Prognostic Value of the TyG Index and CHG Index in Gastric Cancer

OBJECTIVE: To assess associations of the triglyceride-glucose (TyG) index and cholesterol high-density lipoprotein glucose (CHG) index with overall survival (OS) and progression-free survival (PFS) in gastric cancer (GC), and to explore whether prognostic value differs by pathological stage. METHODS: We conducted a retrospective cohort study using routinely collected electronic medical record data from West China Hospital, Sichuan University, including patients who underwent GC resection between 2008 and 2021. TyG and CHG were calculated from preoperative laboratory parameters. Associations with OS and PFS were assessed using multivariable Cox models, with subgroup analyses by pathological stage. Kaplan-Meier and time-dependent receiver operating characteristic analyses were also performed. RESULTS: In the overall cohort, TyG and CHG have no independent association with OS or PFS after adjustment. Subgroup analyses stratified by cancer stage showed higher CHG index was associated with worse OS in Stage 1 (hazard ratios [HR] = 2.038, 95% confidence interval [CI]: 1.336-3.110, p < 0.001), whereas higher TyG index was associated with better OS in Stage 4 (HR = 0.860, 95% CI: 0.756-0.980, p = 0.023). Kaplan-Meier analyses supported these stage-specific associations. CHG showed the best predictive performance for Stage 1 OS, while TyG index showed relatively stable discrimination for Stage 4 OS. CONCLUSIONS: The prognostic value of TyG and CHG in GC appears to be stage-dependent. CHG index may be more useful in stage 1, whereas lower TyG index may indicate poorer prognosis in stage 4.