The importance of blood parameters in the detection of intestinal metaplasia and early diagnosis of gastric cancer

Abstract

Background: We aimed to determine whether complete blood count(CBC) parameters, such as the white blood count(WBC), hemoglobin(Hb), platelet(PLT), red cell distribution width(RDW), mean platelet volume(MPV), platelet distribution width(PDW), neutrophil-to-lymphocyte ratio(NLR), platelet-to-lymphocyte ratio(PLR), and monocyte-to-lymphocyte ratio(MLR), have a predictive value in the detection of gastric cancer(GC) and intestinal metaplasia(IM). Methods: While proven GC, IM, and healthy control(HC) patients were included, patients with the comorbid disease were excluded, and univariate analyses compared three groups. The receiver operating characteristic(ROC) curve analysis was run for CBC parameters. The area under the curve(AUC) was evaluated, and a cut-off value was determined. The sensitivity and specificity of each parameter were considered. Results: The GC, IM, and HC groups consisted of 72(33%), 73(34%), and 72(33%) patients, respectively. RDW, PLT, NLR, PLR, and MLR were significant between GC and IM. The highest AUC (0.727) was obtained for the PLT yielding a 56.9% sensitivity and 79.4% specificity at a cut-off value of 151.8. The AUC of RDW was found as 0.691 and 0.626 for pairwise comparisons of GC-HC and IM-HC, respectively. At a cut-off value of 13.4, PLR yielded 70.8% sensitivity and 61.1% specificity in the detection of GC, while 64.4% sensitivity and 51.1% specificity for IM. Conclusion: CBC parameters, such as RDW, PLT, NLR, PLR, and MLR, have value in detecting GC. RDW also has diagnostic value in helping to detect IM. PLR can help to distinguish patients with GC from those with IM. These inexpensive, easily accessible parameters may help in the timely diagnosis of GC and IM. Keywords: Gastric cancer; intestinal Metaplasia; Monocyte to lymphocyte ratio; red cell distribution; hemoglobin; platelet; neutrophil-lymphocyte ratio; platelet-lymphocyte ratio; inflammation.