The Diagnostic Value Of NLR And PLR Combined With Tumor Markers For Tumor Invasion Depth And Lymph Node Metastasis In Advanced Gastric Cancer

Objective:To investigate the relationship between neutrophil-to-lymphocyte ratio(NLR),platelet-to-lymphocyte ratio(PLR)and clinicopathological characteristics of patients with advanced gastric cancer(AGC).Correlation,as well as the analysis of NLR and PLR combined tumor markers for AGC infiltration depth and lymph node metastasis,established a unique and novel diagnostic analysis to provide a comprehensive and applicable diagnostic value indicator for AGC patients.Methods:Using the case-control study method,220 patients with advanced gastric cancer who were first diagnosed in the Department of Gastrointestinal Surgery of Affiliated Hospital of Qinghai University from October 2019 to October 2021 were collected as the case group,and 100 healthy adults who underwent physical examination as the control group.The correlation between NLR and PLR was analyzed.The clinicopathological features of advanced gastric cancer,and the diagnostic value of combined tumor markers for the depth of tumor invasion and lymph node metastasis of AGC were expressed as the median [P50(P25-P75)] for the measurement data that did not conform to the normal distribution.Mann-Whitney U nonparametric test to compare continuous variables between the two groups;according to the receiver operating characteristic curve(Receiver Operating Characteristic Curve,ROC)to determine the area under the curve of NLR and PLR in AGC patients with postoperative pathological stage III,and determine the respective area under the curve.Best cut-off value(Cut-off value);AGC patients were divided into high and low groups according to the best cut-off values of NLR and PLR,and 2was used to compare categorical variables between groups;binary logistic regression was used to analyze AGC tumor invasion depth and lymph nodes The related risk factors of metastasis;the independent and combined indicators of NLR,PLR and tumor markers were used to predict the actual efficacy of AGC tumor invasion depth and lymph node metastasis by ROC curve,and the area under the ROC curve(AUC)was evaluated.The test level P< 0.05.Results:1.A total of 220 AGC patients(case group)and 100 healthy adults(control group)were included.The NLR and PLR of AGC patients were higher than those of healthy adults(P<0.001);2.The ROC curve shows: the areas under the NLR and PLR curves are 0.602 and0.603,respectively,P<0.001;when the Youden index takes the maximum value,the best cut-off values corresponding to NLR and PLR are: 2.72(sensitivity 30.7%,Specificity 87.7%),167.92(sensitivity 43.9%,specificity 76.4%),NLR and PLR have poor sensitivity and relatively high specificity in diagnosing AGC patients with pathological stage III;3.The chi-square test results showed that compared with the low NLR group,the differentiation degree,infiltration depth,lymph node metastasis and CA724 were significantly different between the high NLR group and the low NLR group(P<0.05).Compared with the low PLR group,the infiltration depth,lymph node metastasis,CEA,CA199 and differentiation degree were significantly different between the high PLR group and the low PLR group(P<0.05)4.Multivariate Logistic regression analysis showed that the factors such as tumor invasion depth and degree of differentiation,lymph node metastasis and high NLR were statistically significant in advanced gastric cancer,and the factors such as lymph node metastasis and differentiation degree,invasion depth and CEA were statistically significant;5.ROC curve shows: NLR,PLR combined with tumor markers to detect the depth of invasion and lymph node metastasis of AGC patients,among which NLR combined with CEA,AUC=0.686,sensitivity=50.0%,specificity=81.5%,P<0.01;among which PLR combined CA724,AUC=0.629,sensitivity=31.3%,specificity=90.4%,P=0.0020.6.ROC curve shows: NLR and PLR combined with tumor markers predict the diagnostic value of tumor invasion depth and lymph node metastasis in advanced gastric cancer,among which NLR and PLR combined with CEA(AUC=0.691,sensitivity=54.2%,specificity=77.8 %,P=0.001)is a relatively good indicator for detecting the depth of tumor invasion in advanced gastric cancer;among them,NLR and PLR combined with CEA(AUC=0.643,sensitivity=59.9%,specificity=64.4%,P=0.002)are used to detect progress It is a relatively good indicator of lymph node metastasis in stage gastric cancer.Conclusion:NLR and PLR are correlated with the clinicopathological features of advanced gastric cancer and are potential diagnostic markers for advanced gastric cancer.The combination of NLR and PLR with CEA,CA199 and CA724 can improve the diagnostic value of the depth of invasion and lymph node metastasis in advanced gastric cancer to a certain extent.