Goyal Hemant, Hu Zhi-De
Mercer University School of Medicine, Macon, Georgia, USA.
Department of Laboratory Medicine, General Hospital of Jinan Military Region of PLA, Jinan 250031, China.
Ann Transl Med. 2017 Jul;5(13):271. doi: 10.21037/atm.2017.06.30.
Red blood cell distribution width (RDW) is a simple, inexpensive, routinely measured and automatically reported blood test parameter, which reflects the degree of anisocytosis of red blood cells in peripheral blood. RDW was found to be associated with and retain clinical significance for assessing disease severity and outcomes in a number of hematological and solid malignancies. Motley of interacting clinical and biochemical factors have an impact on the red cell population biology. Malignancies per se can act as a causative factor, or anisocytosis may develop as a result of chronic inflammation. RDW has also been shown to be affected by nutritional status, which is typically deranged in malignancies. RDW is shown to be a clinically useful marker of disease severity and level of fibrosis in liver cirrhosis of various causes such as hepatitis B, hepatitis C and non-alcoholic fatty liver disease. Whether liver cirrhosis patients with higher RDW are at increased risk of hepatocellular cancer is yet to be determined, but several lines of evidence confirm that RDW has clinical significance in hepatocellular carcinoma (HCC). In this review, we specifically discuss the current literature about the association between RDW and HCC. The available evidences were summarized and the potential underlying mechanisms were analyzed.
红细胞分布宽度（RDW）是一项简单、廉价、常规检测且自动报告的血液检测参数，它反映外周血中红细胞大小不均一性的程度。人们发现RDW与多种血液系统恶性肿瘤和实体恶性肿瘤的疾病严重程度及预后评估相关且具有临床意义。多种相互作用的临床和生化因素会影响红细胞群体生物学特性。恶性肿瘤本身可能是一个致病因素，或者红细胞大小不均一性可能是慢性炎症的结果。RDW也已被证明受营养状况影响，而营养状况在恶性肿瘤中通常会紊乱。RDW被证明是各种病因（如乙型肝炎、丙型肝炎和非酒精性脂肪性肝病）所致肝硬化疾病严重程度和纤维化程度的一项临床有用指标。RDW较高的肝硬化患者肝细胞癌风险是否增加尚待确定，但有几条证据证实RDW在肝细胞癌（HCC）中具有临床意义。在本综述中，我们特别讨论了关于RDW与HCC之间关联的当前文献。对现有证据进行了总结，并分析了潜在的潜在机制。
