Clinical Report: Evaluating the Diagnostic Significance of Combined Systemic Immune-Inflammation Indices and Nutritional and Tumor Markers for Staging Pancreatic Cancer

Overview

This study investigates the diagnostic value of combining systemic immune–inflammation indices and nutritional and tumor markers for staging pancreatic cancer.

Background

Pancreatic cancer is a highly aggressive malignancy with a poor prognosis, often diagnosed at advanced stages due to non-specific early symptoms. Accurate staging is crucial for treatment planning and improving patient outcomes, highlighting the need for reliable biomarkers. Current tumor markers like CA19-9 have limitations, necessitating the exploration of additional diagnostic strategies.

Data Highlights

Key Findings

• Patients with non-early-stage pancreatic cancer had significantly higher SII, SIRI, CA19-9, and CEA levels compared to early-stage patients (P < 0.01).
• PNI demonstrated the best diagnostic performance for early-stage pancreatic cancer with an AUC of 0.78.
• The combined model of SII, SIRI, and PNI achieved an AUC of 0.82, surpassing individual markers.
• When all inflammatory, nutritional, and tumor markers were combined, the diagnostic performance improved to an AUC of 0.88.
• The combined model maintained good diagnostic value in CA19-9–negative patients with an AUC of 0.85.

Clinical Implications

The findings indicate that combining systemic immune–inflammation indices with nutritional parameters and tumor markers can enhance the diagnostic accuracy for early-stage pancreatic cancer.

Conclusion

The study supports the use of a multi-marker strategy to improve the diagnosis of early-stage pancreatic cancer.

Related Resources & Content

1. Journal of Gastrointestinal Surgery, 2019 -- Systemic Immune-Inflammation Index (SII) as a Prognostic Indicator for Survival in Patients with Resected Pancreatic Cancer
2. Journal of Gastrointestinal Surgery, 2018 -- Evaluating the Prognostic Significance of Staging Systems and Inflammatory Markers in Surgical Candidates with Combined Hepatocellular Cholangiocarcinoma: A Retrospective Analysis
3. Frontiers in Oncology, 2026 -- Distinct roles of nutritional and inflammatory signatures in predicting pathological response versus long-term survival in locally advanced gastric cancer treated with neoadjuvant immunotherapy
4. Frontiers in Immunology, 2026 -- An integrated SII-PNI immune-nutritional scoring system predicts efficacy and immune-related adverse events in locally advanced gastric cancer patients undergoing neoadjuvant immunotherapy
5. NCCN Guidelines, 2025 -- Pancreatic Adenocarcinoma
6. PMC, 2023 -- Prognostic Nutritional Index and Cancer Prognostic Outcomes: An Umbrella Review of Systematic Reviews and Meta-analyses of Observational Studies
7. BMC Gastroenterology, 2025 -- The prognostic value of systemic inflammation response index in digestive system carcinomas: a systematic review and meta-analysis
8. PubMed, 2023 -- Comparative diagnostic performance of endoscopic ultrasound, MRI, and CT for preoperative assessment of pancreatic cancer: a Bayesian network meta-analysis under a graded reference standard
9. https://www.oregon.gov/oha/HPA/DSI-HERC/MembersOnly/7.1d%20NCCN%202.2025%20pancreatic.pdf
10. Prognostic Nutritional Index and Cancer Prognostic Outcomes: An Umbrella Review of Systematic Reviews and Meta-analyses of Observational Studies - PMC
11. The prognostic value of systemic inflammation response index in digestive system carcinomas: a systematic review and meta-analysis | BMC Gastroenterology | Springer Nature Link
12. Comparative diagnostic performance of endoscopic ultrasound, MRI, and CT for preoperative assessment of pancreatic cancer: a Bayesian network meta-analysis under a graded reference standard - PubMed