Role of red cell dstribution width in colorectal cancer diagnosis and prognosis

Year 2022, Volume: 5 Issue: 3, 875 - 881, 30.05.2022

Ahmet Karayiğit Dursun Burak Özdemir Hayrettin Dizen Bülent Ünal İlter Ozer Murat Ulaş

https://doi.org/10.32322/jhsm.1102938

Abstract

Objective: We aimed to assess whether red cell distribution width (RDW) was associated with pre-operative clinical features or post-operative clinicopathological outcomes in patients with colorectal cancer (CRC), and to determine the utility of RDW as a diagnostic or prognostic marker of CRC.
Material and Method: This retrospective cohort study was conducted between January 2018 and May 2021 at a university hospital in Turkey. A total of 188 patients histologically diagnosed with CRC who had undergone surgery were included in the study.
Results: Our study included 118 (62.77%) male patients, and the mean age of the patients was 66.28±11.71 years. We found that RDW values were significantly higher in females compared to males (p=0.033), in patients with T3 or T4 tumors compared to those with T1 or T2 tumors (p<0.001), in patients with stage 2 and stage 3 tumors compared to stage 1 patients, those with early mortality (p=0.012), in patients with right or transverse colon tumors compared to those with descending colon or sigmoid colon or rectum tumors (p<0.001), and those that died during follow-up compared to survivors (p=0.001). Additionally, age (r=0.233, p<0.001), tumor size (r=0.229, p=0.002) and length of stay in hospital (r=0.167, p=0.022) were positively correlated with RDW values. RDW had 75.7% sensitivity and 67.5% specificity to predict mortality for the cut-off point of 15.7 (AUC: 0.704, 95.0%CI: 0.615-0.793, p<0.001).
Conclusion: These results show that RDW has a potential function as a biomarker for the diagnosis and prognosis of CRC.

Keywords

Colorectal cancer, RDW, prognosis, progression, overall survival

References

• Pedrazzani C, Tripepi M, Turri G, et al. Prognostic value of red cell distribution width (RDW) in colorectal cancer. Results from a single-center cohort on 591 patients. Sci Rep 2020; 10: 1072.
• Simon K. Colorectal cancer development and advances in screening. Clin Interv Aging 2016; 11: 967-76.
• Song Y, Huang Z, Kang Y, et al. Clinical Usefulness and prognostic value of red cell distribution width in colorectal cancer. Biomed Res Int 2018; 2018: 9858943.
• Shi C, Xie M, Li L, Li K, Hu BL. The association and diagnostic value of red blood cell distribution width in colorectal cancer. Medicine (Baltimore) 2019; 98: e15560.
• Jandial A, Kumar S, Bhalla A, Sharma N, Varma N, Varma S. Elevated red cell distribution width as a prognostic marker in severe sepsis: a prospective observational study. Indian J Crit Care Med 2017; 21: 552-62.
• Ay S, Eryilmaz MA, Aksoy N, Okus A, Unlu Y, Sevinc B. Is early detection of colon cancer possible with red blood cell distribution width? Asian Pac J Cancer Prev 2015; 16: 753-6.
• Kust D, Lucijanic M, Urch K, et al. Clinical and prognostic significance of anisocytosis measured as a red cell distribution width in patients with colorectal cancer. QJM 2017; 110: 361-7.
• Yang D, Quan W, Wu J, et al. The value of red blood cell distribution width in diagnosis of patients with colorectal cancer. Clin Chim Acta 2018; 479: 98-102.
• Siegel R, Jemal A. Colorectal cancer facts & Figures, 2011–2013. Atlanta, GA: American Cancer Society 2011.
• Group UCSW. United States cancer statistics: 1999–2014 incidence and mortality web-based report. Atlanta: US Department of Health and Human Services, Centers for Disease Control and Prevention and National Cancer Institute 2017.
• Gao Y, Wang J, Zhou Y, Sheng S, Qian SY, Huo X. Evaluation of serum CEA, CA19-9, CA72-4, CA125 and ferritin as diagnostic markers and factors of clinical parameters for colorectal cancer. Sci Rep 2018; 8: 2732.
• Nikolaou S, Qiu S, Fiorentino F, Rasheed S, Tekkis P, Kontovounisios C. Systematic review of blood diagnostic markers in colorectal cancer. Tech Coloproctol 2018; 22: 481-98.
• Li Y, Xing C, Wei M, et al. Combining red blood cell distribution width (RDW-CV) and CEA predict poor prognosis for survival outcomes in colorectal cancer. J Cancer 2019; 10: 1162-70.
• Zhao JX, Liu LR, Yang XY, Liu F, Zhang ZG. Serum CA19-9 as a marker of circulating tumor cells in first reflux blood of colorectal cancer patients. Oncotarget 2017; 8: 67918-32.
• Karsa LV, Lignini TA, Patnick J, Lambert R, Sauvaget C. The dimensions of the CRC problem. Best Pract Res Clin Gastroenterol 2010; 24: 381-96.
• Koma Y, Onishi A, Matsuoka H, et al. Increased red blood cell distribution width associates with cancer stage and prognosis in patients with lung cancer. PLoS One 2013; 8: e80240.
• Zhao T, Cui L, Li A. The significance of RDW in patients with hepatocellular carcinoma after radical resection. Cancer Biomark 2016; 16: 507-12.
• Yazici P, Demir U, Bozkurt E, Isil GR, Mihmanli M. The role of red cell distribution width in the prognosis of patients with gastric cancer. Cancer Biomark 2017; 18: 19-25.
• Chen GP, Huang Y, Yang X, Feng JF. A nomogram to predict prognostic value of red cell distribution width in patients with esophageal cancer. Mediators Inflamm 2015; 2015: 854670.
• Huang DP, Ma RM, Xiang YQ. Utility of red cell distribution width as a prognostic factor in young breast cancer patients. Medicine (Baltimore) 2016; 95: e3430.
• Di Somma S, Magrini L, Travaglino F, et al. Opinion paper on innovative approach of biomarkers for infectious diseases and sepsis management in the emergency department. Clin Chem Lab Med 2013; 51: 1167-75.
• Mahmood NA, Mathew J, Kang B, Debari VA, Khan MA. Broadening of the red blood cell distribution width is associated with increased severity of illness in patients with sepsis. Int J Crit Illn Inj Sci 2014; 4: 278-82.
• Sargento L, Simões AV, Longo S, Lousada N, Palma Dos Reis R. Red blood cell distribution width is a survival predictor beyond anemia and Nt-ProBNP in stable optimally medicated heart failure with reduced ejection fraction outpatients. Clin Hemorheol Microcirc 2017; 65: 185-94.
• Spell DW, Jones DV, Jr., Harper WF, David Bessman J. The value of a complete blood count in predicting cancer of the colon. Cancer Detect Prev 2004; 28: 37-42.
• Kambara T, Simms LA, Whitehall VL, et al. BRAF mutation is associated with DNA methylation in serrated polyps and cancers of the colorectum. Gut 2004; 53: 1137-44.
• Dogan M, Kucuk U, Uz O. Red blood cell distribution width is worthwhile when interpreted with other inflammatory markers. J Geriatr Cardiol 2015; 12: 457-8.
• Ephrem G. Red blood cell distribution width should indeed be assessed with other inflammatory markers in daily clinical practice. Cardiology 2013; 124: 61.
• De Gonzalo-Calvo D, De Luxán-Delgado B, Rodríguez-González S, et al. Interleukin 6, soluble tumor necrosis factor receptor I and red blood cell distribution width as biological markers of functional dependence in an elderly population: a translational approach. Cytokine 2012; 58: 193-8.
• Goyal H, Hu ZD. Prognostic value of red blood cell distribution width in hepatocellular carcinoma. Ann Transl Med 2017; 5: 271.
• Zhang X, Wu Q, Hu T, Gu C, Bi L, Wang Z. Elevated red blood cell distribution width contributes to poor prognosis in patients undergoing resection for nonmetastatic rectal cancer. Medicine (Baltimore) 2018; 97: e9641.
• Wang PF, Song SY, Guo H, Wang TJ, Liu N, Yan CX. Prognostic role of pretreatment red blood cell distribution width in patients with cancer: A meta-analysis of 49 studies. J Cancer 2019; 10: 4305-17.
• Song CS, Park DI, Yoon MY, et al. Association between red cell distribution width and disease activity in patients with inflammatory bowel disease. Dig Dis Sci 2012; 57: 1033-8.
• Corley DA, Jensen CD, Marks AR, et al. Adenoma detection rate and risk of colorectal cancer and death. N Engl J Med 2014; 370: 1298-306.
• Salvagno GL, Sanchis-Gomar F, Picanza A, Lippi G. Red blood cell distribution width: A simple parameter with multiple clinical applications. Crit Rev Clin Lab Sci 2015; 52: 86-105.
• Lippi G, Sanchis-Gomar F, Danese E, Montagnana M. Association of red blood cell distribution width with plasma lipids in a general population of unselected outpatients. Kardiol Pol 2013; 71: 931-6.
• Sharma R, Agrawal V, editors. The relationship between red blood cell distribution width (RDW CV) and C reactive protein (CRP) with the clinical outcomes in non-ST elevation myocardial infarction and unstable angina pectoris: a 6 months follow up study. International Cardiovascular Forum Journal; 2015.
• Bilgin B, Sendur MaN, Hizal M, et al. Prognostic effect of red cell distribution width-to-platelet ratio in colorectal cancer according to tumor stage and localization. J Cancer Res Ther 2019; 15: 54-60.
• Dunne JR, Gannon CJ, Osborn TM, Taylor MD, Malone DL, Napolitano LM. Preoperative anemia in colon cancer: assessment of risk factors. Am Surg 2002; 68: 582-7.
• Alis R, Fuster O, Rivera L, Romagnoli M, Vaya A. Influence of age and gender on red blood cell distribution width. Clin Chem Lab Med 2015; 53: e25-8.
• Lippi G, Salvagno GL, Guidi GC. Red blood cell distribution width is significantly associated with aging and gender. Clin Chem Lab Med 2014; 52: e197-9.