Objective To explore the characteristics of changes in blood test indicators and the combined detection for the differential diagnosis value of early gastric cancer and atrophic gastritis.Methods A total of 44 patients with early gastric cancer admitted to the hospital from January 2023 to March 2024 were selected as the early gastric cancer group.Another 59 patients with atrophic gastritis who were admitted to the hospital during the same period were selected as the atrophic gastritis group.Analyze the characteristics of changes in blood test indicators of the two groups.The receiver operating characteristic(ROC)curve was drawn to eval-uate the clinical value of blood test indicators in differentiating early gastric cancer from atrophic gastritis.Re-sults The levels of white blood cell count(WBC),platelet count(PLT),C-reactive protein(CRP),pro-thrombin time(PT),fibrinogen(Fib),D-dimer(D-D),and carbohydrate antigen 199(CA199)in the early gastric cancer group were significantly higher than those in the atrophic gastritis group,and the differences were statistically significant(P<0.05).The levels of red blood cells(RBC),hemoglobin(HGB),total pro-tein(TP),thrombin time(TT),and ferritin(Fer)in the early gastric cancer group were significantly lower than those in the atrophic gastritis group,and the difference was statistically significant(P<0.05).The re-sults of the ROC curve analysis show that the area under the curve(AUC)for the individual detection and dif-ferential diagnosis of early gastric cancer and atrophic gastritis by WBC,RBC,HGB,PLT,CRP,TP,PT,TT,Fib,D-D,Fer and CA199 were 0.591,0.716,0.764,0.623,0.728,0.671,0.692,0.746,0.721,0.689,0.770 and 0.680,respectively.The AUC of the combined detection of RBC,HGB,CRP,TT,Fib and Fer for the dif-ferential diagnosis of early gastric cancer and atrophic gastritis was 0.857(95%CI:0.772-0.941),which was significantly higher than AUC of the individual detection.Conclusion The combined detection of blood test indicators such as RBC,HGB,CRP,TT,Fib and Fer has certain clinical value in the differential diagnosis of early gastric cancer and atrophic gastritis.