Pan-Immune-Inflammation Value is a novel prognostic biomarker in advanced Gastric Cancer Patients

Background: Advanced gastric cancer (GC) is a common malignancy with a poor prognosis, which remains the leading cause of cancer death worldwide. Identifying novel biomarkers is needed to predict survival for this highly progressive cancer. Many studies have confirmed that pan-immune-inflammation value (PIV) is related to the prognosis of various tumors in recent years. However, the prognostic value of PIV remains unclear in gastric cancer. The purpose of this study was to discuss the prognostic role of PIV in stage III and IV gastric cancer. Methods: The clinical data of 646 patients with gastric cancer after gastrectomy were retrospectively analyzed. The calculation method of PIV is PIV=neutrophil count (10 ⁹ /L) × platelet count (10 ⁹ /L) × monocyte count (10 ⁹ /L)/lymphocyte count (10 ⁹ /L). Patients were divided into high and low PIV group by cut-off value based on receiver operating characteristic (ROC) curve. Effects of PIV and other IIB on survival were analyzed based on the ROC curves. Kaplan-Meier method was plotted to indicate the value of immune-inflammatory biomarkers (IIBs) in predicting the overall survival of gastric cancer. The overall survival (OS) in advanced gastric cancer patients were analyzed and univariate and multivariate statistics were used to evaluate the prognostic value. Results: PIV had the most significantly predictive value in advanced GC patients compared with other peripheral blood parameters and IIBs. Cases in the high PIV group were more likely to have low serum albumin (Alb) level, larger tumor size compared with those in the low PIV group. PIV was identified an independent prognostic indicator for survival outcome in advanced GC patients in univariate and multivariate models. Conclusions: This study confirmed that PIV can reflect the prognosis of advanced GC patients who have undergone gastrectomy, suggesting a potential application of PIV in GC treatment outcomes. Compared to other IIb indicators, PIV is more sensitive as a prognostic indicator. PIV will also provide some insight into the underlying mechanisms of immune and inflammatory effects in GC development and progression. Trial registration: This study was a retrospective analysis, which has no intervention on human participants.