Cachexia is associated with adverse clinical outcomes in patients with gastric cancer (GC); therefore, a convenient and reliable method for monitoring cachexia is essential. This study aimed to evaluate the utility of the cachexia index (CXI) as a biomarker for estimating cancer cachexia and health-related quality of life (HRQoL) in GC patients. The CXI was calculated as the skeletal muscle index (SMI) × serum albumin / neutrophil-lymphocyte ratio (NLR). Diagnosis of cachexia was based on Asian Working Group for Cachexia (AWGC) criteria and Fearon's criteria. Univariate and multivariate logistic regression analyses were carried out to identify potential risk factors related to cancer cachexia and HRQoL respectively. Receiver Operating Characteristics (ROC) analysis was conducted to evaluate the diagnostic value in identifying cancer cachexia, and the area under the ROC curve (AUC) was calculated. This study comprised a total of 431 patients diagnosed with GC, including 309 males (71.7%) and 122 females (28.3%), with a median age of 68 years. Compared to patients without cachexia, the CXI values were significantly lower in those with cachexia defined by either the AWGC criteria or Fearon's criteria (p < 0.001). After adjusting for potential confounding factors in the multivariate logistic analysis, CXI was found to be independently associated with AWGC-defined cachexia (OR = 0.98, 95% CI: 0.97-0.99, p < 0.001), but not with Fearon-defined cachexia (OR = 1.00, 95% CI: 0.99-1.01, p = 0.601). Based on ROC curve analysis, the AUC was 0.752 for males and 0.717 for females, with cut-off CXI values of 74.46 and 43.80 for identifying AWGC-defined cachexia, respectively. Patients with low CXI demonstrated greater severity in major aspects of HRQoL, and low CXI was independently associated with poor HRQoL (OR = 1.79, 95% CI = 1.05-3.07, p = 0.033). CXI could serve as a useful biomarker for evaluating cancer cachexia and HRQoL in patients with GC.

Background: Systemic inflammation is regarded as a key driver of cancer cachexia. This study aimed to explore the relationship between systemic inflammatory biomarkers and cancer cachexia and compare their predictive capabilities in patients with gastric cancer (GC). Methods: Cancer cachexia was diagnosed according to Asian Working Group for Cachexia (AWGC) criteria. Logistic regression analyses were utilized to evaluate the association between systemic inflammation biomarkers and cancer cachexia. The receiver operating characteristic curve was used to assess the predictive performance of these biomarkers in identifying cancer cachexia. Results: A total of 440 patients were included in this study. Among them, 167 patients (37.95%) were diagnosed with cachexia. In GC patients with cachexia, systemic inflammation biomarkers including neutrophil-to-lymphocyte ratio (NLR), systemic immune-inflammation index (SII), systemic inflammatory response index (SIRI), aggregate index of systemic inflammation (AISI), inflammatory prognostic index (IPI), and inflammatory burden index (IBI) were significantly elevated, while the advanced lung cancer inflammation index (ALI) was significantly decreased (all p < 0.001). After adjusting for potential confounding variables, all these systemic inflammation biomarkers were significantly associated with cancer cachexia (all p < 0.001). According to the Delong test, ALI showed the highest AUC (AUC = 0.746, 95%: 0.698–0.794) compared with the other systemic inflammation biomarkers (all p < 0.05). Conclusion: Our findings demonstrated that NLR and NLR-related systemic inflammatory biomarkers (SII, SIRI, AISI, IPI, IBI, and ALI) were significantly associated with cancer cachexia. Among these biomarkers, ALI exhibited the highest efficacy in identifying GC patients with cancer cachexia.

Background: STAD ranked 5th most common in the incidence of malignant tumors and 3rd most common in the death rate of cancer worldwide. CXC chemokines affect the biological progress of various tumors, resulting in therapeutic failure. The role of CXCL2 in STAD was still a mystery. Methods: The expression, prognostic value, and clinical function of CXCL2 were analyzed using several online bioinformatics tools and clinical tissues. Results: CXCL2 level was significantly upregulated in STAD tissues. Strong correlation was obtained between CXCL2 level and immune cells as well as immune biomarkers. High CXCL2 expression in STAD was correlated with a favorable prognosis. Further analysis revealed that CXCL2, pTNM stage and age were independent factors affecting the prognosis of STAD patients. A predictive nomogram indicated that the calibration plots for the 1-year, 3-year and 5-year OS rates were predicted relatively well compared with an ideal model in the entire cohort. Validation analysis revealed that CXCL2 expression was upregulated in STAD and high CXCL2 level had a better overall survival. CXCL2 was associated with resistance to numerous drugs or small molecules in STAD. Conclusions: We identified CXCL2 as a novel therapeutic target and associated with immune infiltration in STAD.