The predictive value of laboratory parameters in diagnosing gastrointestinal malignancy in older adults

Purpose: This retrospective study aimed to evaluate the predictive value of pre-endoscopic biochemical parameters for detecting malignant lesions in older adults undergoing upper and lower gastrointestinal (GI) endoscopies. Materials and Methods: We retrospectively analyzed 419 individuals aged 60 and above. Of these, 109 older adult patients who underwent both upper and lower GI endoscopies were included in the study. Patients with a prior history of GI cancer or those who could not complete the procedure due to intolerance were excluded. Patients were categorized based on the presence of benign or malignant lesions. Results: Malignant lesions were identified in 10.1% of patients (11/109). Statistically significant differences were observed between the benign and malignant groups in terms of hemoglobin (Hb), neutrophil count, mean corpuscular volume (MCV), neutrophil-lymphocyte ratio (NLR), iron (Fe), 25-hydroxyvitamin D [25(OH)D], C-reactive protein (CRP), total protein, albumin (Alb), blood urea nitrogen (BUN), CRP/albumin ratio (CAR), and aspartate aminotransferase (AST). The ROC curve analysis suggests that MCV, NLR, 25(OH)D, Fe, and CAR are valuable indicators for predicting malignant lesions in older adults, with optimal cut-off values of 79.5 fL, 3.28, 12 µg/L, 22 µg/dL, and 5.93, respectively. Conclusion: Laboratory parameters such as MCV, NLR, 25(OH)D, Fe, and CAR can support risk stratification when interpreted alongside clinical assessment and guideline-based recommendations.