Evaluation of platelet-to-lymphocyte ratio, red cell distribution width and neutrophil-to-lymphocyte ratio as potential biomarkers in the early detection of gastric cancer

Gastric cancer is the third highest malignity for cancer-related mortality worldwide. Reduction of morbidity and mortality requires early recognition and management of gastric cancer. In recent years, biomarkers reflecting the systemic inflammatory state have been used for both diagnostic and prognostic testing. Our objective was to determine whether global inflammatory markers such as platelet-to-lymphocyte ratio (PLR), red cell distribution width (RDW), and neutrophil-to-lymphocyte ratio (NLR) have clinical utility in the early diagnosis of gastric cancer. We included 53 individuals diagnosed as stomach cancer, and 53 healthy age-and sex-matched subjects. Preoperative clinical and pathological data as well as information on hemoglobin levels, neutrophil, lymphocyte and platelet counts were derived from the medical records of patients. A receiver-operating characteristic (ROC) curve was calculated to identify potential criteria for using these biomarkers in the diagnosis of gastric cancer. In patients with gastric cancer, PLR, RDW, and NLR were significantly elevated when compared to healthy control subjects (P < 0.001). The optimal diagnostic cut-off was 2.17 in the ROC curve analysis [area under the curve (AUC): 0.750, sensitivity: 73%, specificity: 61%] for NLR, 128 (AUC: 0.747, sensitivity: 72%, specificity: 64%) for PLR, and 14 (AUC: 0.768, sensitivity: 70%, specificity: 74%) for RDW. The present study suggests that NLR, PLR and RDW, which are easily obtained from a routine complete blood count may be useful as potential, biomarkers for determination of early diagnosis and prognosis of gastric cancer