Mean platelet volume, platelet distribution width and carcinoembryonic antigen to discriminate gastric cancer from gastric ulcer

Activated platelets are involved in cancer development and progression. Mean platelet volume (MPV) and platelet distribution width (PDW) are early indexes of platelet activation. The objectives of this study were to investigate the ability of MPV, PDW and carcinoembryonic antigen (CEA) individually or in combination, to distinguish between gastric cancer and gastric ulcer. The study involved 194 patients with gastric cancer, 191 patients with gastric ulcer, and 185 control subjects. Subjects' characteristics and hematologic tests data at initial diagnosis were collected. We found that MPV levels are significantly increased and PDW levels are significantly reduced in patients with gastric ulcer and in control subjects compared with those in gastric cancer. When the area under the curve (AUC) was used to analyze control subjects versus gastric cancer, the combination of PDW and CEA exhibited a significantly larger AUC of 0.939 (0.910-0.961) compared with the combination of MPV and CEA (p = 0.0045). When AUC was used to analyze gastric ulcer versus gastric cancer, PDW alone had the high specificity (98.5%) and high sensitivity (97.4%). In conclusion, combined use of MPV, PDW and CEA can accurately distinguish gastric cancer from gastric ulcer and controls. Further studies in larger samples are warranted.