Correlation analysis of clinical efficacy and prognosis of endoscopic submucosal dissection of early gastric cancer with peripheral blood indexes

Background This study aimed to investigate the correlation between peripheral blood indicators and the clinical efficacy and prognosis of patients with early gastric cancer (EGC) undergoing endoscopic submucosal dissection (ESD). Methods A single-center, retrospective cohort study was conducted on 120 EGC patients treated with ESD between January 2017 and August 2019. Patients were stratified into good (n=84) and poor (n=36) prognosis groups based on defined criteria. Univariate and multivariate logistic regression analyses were performed to identify factors influencing prognosis. The predictive performance of peripheral blood indicators was evaluated using receiver operating characteristic (ROC) curve analysis. Changes in biomarkers and patient-reported quality of life (assessed by QLQ-STO22) before and after ESD were compared, and their correlations were analyzed. Results Univariate analysis revealed differences in Carbohydrate Antigen 19-9 (CA19-9), Carcinoembryonic Antigen (CEA), Neutrophil-to-lymphocyte ratio (NLR), Red blood cell distribution width (RDW), and Homocysteine (Hcy) levels between prognosis groups (all P<0.05). Multivariate analysis identified these five indicators as independent prognostic factors. ROC analysis demonstrated area under the curve (AUC) values of 0.723, 0.669, 0.757, 0.709, and 0.606 for CA19-9, CEA, NLR, RDW, and Hcy, respectively, in predicting prognosis. The combined model achieved an AUC of 0.950. Postoperative levels of all five biomarkers and QLQ-STO22 scores were lower than preoperative levels (all P<0.001). Furthermore, CA19-9, CEA, NLR, RDW, and Hcy showed positive correlations with QLQ-STO22 scores (all P<0.001). Conclusion Peripheral blood indicators, particularly CA19-9, CEA, NLR, RDW, and Hcy, hold predictive value for the prognosis of EGC patients after ESD. Their postoperative reduction and positive correlation with quality-of-life scores suggest they reflect clinical efficacy. The combined use of these indicators provides the highest prognostic accuracy.