Can Neutrophil-To-Lymphocyte Ratio (Nlr) be a simple predictive marker for differentiating gastric intestinal metaplasia and gastric atrophy from non-atrophic non-metaplastic chronic gastritis?

Abstract

Background: Gastric İntestinal Metaplasia (GIM) and Gastric Atrophy (GA) are pre-neoplastic lesions that can lead to gastric cancer. Nowadays, there are no recognized good biomarkers of GIM and GA. The neutrophil-to-lymphocyte ratio (NLR) is an economical, effective, and repetitive indicator of inflammation. We aimed to comparatively evaluate Red Cell Distribution Width (RDW) and the NLR. Methods: 88 patients with GIM and 48 patients with GA and 64 patients with non-atrophic-non-metaplastic gastritis were included in the study. NLR and RDW levels were measured in patients and controls. Results: NLR levels were significantly higher in patients with GIM than in controls (p < 0.05). NLR level was correlated positively with presence of GIM (p < 0.05), H.pylori presence in GIM and GA (p < 0.05), and menopause (p < 0.05). A multiple logistic regression analysis showed the GIM was predictor for elevated NLR (p < 0.05). According to the ROC curve analysis, the best cut-off NLR value to differentiate between patients with GIM from GA and/or controls was >2.92 (p < 0.05). In this study, we mainly found a significant association between GIM and NLR. Conclusions: NLR is significantly higher in patients with GIM. NLR can be an independent determinant factor for GIM. Keywords: Intestinal metaplasia; gastric atrophy; biomarker.