Diagnostic value of systemic immune-inflammation index and prognostic nutritional index combined with CEA in gastric cancer with lymph node metastasis.

Background: Carcinoembryonic antigen (CEA), systemic immune-inflammation index(SII), and prognostic nutritional index (PNI) are diagnostic markers for cancer, but their combined significance in gastric cancer (GC) with lymph node metastasis remains unclear. The aim of this study was to evaluate the association between these serum biomarkers and lymph node metastasis in patients with GC. Methods: Records of patients with GC were reviewed retrospectively. Univariate and multivariate logistic regression were performed to examine the association between tumor markers, serum biomarkers and lymph node metastasis in GC. Based on the results of multivariate regression, a nomogram was developed and verified. Results: Of the 395 patients aged 68.5 ± 9.1 years, 192 (48.6%) were diagnosed with lymphatic node metastasis. After adjusting for confounding factors, CEA (Odd ratio (OR):2.21; 95%CI: 1.17-3.81) and SII (OR:1.02; 95%CI: 1.01-1.04) was identified as significant risk factors, while PNI (OR:0.90; 95%CI: 0.85~0.96) was a protective factor for lymph node metastasis. The established nomogram by incorporating CEA, SII, PNI, differentiation, and tumor diameter can effectively predict lymph node metastasis in GC. Conclusion: CEA, SII, PNI, differentiation, and tumor diameter were significantly associated with lymph node metastasis in patients with GC, and the combination of CEA, SII, PNI, differentiation, and tumor diameter has a better diagnostic value than either index alone.