Comparison of Clinicopathological Features in Gastric Cancer Patients with and without Bleeding at Initial Presentation İlk Başvuru Anında Kanama Bulgusu Olan ve Olmayan Mide Kanseri Hastalarında Klinikopatolojik Özelliklerin Karşılaştırılması

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Akay S., Pehlivanoğlu K.

Anatolian Journal of General Medical Research, cilt.35, sa.3, ss.294-300, 2025 (Scopus, TRDizin)

Özet

Objective: We aimed to investigate whether the presence of bleeding complaints at initial presentation affected laboratory and histopathological features in patients diagnosed with gastric cancer, dividing the patients into two groups: those with and those without such complaints. Methods: Data from 148 patients diagnosed with gastric cancer were retrospectively analyzed using the hospital’s computerized medical record system. Patients were grouped based on the presence or absence of hematemesis or endoscopic signs of bleeding, and compared with respect to age, sex, tumor location, disease stage, hemogram parameters, neutrophil-to-lymphocyte ratio (NLR), mean platelet volume (MPV)-to-platelet ratio (PLT), and blood group characteristics. Tumors located in the fundus or cardia were classified as proximal gastric tumors. Non-parametric variables were analyzed using the Mann-Whitney U test, parametric variables were analyzed using the independent samples t-test, and categorical variables were analyzed using the chi-square test. A p-value of ≤0.05 was considered statistically significant. Results: Among the 148 patients included in the study (median age: 61.09 years; range: 29-87 years), 67 presented with bleeding symptoms, while 81 did not. There was no statistically significant difference in age or sex distribution between the two groups. Tumor localization, histological subtype, disease stage, and blood group characteristics were also similar between groups. Although the hemoglobin levels were lower in the bleeding group, this difference was not statistically significant (p=0.352). However, neutrophil counts were significantly higher (p=0.020) and lymphocyte counts significantly lower (p=0.007) in patients with bleeding. No significant differences were observed in platelet count, MPV, NLR, or MPV/PLT. The presence of bleeding was not associated with the need for neoadjuvant chemotherapy (p=0.155). Conclusion: The presence of bleeding at initial presentation in patients with gastric cancer was not associated with differences in demographic features, tumor localization, histopathological subtype, or clinical stage. However, altered neutrophil and lymphocyte counts suggest that the bleeding may indicate an acute inflammatory response. These findings highlight the potential role of hematologic parameters as adjunctive markers in the initial assessment of gastric cancer patients presenting with gastrointestinal bleeding.