Application Value Of Preoperative Neutrophil-lymphocyte Ratio Combined With Serum CEA,CA199,CA125 And CA724 Levels In Clinicopathological Staging Of Gastric Cancer

Objective:We aimed to investigate the application value of preoperative neutrophil-lymphocyte ratio(NLR)and serum CEA,CA199,CA125 and CA724 levels in clinicopathological staging of gastric cancer by single or combined detection.Methods:Clinical data of patients with gastric cancer admitted to the Second Affiliated Hospital of Nanchang University from June 2017 to April 2019 with complete postoperative pathological report were collected.They were divided into early gastric cancer group and advanced gastric cancer group,including 58 cases of early gastric cancer,195 cases of advanced gastric cancer,74 cases of stage I,62 cases of stage Ⅱ,and 117 cases of stage Ⅲ gastric cancer.The preoperative levels of NLR,serum CEA,CA199,CA125 and CA724 in the early gastric cancer group and the advanced gastric cancer group were detected,and the covariates between the groups were equalized by the propensity assessment distribution ratio(PSM)for comparative analysis.The threshold value of advanced gastric cancer was determined by receiver operating characteristic(ROC)curve,and the histogram of Logistic regression model was drawn to evaluate the value of single and combined index detection in preoperative staging diagnosis of gastric cancer.Results:A total of 253 patients with gastric cancer confirmed by postoperative pathology were included in this study.The levels of NLR,serum CEA,CA199,CA125 and CA724 in advanced gastric cancer group were higher than those in early gastric cancer group before and after matching(all P<0.05).The higher the PTNM stage,the higher the serum CEA,CA199,CA125 and CA724 levels(all P<0.05).The thresholds of NLR,serum CEA,CA199,CA125 and CA724 were 2.255,2.645ng/mL,16.665 U/mL,6.95 U/mL and 1.36 IU/mL,respectively.The accuracy of NLR,serum CEA,CA199,CA125,CA724 and combined detection were 60%,62%,59%,63%,64%and 73%,respectively.The sensitivity was 64.6%,62.1%,46.7%,70.3%,67.7%and 86.2%,respectively.The specificity was 53.4%,60.3%,77.6%,50.0%,56.9%and 75.9%,respectively.The C statistic evaluated by Logistic regression model was 0.758.Conclusion:The preoperative NLR,serum CEA,CA199,CA125 and CA724 levels are closely related to the clinicopathological stages of gastric cancer patients.Compared with the single detection of various molecular markers combined detection,the accuracy and sensitivity of preoperative diagnosis of gastric cancer are improved,and it has a certain predictive ability for the diagnosis of advanced gastric cancer.