EARLY diagnosis of stomach cancer and intestinal metaplasiathe importance of hemogram parameters in detection

Gastric cancer (GC) is one of the most common causes of cancer-related mortality in the world. Stage is an important prognostic factor in gastric cancer, and early diagnosis is very important in reducing mortality. Upper gastrointestinal endoscopy is the gold standard for gastric cancer screening. Many studies have been done and continue to be done to determine the group to be screened early endoscopically. For this purpose, cheap, practical, easily applicable hemogram parameters can be used. Hemogram parameters used on the basis of cancer-inflammation relationship may be predictive for cancer and early endoscopy can be performed when cancer suspicion is high. Thus, early diagnosis can be achieved by endoscopy by easily identifying the high-risk group. In our study, among GC, Intestinal Metaplasia (IM), healthy control (HC) groups, Hb (Hemoglobin), WBC (leukocyte), PLT (Platelet), RDW (Erythrocyte distribution width), MPV (Mean Platelet volume), PDW (Platelet distribution width), NLR (Neutrophil lymphocyte ratio), PLR (platelet lymphocyte ratio), MLR (Monocyte lymphocyte ratio) and its value in predicting GC early lesion lesions and GC were investigated. A total of 217 people were included in the study, including 72 (33%) GC, 73 (34%) IM, and 72 (33%) HC. The mean age of those included in the study was 60.47±10.55 in the GC group, 57.47±10.30 in the IM group, and 55.08±12.25 in the HC group, respectively. There was a statistically significant difference between gastric cancer and HC groups in terms of age, with a higher difference in GC (p:0.015). There was no statistically significant difference between GC and IM and IM and HC groups in terms of age (p:0.651). 50% (n:109) of the patients in the study were male and 50% (n:108) were female. There was no statistically significant difference in terms of gender in the comparison of gastric cancer, IM and HC groups (p:0.843). When gastric cancer, IM and HC groups were compared in pairs, there was no statistically significant hemogram parameter in all of them at the same time. There was no statistically significant difference between the paired comparison groups for leukocytes, MPV, and PDW (p values 0.092/0.273/0.951, respectively). There was a statistically significant difference in erythrocyte distribution width, with a higher difference in GC between GC and HC groups, and higher in IM between IM and HC groups (p<0.001). For hemoglobin, PLT, NLR, PLR, and MLR, there was a statistically significant difference between GC and IM and GC and HC groups, with a higher difference in GC (p values <0.001/<0.001/<0.003/<0.001/<0.030, respectively). The patients who applied to Tokat Gaziosmanpaşa University Health Research and Application Hospital, Department of Internal Medicine between 1 June 2014 and 15 December 2021 as outpatients or hospitalized patients were evaluated. The healthy control group, whose histopathological results were reported as GC, IM of biopsies taken by upper gastrointestinal endoscopy, and without GC or IM, who underwent endoscopy for any reason, were included. Age, gender, Hb, WBC, PLT, RDW, MPV, PDW, NLR, PLR, MLR levels were recorded by scanning the files of those included in the study retrospectively. These values were compared between GC, IM and HC groups. Hemogram parameters at the time of endoscopy were taken into account in all groups. As a result, hemogram parameters such as Hb, PLT, RDW, NLR, PLR, MLR can help for early diagnosis by enabling endoscopy, which is the gold standard for GC screening, to be performed earlier and with accurate indication. Erythrocyte distribution width can help in the early diagnosis of GC by alerting the physician to the precursor lesion IM. However, larger studies are needed before it can be used in clinical practice.