Single and combined use of neutrophil-lymphocyte ratio, platelet-lymphocyte ratio and carcinoembryonic antigen in diagnosing gastric cancer

To investigate the value of neutrophil-lymphocyte ratio (NLR), platelet-lymphocyte ratio (PLR) and carcinoembryonic antigen (CEA), alone or in combination, in diagnosing gastric cancer (GC), we retrospectively analyzed a cohort of 201 patients with GC, 161 patients with benign gastric lesions, and 157 healthy subjects. We obtained routine blood indices and CEA levels to evaluate the diagnostic value of NLR, PLR and CEA for GC, based on receiver operating characteristic (ROC) curves. We found that serum NLR, PLR and CEA in the GC group were significantly higher than those in the benign lesion group (P-NLR < 0.001,P-PLR < 0.001,P-CEA = 0.034) or the healthy control group (P-NLR < 0.001,P-PLR < 0.001,P-CEA = 0.028). Moreover, there were significant differences in NLR and PLR among different serosa invasion, lymph node metastasis, tumor size and stage. CEA showed a difference in distant metastasis and tumor size. Combining PLR with CEA produced a larger AUC (AUC: 0.780, 95% CI: 0.734-0.822) than using PLR (P = 0.011) or CEA (P < 0.001) alone. Similarly, NLR + CEA produced a larger AUC (AUC: 0.756, 95% CI:0.709-0.800) than using NLR (P = 0.004) or CEA (P = 0.001) alone. Whereas NLR, PLR and CEA are known to help distinguish GC from benign gastric lesions, combining CEA with PLR or NLR offers better diagnostic value for GC than any of them used alone.