Evaluation of multiple biological indicators for combined diagnosis of gastric cancer: A retrospective analysis

To assess carcinoembryonic antigen (CEA), carbohydrate antigen 19-9 (CA19-9), platelet distribution width (PDW), neutrophil-to-lymphocyte ratio (NLR), and platelet-lymphocyte ratio (PLR) for gastric cancer’s (GC) diagnostic efficiency, and the use of receiver operating characteristic curves (ROC) combined with logistic regression to evaluate multi-index combination’s diagnostic value of GC. 773 GC patients’ clinical data were retrospectively collected in the Weihai Municipal Hospital, affiliated hospital of Shandong University from April 2018 to May 2021, and selected 2368 healthy physical examination patients during the same period as the control group. A total of 3141 samples was included in this study, including 773 cases in the GC group and 2368 cases in the healthy physical examination group. The results of the overall comparison between groups showed that apart from gender, the age differences, CEA, CA19-9, PDW, NLR, and PLR were statistically significant (P < .001). Spearman ranks correlation analysis’s results showed that CA19-9, CEA, PLR, and NLR were correlated with GC patients’ clinical-stage positively, and the correlation coefficients r was 0.249, 0.280, 0.252, 0.262 (all P < .001), and PDW was correlated with the clinical stage negatively (r = −0.186, P < .001). The ROC curve analysis results of CEA, CA19-9, PDW, NLR and PLR showed that CEA’s diagnostic cutoff value for GC was 3.175 (area under the curve [AUC] = 0.631, 95% CI: 0.606–0.655, P < .001), the CA19-9’s diagnostic cutoff value is 19.640 (AUC = 0.589, 95% CI: 0.563–0.615, P < .001), PDW’s diagnostic cutoff value is 15.750 (AUC = 0.799, 95% CI: 0.778–0.820, P < .001), NLR’s diagnostic cutoff value was 2.162 (AUC = 0.699, 95% CI: 0.675–0.721, P < .001), and PLR’s diagnostic cutoff value was 149.540 (AUC = 0.709, 95% CI: 0.688–0.732, P < .001). The area under the ROC curve for the combined diagnosis of GC with 5 indicators was 0.877 (95% CI: 0.860–0.894, P < .001), which was better than a single indicator (P < .05). The diagnostic efficiency of combined detection of CEA, CA19-9, PDW, NLR, and PLR is better than that of single index detection alone, which can reduce the misdiagnosis rate of GC effectively.