Department of Urology, Northern Jiangsu People's Hospital, Yangzhou University, No. 98 West Nantong Road, Yangzhou, Jiangsu, 225001, China.
Department of Urology, College of Clinical Medicine, Yangzhou University, Yangzhou, Jiangsu, China.
Int Urol Nephrol. 2021 Sep;53(9):1765-1771. doi: 10.1007/s11255-021-02900-z. Epub 2021 May 28.
The present study aims to assess the relationship between red blood cell distribution width (RDW) and clinically significant prostate cancer (csPCa).
A total of 458 patients with prostate-specific antigen (PSA) ≤ 10 ng/ml, who subsequently underwent 11-core transperineal template-guided prostate biopsy from June 15, 2015 to November 24, 2020, were included in the present study. Receiver-operating characteristic (ROC)-derived area under the curve analysis was performed to evaluate the predictive accuracy. In addition, univariate and multivariate logistic regression analysis was carried out to determine the association between RDW and csPCa detection.
A total of 89 patients were diagnosed with csPCa, and these patients presented with higher median RDW. The optimal RDW cut-off was set at 12.35%, which gained the maximal Yuden's index. In addition to csPCa, RDW demonstrated a positive correlation with age (r = 0.210, P < 0.001). It was observed that RDW was independent of prostate-specific antigen density for csPCa detection. Compared with the low-RDW group, patients in the high-RDW group had a 1.586-fold increased risk of being diagnosed with csPCa (OR = 2.586, P = 0.007). In the ROC analysis, the accuracy level increased by 3.1% for the prediction of csPCa, when RDW was added to the multivariate logistic model.
A high-RDW value is an independent risk factor for csPCa detection. However, more large-scale studies are needed to confirm these findings. If validated, RDW can become an inexpensive, non-invasive, and convenient indicator for csPCa prediction.
本研究旨在评估红细胞分布宽度（RDW）与临床显著前列腺癌（csPCa）之间的关系。
本研究共纳入了 458 例前列腺特异性抗原（PSA）≤10ng/ml 的患者，这些患者随后于 2015 年 6 月 15 日至 2020 年 11 月 24 日接受了 11 核经会阴模板引导前列腺活检。采用受试者工作特征（ROC）曲线下面积分析评估预测准确性。此外，还进行了单因素和多因素逻辑回归分析，以确定 RDW 与 csPCa 检测之间的关系。
共有 89 例患者被诊断为 csPCa，这些患者的 RDW 中位数较高。最佳 RDW 截断值设定为 12.35%，此时获得了最大的 Yuden 指数。除了 csPCa 外，RDW 与年龄呈正相关（r=0.210，P<0.001）。研究还发现，RDW 与 csPCa 检测的前列腺特异性抗原密度独立相关。与低 RDW 组相比，高 RDW 组患者被诊断为 csPCa 的风险增加了 1.586 倍（OR=2.586，P=0.007）。在 ROC 分析中，当 RDW 被添加到多因素逻辑模型中时，csPCa 预测的准确性水平提高了 3.1%。
高 RDW 值是 csPCa 检测的独立危险因素。然而，还需要更多的大规模研究来证实这些发现。如果得到验证，RDW 可以成为一种廉价、无创和方便的 csPCa 预测指标。
