Diagnosis Of Gastric Cancer Based On The Scoring Of Conventional Blood Indicators

Research Objectives:To analyze the diagnostic value of common clinical blood detection index for gastric cancer and establish a diagnostic model and scoring system based on clinical index,and provide a new method for the diagnosis of gastric cancer.Materials and Methods:The data of clinical diagnosis and treatment of hospitalized patients with gastric cancer and benign gastric disease confirmed by tissue biopsy and pathological examination were retrospectively collected,including tumor markers,blood cell analysis,blood biochemistry,coagulation function examination,gastroscopy,pathological examination,etc.The diagnostic value of each index was evaluated by the area under the subject operating characteristic(ROC)curve(AUROC).The study subjects were randomly divided into training group and validation group according to 7 : 3,and the multivariate binary Logistic regression analysis was conducted to establish a gastric cancer diagnostic model based on the combination of clinical routine blood testing indicators,and to evaluate the diagnostic value of the model on gastric cancer by the validation group.A diagnostic score system for gastric cancer was established according to the diagnostic model,and its clinical diagnostic value was evaluated.Results:A total of 972 patients were included,including 402 gastric cancer,150 chronic gastritis,161 peptic ulcer,135 gastric polyps and 124 benign gastric tumors.There were 564 males and 408 females,with a mean age of 57.3±13.5 years.Univariate analysis showed that most of the blood test indicators have certain diagnostic value for gastric cancer,but generally poor,with AUROC above 0.7(0.702～0.847): CEA、CA125、CA72-4、HB、RBC、TP、ALB、CR、TC、Ca、PT、PTR、PTA、INR and AFR.Through multivariate Logistic gradual regression analysis established gastric cancer diagnostic model,there are 10 clinical indicators into the model: age,sex,cancer embryo antigen(CEA),average red blood cell hemoglobin content(MCH),platelet distribution width(PDW),albumin(ALB),fibrinogen(Fbg),thrombin time(TT),neutrophil to lymphocyte ratio(NLR),platelet to lymphocyte ratio(PLR).The diagnostic model had similar GC diagnostic efficiency in the training and validation groups.CIDS): CIDS score = 2.5 * Age–73.4 * Sex–14.1 *CEA–9.3 * MCH + 21 * PDW–9.2 * ALB + 35.3 * Fbg–20.8 * TT–18.7 * NLR– 0.5 * PLR – 635.Calculating the score of each patient,the AUROC of CIDS evaluation was 0.838(95%CI 0.808-0.866),sensitivity was 78.4%,specificity 75.0%,accuracy 76.3%,and 54.7% in early stage gastric cancer(TNM I + II).Conclusion:(1)Among the commonly used serum tumor markers,CEA,CA19-9,and CA72-4 have a weak diagnostic value for gastric cancer,among which CEA is relatively good.(2)Among the conventional blood test indicators,some blood cell count,blood biochemistry and coagulation function indicators have a weak diagnostic value for gastric cancer.(3)Based on the commonly used serum tumor markers and conventional blood testing indicators,the diagnostic model of gastric cancer diagnosis has been successfully established,which has good diagnostic value for gastric cancer and is better than any single index.(4)The CIDS score of gastric cancer established based on the gastric cancer diagnostic model is of good value for the differential diagnosis of gastric cancer and benign gastric disease,and is significantly better than the combination of CEA and tumor markers.