Connecting systemic inflammation to prognosis in neuroendocrine neoplasms: a biomarker-based approach

Background Neuroendocrine neoplasms (NENs) comprise a diverse group of tumors with distinct clinical courses and prognoses. However, there remains a need to identify affordable biomarkers that can augment traditional prognostic indicators. Methods To address this clinical need, we performed a retrospective analysis of 60 patients with NENs treated at the University Emergency Hospital of Bucharest (2016–2023). The baseline neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and systemic immune-inflammation index (SII) were derived from routine blood counts and were associated with demographic, histopathological, and mortality during follow-up. Logistic regression models assessed prognostic significance. Results Of the 60 patients, 38.3% died during follow-up. Univariate analysis identified low lymphocyte counts, elevated platelet counts, PLR, NLR and SII as significant predictors of mortality. Building upon these findings, multivariate models revealed that advanced age, poorly differentiated NEC histology, and elevated SII were significantly associated with increased mortality. Conclusion In summary, this study identifies SII, NLR and PLR as accessible, reliable, and cost-effective biomarkers with prognostic value in NENs. Thus, integrating these indices with established clinicopathological features may improve risk stratification and inform personalized management. Nonetheless, validation in larger, prospective cohorts is necessary to substantiate these findings.