Miszczyk Marcin, Jabłońska Iwona, Magrowski Łukasz, Masri Oliwia, Rajwa Paweł
IIIrd Radiotherapy and Chemotherapy Clinic, Maria Skłodowska-Curie Memorial Cancer Center and Institute of Oncology, Gliwice, Poland.
Department of Urology, Medical University of Silesia, 3 Maja Street 13-15, 41-800 Zabrze, Poland.
Rep Pract Oncol Radiother. 2020 Jul-Aug;25(4):494-499. doi: 10.1016/j.rpor.2020.03.026. Epub 2020 Apr 19.
The purpose of this study was to evaluate the prognostic impact of red-cell distribution width (RDW) on the overall survival (OS) of patients with squamous cell carcinoma (SCC) of the tongue.
Development of cancer is connected with an ongoing inflammatory process which is reflected by laboratory indices, such as RDW that can be used as prognostic tools.
The study group consists of 74 consecutive patients treated with radical radiotherapy or chemo-radiotherapy for SSC of the tongue at one institution between 2005-2014. RDW was assessed based on routine blood tests done before the start of the treatment. ROC curve was applied to assess value of RDW in prediction of OS, and a cut-off value for further tests was obtained using the Younden index. The survival analysis was performed using the Kaplan-Meier method, log-rank testing and Cox regression model.
The AUC for RDW in ROC analysis was 0.703, and the optimal cut-off value was 13.5%. 5-year OS was significantly lower in patients with RDW ≥ 13.5% compared with patients with RDW < 13.5% (67% vs. 26%, p-value = 0.0005). Additionally, high RDW was associated with a greater odds ratio for 5-year OS in a multivariate Cox proportional hazards regression analysis (3.43, 1.62-7.25; p = 0.001).
Our study demonstrated that pre-treatment RDW ≥ 13,5% is an indicator of poor overall survival in patients with SCC of the tongue. Since RDW is a cheap and convenient marker, usually routinely assessed during complete blood count tests, it could be further used as an additional prognostic tool in patients with tongue cancers.
本研究旨在评估红细胞分布宽度（RDW）对舌鳞状细胞癌（SCC）患者总生存期（OS）的预后影响。
癌症的发展与持续的炎症过程相关，这可通过实验室指标反映出来，如RDW，其可作为预后工具。
研究组由2005年至2014年期间在一家机构接受根治性放疗或放化疗的74例连续性舌鳞状细胞癌患者组成。在治疗开始前根据常规血液检查评估RDW。应用ROC曲线评估RDW在预测总生存期方面的价值，并使用约登指数获得进一步检测的临界值。采用Kaplan-Meier法、对数秩检验和Cox回归模型进行生存分析。
ROC分析中RDW的AUC为0.703，最佳临界值为13.5%。RDW≥13.5%的患者5年总生存期显著低于RDW<13.5%的患者（67%对26%，p值=0.0005）。此外，在多变量Cox比例风险回归分析中，高RDW与5年总生存期的较高优势比相关（3.43，1.62 - 7.25；p = 0.001）。
我们的研究表明，治疗前RDW≥13.5%是舌鳞状细胞癌患者总生存期差的一个指标。由于RDW是一种廉价且方便的标志物，通常在全血细胞计数检测时常规评估，它可进一步用作舌癌患者的额外预后工具。
