Clinical Significance Of Neutruphil-to-lymphocyte Ratio And Platelet-to-lymphocyte Ratio In Peripheral Blood Of Patients With Gastric Cancer

Objective:1.To analyze the difference of NLR and PLR in peripheral blood of healthy people,chronic atrophic gastritis and gastric cancer patients;2.To explore the predictive value of NLR,PLR and CEA alone or in combination with gastric cancer;3.To analyze the relationship between NLR,PLR and clinicopathological features of gastric cancer.method:150 Gastric cancer(GC)patients admitted to the affiliated hospital of yan ’an university from January 2014 to December 2016 were retrospectively collected as GC group(These included 36 cases of early gastric cancer and 114 cases of advanced gastric cancer).101 chronic atrophic gastritis(CAG)patients diagnosed in the same period were selected as CAG group,and 100 healthy control group(HC)patients without obvious abnormality were selected as CAG group.To collect all the GC group of patients with complete clinical and pathological data,and collect the HC,the CAG group and part of GC patients with preoperative blood routine indexes including neutrophils,lymphocyte absolute value of absolute value,monocyte absolute value,the total number of platelets,and carcinoembryonic antigen,according to NEU# and LYM# NLR value calculation,Calculate the PLR value based on PLT and LYM#.SPSS 20.0 statistical analysis software package was used for statistical processing of all data.For the measurement data of normal distribution,univariate anova was used to analyze the overall differences among the three groups,and LSD-t test was used for multiple comparisons among the three groups.The measurement data of non-normal distribution were analyzed by Kruskal-Wallis test of independent samples.The subject’s working characteristic curve was drawn,and the specificity,sensitivity and area under the ROC curve of each indicator were calculated,with α=0.05 as the level,and P < 0.05 as the difference with statistical significance.Result:1.There were differences in NEU#,LYM# and PLT among HC,CAG and GC groups,but no obvious differences in MONO#.Among them,NEU# showed a gradually increasing trend from HC group to GC group,and there were statistically significant differences(P < 0.017).And lymps: compared with the HC and CAG groups,the lymps in the GC group were reduced and the differences were statistically significant(P <0.017),but the lymps in the CAG group and the HC group were not significantly different(P > 0.017).PLT: compared with HC group and CAG group,PLT in GC group increased significantly and the difference was statistically significant(P < 0.017),but there was no significant difference in PLT level between CAG group and HC group(P >0.017).2.The comparison of NLR values among the three groups showed that the NLR levels were different among the three groups with statistically significant differences(H value=71.13,P < 0.05).3.To compare three groups of PLR values,between the three groups of PLR,H value is79.59,the difference was statistically significant(P < 0.05),after two of the two contrast,GC levels of PLR compared with HC group and the CAG group were significantly higher and the difference is statistically significant(P < 0.017),but the HC group is the CAG group differences in the levels of PLR no statistical significance(P > 0.017);4.Comparison of three groups of CEA levels show the CEA between the three groups of different levels(H = 51.11,P < 0.05),two comparison: GC is HC group and CEA level of the CAG group was obviously increased(P < 0.017),and the CEA level difference of the GC is the CAG group has no statistical significance(P > 0.017);5.ROC curve was drawn to evaluate the value of NLR,PLR and CEA in the prediction of gastric cancer: the AUC was 0.785,0.772 and 0.746(all P < 0.001)when NLR,PLR and CEA were used alone for the prediction of gastric cancer,and the combination of NLR and CEA(AUC: 0.798,95%CI: 0.742-0.855)was higher than that of NLR or CEA alone.The combination of PLR and CEA(AUC: 0.765,95%CI: 0.705-0.824)produced AUC higher than that of CEA alone,but lower than that of PLR alone.When combined with NLR,PLR and CEA,the AUC increased to 0.835(95% CI: 0.784-0.887,P<0.001).6.NLR levels in patients with GC analysis can be seen: the NLR level and high risk patients’ age,gender,no significant relationship between(P > 0.05),but the degree of tumor differentiation degree,infiltration depth and lymph node metastasis were related,statistically significant difference(P < 0.05),and the NLR was positively related with gastric cancer infiltration depth(rs = 0.695,P = 0.00),are positively related with the extent of lymph node metastasis(rs = 0.550,P = 0.00);7.PLR levels in patients with GC analysis can be found: PLR level and high risk patients’ age,gender,and tumor differentiation degree had no significant relationship between(P > 0.05),but associated with cancer cells infiltrating depth and extent of lymph node metastasis,statistically significant difference(P < 0.05),the GC group of PLR was positively related with gastric cancer infiltration depth(rs = 0.330,P = 0.001),are positively related with the extent of lymph node metastasis(rs = 0.293,P = 0.00).conclusion:1.There were differences in peripheral blood NLR and PLR levels in healthy people,chronic atrophic gastritis and gastric cancer patients.The NLR and PLR levels in gastric cancer group were significantly higher than those in healthy people group;2.The combination of NLR,PLR and CEA can improve the screening value of gastric cancer,or it can be an auxiliary monitoring index for high-risk population of gastric cancer;3.NLR and PLR levels can reflect the depth of invasion and lymph node metastasis of gastric cancer to some extent,or provide a reference for its evaluation.