Abstract

Objective: We evaluated a comprehensive panel of hematological inflammation indices in relation to histopathological features of gastritis and benchmarked them against age.

Materials and Methods: In this single-center, retrospective, cross-sectional study, 254 adults who underwent upper gastrointestinal endoscopy with gastric biopsy between June and December 2025 were analyzed. Conventional cellular ratios, composite inflammation indices, C-reactive protein- and nutrition-based measures, and exploratory immature granulocyte-based indices were computed from the pre-procedural hemogram. The primary endpoint was active inflammation; secondary endpoints were chronic inflammation, Helicobacter pylori, atrophy, and intestinal metaplasia. Discrimination was assessed by receiver operating characteristic analysis with DeLong comparison, multivariable logistic regression, and five-fold cross-validation; Benjamini-Hochberg correction was applied for multiple testing.

Results: Active inflammation was present in 100 patients (39.4%) and corresponded almost entirely to Helicobacter pylori-associated chronic active gastritis (kappa 0.98). No index differed with respect to any histopathological endpoint, nor did any distinguish gastritis subtypes. After correction, age was the only variable independently associated with active inflammation (an odds ratio of 0.65 per standard deviation, 95% confidence interval 0.50-0.86; p = 0.002). Age discriminated active inflammation better than each other index (area under the curve 0.631 versus 0.51-0.55), and this difference was statistically significant for all comparisons except for the systemic immune-inflammation index (DeLong p = 0.096). Adding the blood panel to age reduced the cross-validated discrimination from 0.632 to 0.594.

Conclusions: Peripheral hematological inflammatory indices did not reflect the histopathological status of the gastric mucosa. The only discriminating variable was age, which reflected the natural history of gastric disease rather than a systemic inflammatory signal.

Keywords: age factors, biomarkers, blood cell count, gastritis, Helicobacter pylori, neutrophils

Copyright and license

Copyright © 2026 The Author(s). This is an open-access article published by Bolu İzzet Baysal Training and Research Hospital under the terms of the Creative Commons Attribution License (CC BY) which permits unrestricted use, distribution, and reproduction in any medium or format, provided the original work is properly cited.

How to cite

1.
Keyif MF, Bolat F. Peripheral blood inflammation indices versus age in predicting gastritis histopathology: A cross-sectional study. Northwestern Med J. 2026;6(4):354-63. https://doi.org/10.54307/NWMJ.2026.273

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