682
≥ 3	121 (60.50)	35 (58.33)	86 (61.43)
< 3	79 (39.50)	25 (41.67)	54 (38.57)
CA199 (ng/mL)				0.08	0.773
< 37	127 (63.50)	39 (65.00)	88 (62.86)
≥ 37	73 (36.50)	21 (35.00)	52 (37.14)
PIIN score				0.72	0.397
Low	68 (34.00)	23 (38.33)	45 (32.14)
High	132 (66.00)	37 (61.67)	95 (67.86)
ECOG				0.76	0.384
0	71 (35.50)	24 (40.00)	47 (33.57)
1	129 (64.50)	36 (60.00)	93 (66.43)
TNM staging				0.16	0.686
III	89 (44.50)	28 (46.67)	61 (43.57)
IV	111 (55.50)	32 (53.33)	79 (56.43)
Peritoneal metastasis				0	0.975
No	113 (56.50)	34 (56.67)	79 (56.43)
Yes	87 (43.50)	26 (43.33)	61 (43.57)
Liver metastasis				2.15	0.143
No	157 (78.50)	51 (85.00)	106 (75.71)
Yes	43 (21.50)	9 (15.00)	34 (24.29)
PD-L1 expression				0.19	0.663
CPS < 5	88 (44.00)	25 (41.67)	63 (45.00)
CPS ≥ 5	112 (56.00)	35 (58.33)	77 (55.00)
MMR status				0.28	0.596
pMMR	158 (79.00)	46 (76.67)	112 (80.00)
dMMR	42 (21.00)	14 (23.33)	28 (20.00)

BMI: Body mass index; CEA: Carcinoembryonic-antigen; CA199: Carbohydrate antigen 199; PIIN: Prognostic immune-inflammatory-nutritional; ECOG: Eastern Cooperative Oncology Group; PD-L1: Programmed death-ligand 1; CPS: Combined positive score; MMR: Mismatch repair; pMMR: Proficient mismatch repair; dMMR: Deficient mismatch repair.

Full Size Table

Table 3 Tumor responses stratified by prognostic immune-inflammatory-nutritional score (< 25.69 vs ≥ 25.69), n (%)

Variables	Total (n = 200)	Low (n = 68)	High (n = 132)	χ²	P value
CR				-	-
No	189 (94.50)	63 (92.65)	126 (95.45)
Yes	11 (5.50)	5 (7.35)	6 (4.55)
PR				-	-
No	108 (54.00)	31 (45.59)	77 (58.33)
Yes	92 (46.00)	37 (54.41)	55 (41.67)
SD				-	-
No	168 (84.00)	57 (83.82)	111 (84.09)
Yes	32 (16.00)	11 (16.18)	21 (15.91)
PD				-	-
No	135 (67.50)	53 (77.94)	82 (62.12)
Yes	65 (32.50)	15 (22.06)	50 (37.88)
ORR				1.41	0.235
No	97 (48.50)	29 (42.65)	68 (51.52)
Yes	103 (51.50)	39 (57.35)	64 (48.48)
DCR				5.12	0.024
No	65 (32.50)	15 (22.06)	50 (37.88)
Yes	135 (67.50)	53 (77.94)	82 (62.12)

CR: Complete response; PR: Partial response; SD: Stable disease; PD: Progressive disease; ORR: Objective response rate; DCR: Disease control rate.

Full Size Table

Table 4 Univariate and multivariate analyses of prognostic factors for progression-free survival

Variables	Univariate		Multivariate
Variables	P value	HR (95%CI)	P value	HR (95%CI)
Gender
Male vs female	0.334	0.83 (0.56-1.22)	0.242	1.27 (0.85-1.91)
Age (years)
≥ 60 vs < 60	0.18	1.30 (0.89-1.91)	0.884	0.97 (0.66-1.44)
BMI (kg/m²)
< 25 vs ≥ 25	0.171	1.38 (0.87-2.19)
CEA (ng/mL)
< 3 vs ≥ 3	0.3	1.22 (0.83-1.80)
CA199 (ng/mL)
< 37 vs ≥ 37	0.103	1.37 (0.94-2.01)
PIIN score
< 25.69 vs ≥ 25.69	0.004	1.82 (1.20-2.76)	0.004	1.88 (1.23-2.87)
ECOG
0 vs 1	0.005	1.80 (1.19-2.73)
TNM staging
III vs IV	< 0.001	2.74 (1.82-4.15)	< 0.001	2.24 (1.44-3.47)
Peritoneal metastasis
No vs yes	0.005	1.74 (1.19-2.56)
Liver metastasis
No vs yes	0.103	1.49 (0.92-2.40)
PD-L1 expression
CPS < 5 vs CPS ≥ 5	< 0.001	0.27 (0.17-0.42)	< 0.001	0.35 (0.22-0.55)
MMR status
pMMR vs dMMR	< 0.001	0.33 (0.19-0.56)	< 0.001	0.35 (0.20-0.63)

BMI: Body mass index; CEA: Carcinoembryonic-antigen; CA199: Carbohydrate antigen 199; PIIN score: Prognostic immune-inflammatory-nutritional score; ECOG: Eastern Cooperative Oncology Group; PD-L1: Programmed death-ligand 1; CPS: Combined positive score; MMR: Mismatch repair; pMMR: Proficient mismatch repair; dMMR: Deficient mismatch repair; HR: Hazard ratio.

Full Size Table

Table 5 Univariate and multivariate analyses of prognostic factors for overall survival

Variables	Univariate		Multivariate
Variables	P value	HR (95%CI)	P value	HR (95%CI)
Gender
Male vs female	0.941	0.98 (0.63-1.54)	0.182	1.38 (0.86-2.21)
Age (years)
≥ 60 vs < 60	0.295	1.29 (0.80-2.06)	0.781	1.07 (0.67-1.70)
BMI (kg/m²)
< 25 vs ≥ 25	0.348	0.73 (0.38-1.41)
CEA (ng/mL)
< 3 vs ≥ 3	0.231	1.31 (0.84-2.02)
CA199 (ng/mL)
< 37 vs ≥ 37	0.200	1.33 (0.86-2.06)
PIIN score
< 25.69 vs ≥ 25.69	< 0.001	2.75 (1.57-4.83)	0.013	2.09 (1.17-3.75)
ECOG
0 vs 1	0.002	2.20 (1.33-3.61)	0.033	1.76 (1.05-2.95)
TNM staging
III vs IV	< 0.001	3.20 (1.98-5.16)	< 0.001	2.77 (1.62-4.75)
Peritoneal metastasis
No vs yes	0.173	1.35 (0.88-2.09)
Liver metastasis
No vs yes	0.008	1.90 (1.18-3.05)
PD-L1 expression
CPS < 5 vs CPS ≥ 5	< 0.001	0.25 (0.16-0.41)	< 0.001	0.41 (0.25-0.69)
MMR status
pMMR vs dMMR	< 0.001	0.30 (0.16-0.58)	0.003	0.37 (0.19-0.72)

Full Size Table

Table 6 Comparison of adverse events stratified by prognostic immune-inflammatory-nutritional score (< 25.69 vs ≥ 25.69) in patients, n (%)

Variables	Total (n = 200)	Low (n = 68)	High (n = 132)	χ²	P value
Leukopenia	82 (41.00)	30 (44.12)	52 (39.39)	0.41	0.520
Anemia	88 (44.00)	32 (47.06)	56 (42.42)	0.39	0.532
Neutropenia	85 (42.50)	35 (51.47)	50 (37.88)	3.39	0.065
Thrombocytopenia	66 (33.00)	27 (39.71)	39 (29.55)	2.10	0.148
Nausea	54 (27.00)	22 (32.35)	32 (24.24)	1.50	0.221
Pyrexia	54 (27.00)	24 (35.29)	30 (22.73)	3.60	0.058
Elevated ALT	31 (15.50)	15 (22.06)	16 (12.12)	3.38	0.066
Elevated AST	38 (19.00)	18 (26.47)	20 (15.15)	3.74	0.053
Hypothyroidism	34 (17.00)	16 (23.53)	18 (13.64)	3.11	0.078
Hypertension	28 (14.00)	10 (14.71)	18 (13.64)	0.04	0.836
Pneumonitis	23 (11.50)	9 (13.24)	14 (10.61)	0.30	0.581
Hyperbilirubinemia	17 (8.50)	6 (8.82)	11 (8.33)	0.01	0.906
Fatigue	31 (15.50)	13 (19.12)	18 (13.64)	1.03	0.310
> 3 grades: Leukopenia	20 (10.00)	9 (13.24)	11 (8.33)	1.20	0.274
> 3 grades: Anemia	17 (8.50)	6 (8.82)	11 (8.33)	0.01	0.906
> 3 grades: Neutropenia	26 (13.00)	12 (17.65)	14 (10.61)	1.97	0.161
> 3 grades: Thrombocytopenia	36 (18.00)	16 (23.53)	20 (15.15)	2.13	0.144
> 3 grades: Nausea	9 (4.50)	4 (5.88)	5 (3.79)	0.10	0.751
> 3 grades: Elevated ALT	7 (3.50)	4 (5.88)	3 (2.27)	0.83	0.363
> 3 grades: Elevated AST	9 (4.50)	3 (4.41)	6 (4.55)	0.00	1.000
> 3 grades: Hypothyroidism	6 (3.00)	3 (4.41)	3 (2.27)	0.16	0.687
> 3 grades: Hypertension	8 (4.00)	3 (4.41)	5 (3.79)	0.00	1.000
> 3 grades: Pneumonitis	3 (1.50)	1 (1.47)	2 (1.52)	0.00	1.000
> 3 grades: Hyperbilirubinemia	6 (3.00)	2 (2.94)	4 (3.03)	0.00	1.000

ALT: Alanine aminotransferase; AST: Aspartate aminotransferase.

Full Size Table

Citation: Hao QL, Li ZY, Yao ZY, Shen YM, Sun DS, Gao C, Jiang RR. Prognostic value of the prognostic immune-inflammatory-nutritional score in patients with advanced gastric cancer treated with immunochemotherapy. World J Gastrointest Oncol 2026; 18(10): 122724
URL: https://www.wjgnet.com/1948-5204/full/v18/i10/122724.htm
DOI: https://dx.doi.org/10.4251/wjgo.122724

Hao QL, Li ZY, Yao ZY, Shen YM, Sun DS, Gao C, Jiang RR. Prognostic value of the prognostic immune-inflammatory-nutritional score in patients with advanced gastric cancer treated with immunochemotherapy. World J Gastrointest Oncol 2026; 18(10): 122724 [DOI: 10.4251/wjgo.122724]

All content on this site: Copyright © 1993-2026 Baishideng Publishing Group Inc, its licensors, and contributors. All rights are reserved, including those for text and data mining, AI training, and similar technologies. For all open access content, the relevant licensing terms apply.