Risk factors and predictive models of postoperative pulmonary infection in gastric cancer: a review_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

DU Nan ¹ , MA Wenxiang ¹ , XIE Jiajing ¹ , YANG Yang ¹ ,  YU Yongjiang ²

1. The First Clinical Medical College of Lanzhou University, Lanzhou 730000, P. R. China;
2. Department of Gastrointestinal Surgery, Hernia and Abdominal Wall Surgery, The First Hospital of Lanzhou University, Lanzhou 730000, P. R. China;

Corresponding?author：

YU Yongjiang, Email: ylongy@163.com

Keywords：

gastric cancer; pulmonary infection; risk factor; predictive model

DOI：

10.7507/1007-9424.202509064

Video：

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Objective To systematically review the research progress on risk factors and predictive models for postoperative pulmonary infection (POPI) in gastric cancer patients, aiming to provide a reference for the early identification of high-risk patients and the optimization of clinical interventions. Methods By reviewing relevant domestic and international studies in recent years, the key risk factors for POPI in gastric cancer were summarized. And the construction methodologies, efficacy, and clinical application value of the latest predictive models developed in the last three years were evaluated. Results In addition to traditional risk factors, recent studies had further confirmed the significant predictive value of novel factors for POPI following gastric cancer surgery, including nutritional-immune-inflammatory markers (such as prognostic nutritional index, C-reactive protein to albumin ratio, C-reactive protein-albumin-lymphocyte index), preoperative frailty, sarcopenia, and specific surgical approaches (e.g., differences between totally laparoscopic and laparoscopically assisted gastrectomy). Regarding predictive models, nomogram models developed based on multivariate logistic regression analysis and risk scoring systems had demonstrated favorable performance in both internal and partial external validations, with the area under the receiver operating characteristic curve mostly ranging from 0.74 to 0.97. Notably, composite models that integrate nutritional and immune-inflammatory markers with frailty assessments had shown superior predictive accuracy and clinical applicability. Conclusions This review provides a novel predictive perspective based on emerging biomarkers and functional assessments for the early identification of high-risk populations of POPI following gastric cancer surgery. Future research should prioritize the validation and refinement of existing models through multicenter collaboration, ultimately transforming them into more effective clinical risk assessment tools to guide precision prevention.

Citation： DU Nan, MA Wenxiang, XIE Jiajing, YANG Yang, YU Yongjiang. Risk factors and predictive models of postoperative pulmonary infection in gastric cancer: a review. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2026, 33(2): 278-286. doi: 10.7507/1007-9424.202509064 Copy

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CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Risk factors and predictive models of postoperative pulmonary infection in gastric cancer: a review

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