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目的:探讨血小板与淋巴细胞比值(PLR)和中性粒细胞与淋巴细胞比值(NLR)与早期胃癌的相关性,评估PLR和NLR对早期胃癌诊断的预测价值。方法:纳入2017年1月1日至2020年12月31日在浙江省台州医院住院治疗的178例早期胃癌、129例慢性胃炎和122例胃上皮内瘤变(GIN)患者,运用Rand随机函数将所有患者按7∶3分为训练组(301例,其中早期胃癌125例,慢性胃炎90例,GIN 86例)和验证组(128例,其中早期胃癌53例,慢性胃炎39例,GIN 36例)。收集所有患者的年龄、性别、血常规指标、癌胚抗原水平、幽门螺杆菌(n H.n pylori)感染情况等资料,比较训练组中早期胃癌、慢性胃炎与GIN患者的血常规指标和临床特征,训练组中早期胃癌患者与慢性胃炎+GIN患者(以下简称非早期胃癌患者)的血常规指标,分析早期胃癌的独立危险因素。绘制受试者操作特征曲线(ROC),分析独立危险因素诊断预测早期胃癌的最佳临界值、曲线下面积(AUC)、n OR和95%置信区间(95%n CI)等,建立诊断预测模型,运用Hosmer-Lemeshow检验模型的拟合度,比较模型应用于训练组与验证组的AUC以评估模型的区分度。统计学方法采用Kruskal-Wallis n H检验、Mann-Whitney n U检验或Wilcoxon秩和检验、卡方检验,以及单因素和多因素logistic回归分析。n 结果:训练组中,慢性胃炎、GIN、早期胃癌患者中男性和女性占比分别为50.0%(45/90)、50.0%(45/90),61.6%(53/86)、38.4%(33/86),69.6%(87/125)、30.4%(38/125),差异有统计学意义(n χ2=8.49,n P=0.014);早期胃癌患者的男性占比高于慢性胃炎患者,差异有统计学意义(n χ2=8.48,n P=0.004)。训练组中慢性胃炎、GIN、早期胃癌患者的n H.n pylori感染率、年龄、PLR、NLR、淋巴细胞计数、中性粒细胞计数、癌胚抗原分别为18.9%(17/90)、18.6%(16/86)和43.2%(54/125),54.0岁(45.5岁,64.0岁)、63.0岁(58.0岁,66.3岁)和66.0岁(58.5岁,71.0岁),113.70(84.48,136.09)、120.00(97.94,138.37)和124.29(101.97,173.57), 1.55(1.17,2.23)、1.71(1.44,2.02)和2.04(1.57,2.62),2.00×10n 9/L(1.50×10n 9/L,2.40×10n 9/L)、1.75×10n 9/L(1.50×10n 9/L,2.40×10n 9/L)和1.60×10n 9/L(1.30×10n 9/L,2.05×10n 9/L),3.00×10n 9/L(2.38×10n 9/L,3.90×10n 9/L)、3.00×10n 9/L(2.48×10n 9/L,3.40×10n 9/L)和3.30×10n 9/L(2.60×10n 9/L,4.30×10n 9/L),1.70 g/L(1.10 g/L,2.50 g/L)、2.05 g/L(1.48 g/L,2.90 g/L)和2.50 g/L(1.55 g/L,3.40 g/L),差异均有统计学意义(n χ2=21.26,n H=41.00、11.79、21.13、10.82、8.54、14.42;均n P138.18(n OR=2.452,95%n CI 1.325~4.539)、癌胚抗原>2.70 g/L(n OR=2.637,95%n CI 1.490~4.667)是早期胃癌的独立危险因素(均n P0.05),提示模型的拟合度较好。在训练组人群中,诊断预测模型的AUC为0.787(95%n CI 0.737~0.832,n P138.18 (n OR=2.452, 95%n CI 1.325 to 4.539), CEA >2.70 g/L ( n OR=2.637, 95%n CI 1.490 to 4.667) were independent risk factors for EGC (all n P0.05), which indicated that the fitting degree of the model was good. In the training group, the AUC of the diagnostic prediction model was 0.787 (95%n CI 0.737 to 0.832, n P<0.001). The model was applied to the validation group for validation, and the result showed that the AUC of the model was 0.664 (95%n CI 0.576 to 0.745, n P<0.001), which indicated that the discrimination of the model was good.n Conclusions:PLR and NLR are independent risk factors of EGC, and may help to identify EGC. In this study the established diagnostic model has good discrimination and fitting degree, which can provide important reference information for early clinical diagnosis of EGC, which may facilitate early treatment and improve prognosis of patients.