Cheng Jie, Wang Siyang, Jia Jingying, Chen Qian, Song Yunxiao, Li Junsheng
Department of Urinary Surgery, Shanghai Xuhui Central Hospital, Shanghai, People's Republic of China.
Department of Geratology, Shanghai Xuhui Central Hospital, Shanghai, People's Republic of China.
J Inflamm Res. 2021 Nov 23;14:6115-6127. doi: 10.2147/JIR.S342272. eCollection 2021.
Red cell distribution width (RDW), an inflammation biomarker, has been linked to poor outcomes in patients with different types of cancers. The present study aimed to investigate the relationship between pre-/post-treatment 3-month RDW levels and changes in RDW with 3-year prognosis of prostate cancer.
A total of 348 patients with prostate cancer were recruited between June 1, 2012 and June 1, 2017 and were followed up for at least 3 years. RDW was measured with the Mindray BC-6800Plus automatic blood counting system at pre- and post-treatment 3-month. Demographic and clinical information of the participants were also collected. The overall survival (OS) and cancer-specific survival (CSS) were analyzed using the Kaplan-Meier method. Cox regression and competing risk regression analyses were performed.
During the follow-up period, 51 (14.66%) deaths occurred. The levels of pre- and post-treatment RDW levels were significantly higher in the death group than in the survival group (p<0.001). In the death group, the level of RDW continued to rise in most subjects, and the mean level of RDW was significantly higher at post-treatment than pre-treatment, contrary to the results observed in the survival group. Multivariate Cox regression analysis revealed that high pre-treatment RDW, high post-treatment RDW, and persistently higher RDW were independently associated with OS and CSS (p<0.001). Similar results were observed in the competing risk regression analysis. Kaplan-Meier analysis revealed that patients with higher pre-treatment RDW levels, higher post-treatment RDW levels, and persistently higher RDW levels had poorer 3-year OS and CSS rates (p<0.05).
The levels of and changes in RDW before and after treatment were associated with the 3-year prognosis of prostate cancer, suggesting that RDW might be an efficient prognostic predictor in patients with prostate cancer.
红细胞分布宽度（RDW）作为一种炎症生物标志物，已被证明与不同类型癌症患者的不良预后相关。本研究旨在探讨前列腺癌患者治疗前/后3个月的RDW水平以及RDW的变化与3年预后之间的关系。
2012年6月1日至2017年6月1日期间共招募了348例前列腺癌患者，并对其进行了至少3年的随访。使用迈瑞BC - 6800Plus全自动血液计数系统在治疗前和治疗后3个月测量RDW。同时收集参与者的人口统计学和临床信息。采用Kaplan - Meier法分析总生存期（OS）和癌症特异性生存期（CSS）。进行Cox回归和竞争风险回归分析。
随访期间，发生51例（14.66%）死亡。死亡组治疗前和治疗后的RDW水平显著高于生存组（p<0.001）。在死亡组中，大多数受试者的RDW水平持续上升，且治疗后的RDW平均水平显著高于治疗前，这与生存组的结果相反。多因素Cox回归分析显示，治疗前高RDW、治疗后高RDW以及持续较高的RDW与OS和CSS独立相关（p<0.001）。竞争风险回归分析也观察到类似结果。Kaplan - Meier分析显示，治疗前RDW水平较高、治疗后RDW水平较高以及持续较高RDW水平的患者3年OS和CSS率较差（p<0.05）。
治疗前后RDW的水平及变化与前列腺癌的3年预后相关，提示RDW可能是前列腺癌患者有效的预后预测指标。
