Prognostic value of combined lymphocyte-to-monocyte ratio and cancer antigen 724 in patients with proximal gastric cancer residing in extremely cold regions

Abstract

Background This study aimed to evaluate the prognostic value of the lymphocyte-to-monocyte ratio (LMR) and cancer antigen 724 (CA724) in patients with proximal gastric cancer residing in cold climate regions. Methods A retrospective analysis was conducted on 313 patients diagnosed with proximal gastric cancer in cold climate regions between 2014 and 2017. Preoperative hematological markers, including LMR and CA724, were assessed. Receiver operating characteristic (ROC) curves were used to determine optimal cutoff values, which were then combined to form the LMR + CA724 score. Statistical analyses included Kaplan-Meier survival curves, log-rank tests, and Cox proportional hazards regression. Results A high preoperative LMR + CA724 score was significantly associated with older age, advanced pTNM stage, vascular invasion, and elevated levels of NMPVR, NMR, and AAR. The LMR + CA724 score demonstrated a higher area under the curve (AUC) compared to LMR or CA724 alone. Multivariate analysis identified pTNM stage, Borrmann type, histological type, and the LMR + CA724 score as independent prognostic factors for overall survival (OS). A nomogram incorporating these four variables achieved an AUC of 0.817, indicating strong predictive performance. Conclusion The LMR + CA724 score is a reliable and independent prognostic indicator for patients with proximal gastric cancer in cold climate regions. Its integration into clinical practice may support treatment planning and long-term management by enhancing personalized care. Further prospective studies are warranted to validate these findings in broader and more diverse patient populations.

Keywords

proximal gastric cancer / cold regions / lymphocyte-to-monocyte ratio / carbohydrate antigen 724 / prognostic evaluation

Acknowledgements:

The authors express their gratitude to Harbin Medical University Cancer Hospital for providing the data used in this study.

Research ethics

This study was approved by the Ethics Committee of Harbin Medical University Cancer Hospital (2019-164-R). The study was conducted in accordance with the ethical standards set out in the 1964 Declaration of Helsinki and its later amendments.

Informed consent

Not applicable.

Author contributions

Use of large language models, AI and machine learning tools

Not applicable.

Conflict of interest

The authors declare no conflicts of interest related to this study.

Data availability

Patient data were stored in the Gastric Cancer Information Management System v1.2, developed by Harbin Medical University Cancer Hospital (Copyright No. 2013SR087424,http://www.sgihmu.com).

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