| Objective:By analyzing the expression levels of serum RDW and NLR in patients with gastric cancer,and combining the two at the same time,the value of their application in the diagnosis of gastric cancer is explored.Methods:A total of 900 patients who attended the Third Affiliated Hospital of Anhui Medical University from August 2018 to August 2020 were selected.According to the inclusion and exclusion criteria,a total of 900 patients were included in this study.At the same time,according to the gastroscopy report and histopathological results of each patient,300 cases were divided into gastric cancer group,including 165 males and 135 females,aged 48-87 years old,with an average of(65.4±10.6)years old.There were300 patients in the benign group,including 147 males and 153 females,aged 44-84 years old,with an average of(68.6±9.1)years old,and 300 patients in the control group,including 133 males and 167 females,with an average age of 35-88 years.(57±5.7)years old.Serum levels of CEA and CA724 were detected in the three groups,and the two groups were sent for routine blood tests.RDW,NR,and LYMP were obtained directly by the instrument,and NR/LYMP obtained by calculation was NLR.The gastroscopic pathology and general data of the three groups were collected.Compare the levels of serum RDW,NLR,CEA and CA724 in gastric cancer group,benign group and healthy control group;use ROC curve analysis to compare the sensitivity,specificity,cut-off value and AUC of RDW,NLR,CEA and CA724 in the diagnosis of gastric cancer;establish Logistic Regression model,combined RDW,NLR and CEA,CA724 respectively,and draw the corresponding ROC curve.Results:1.Comparison of the levels of RDW,NLR,CEA and CA724 in gastric cancer group,benign group and control group: RDW is(16.33±2.24)%VS(13.16±0.87)%V(12.50±0.95),NLR is(4.53± 3.71)VS(2.11±1.43)VS(1.44±0.72),CEA is(6.89±2.38)ng/ml VS(3.46±1.93)ng/ml VS(3.22±1.76)ng/ml,CA724 is(11.33±9.63))U/ml VS(5.31±5.45)u/ml VS(4.63±3.91)u/ml.The levels of RDW,NLR,CEA,and CA724 in the gastric cancer group were significantly higher than those in the benign group and the control group.2.The positive detection rates of RDW,NLR,CEA and CA724 in the gastric cancer group were 60.00%,80.33%,23.33% and 32.70%,which were significantly higher than those of the benign group 8.00%,44.33%,18.00% and 13.00%and the control group.Group 2.67%,18.00%,12.33% and 9.33%.3.Comparison of the efficiency of RDW,NLR,CEA and CA724 in the diagnosis of gastric cancer in the gastric cancer group: RDW has the highest diagnostic efficiency in the diagnosis of gastric cancer,with an AUC of 0.891,sensitivity and specificity of 77.30%,89.80%,and 95% confidence.The interval is(0.866-0.915),and the best cut-off value is 13.84%;NLR has a certain accuracy in the diagnosis of gastric cancer,with AUC of 0.828,sensitivity of 66.30%,specificity of 87.80%,and 95% confidence interval of(0.855-0.908),the best cut-off value is 2.44;while CEA and CA724 are not capable of diagnosing gastric cancer.AUC is 0.553 and 0.784,sensitivity is 26.00%,67.00%,specificity is 99.20%,83.20%,95%,respectively The confidence intervals are(0.524-0.605)and(0.766-0.832),and the best cutoff values ??are 4.34 and 6.16 respectively.4.Comparison of RDW and NLR combined with CEA and CA724 in the diagnosis of gastric cancer: the diagnostic efficacy of RDW and NLR combined is significantly higher than that of a single diagnosis.From the analysis of ROC curve,it can be seen that the AUC of RDW and NLR combined is The sensitivity was 0.951,the sensitivity was 95.22%,and the specificity was 86.37%;the AUC of CEA and CA724 combined was 0.727,the sensitivity was 88.46%,and the specificity was 77.31%.And the combination of RDW and NLR has higher diagnostic efficacy than the combination of CEA and CA724.Conclusion:1.The two indicators are used to diagnose gastric cancer separately or in combination,and the diagnostic efficiency of RDW and NLR are better than traditional tumor markers CEA and CA724.2.The diagnostic efficiency of gastric cancer after the combination of RDW and NLR is significantly improved compared with the diagnosis of each index alone.3.Serum RDW and NLR can be used as serum markers for the diagnosis of gastric cancer,and can provide important references for whether patients need further diagnosis. |
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