Prognostic Role of Inflammatory Biomarkers in Gastrointestinal Neuroendocrine Neoplasms: A Cross-Sectional Study

Gastrointestinal neuroendocrine neoplasms (g-NENs) represent a heterogeneous group of tumors with variable prognoses. Inflammation-based markers, such as the neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR), have emerged as potential prognostic indicators in various malignancies. This study aimed to evaluate the prognostic significance of NLR and PLR in g-NENs and their associations with histopathological features and survival outcomes.

A retrospective, cross-sectional study was conducted on 80 patients with histologically confirmed g-NENs from April 2017 to March 2019. Baseline NLR and PLR were calculated, and their relationships with tumor grade, Ki-67 proliferation index, metastatic status, and survival outcomes were analyzed. Cox regression and logistic regression models were used to determine independent prognostic factors.

The hazard of death was approximately one-third in the low NLR group after adjusting for metastasis and tumor grade (HR = 0.33, 95% CI: 0.14-0.80, p < 0.05). Elevated PLR was associated with poor outcomes; however, the difference between the high and low PLR groups was not statistically significant. Higher tumor grades and elevated Ki-67 indices correlated with worse survival and increased metastatic potential (p < 0.001). No significant associations were observed for CRP or ESR levels with survival.

Our findings suggest that NLR may serve as an independent and accessible prognostic marker in g-NENs, potentially offering a cost-effective tool to support clinical decision-making. The combined assessment of inflammatory biomarkers and histopathological parameters could improve prognostic accuracy and help guide personalized management strategies in patients with g-NENs. Nevertheless, these observations should be interpreted with caution due to the retrospective, single-center design and limited sample size. Future large-scale, prospective studies are warranted to confirm and expand upon these results.