Lee Han Shin, Jung Eun Jung, Kim Jae Myung, Kim Ju Yeon, Kim Jae Ri, Kim Tae Han, Jang Jae Yool, Woo Jung Woo, Lee Jinkwon, Park Taejin, Jeong Sang-Ho
Department of Surgery, Gyeongsang National University Changwon Hospital, Gyeongsang National University College of Medicine, Changwon, Korea.
Department of Surgery, Gyeongsang National University Hospital, Gyeongsang National University School of College, Jinju, Korea.
Gland Surg. 2022 Dec;11(12):1864-1873. doi: 10.21037/gs-22-410.
To date, red blood cell distribution width (RDW) and RDW-to-platelet count ratio (RPR) have been investigated for their association with cancer. This study aimed to investigate the prognostic value of RDW and RPR in breast cancer before and after treatment.
We retrospectively enrolled 395 patients with breast cancer, who were diagnosed between December 2009 and December 2015 and analyzed the association between RDW, RPR, and long-term prognosis. We also compared the RDW and RPR values with the pathologic parameters of breast cancer. The cutoff values for before-treatment RDW, RPR value, after-treatment RDW, and RPR were determined using receiver operating characteristic (ROC) curve analysis by identifying the highest Youden index.
In the before-treatment state, no significant disease-free survival (DFS) or overall survival (OS) was found in the RPR and RDW values. However, we found that elevated after-treatment RPR and RDW were significant prognostic factors for DFS, with hazard ratios (HRs) of 2.233 [95% confidence interval (CI): 1.073-4.649; P=0.032] and 2.067 (95% CI: 1.085-3.937; P=0.027). Kaplan-Meier analysis indicated that the after-treatment RPR and RDW groups had poor OS (HR =30.461; 95% CI: 5.138-180.575; P<0.001) compared with the lower after-treatment RPR and RDW groups. In particular, when the RPR and RDW were in the lower group before the treatment and became elevated after the treatment, it showed a remarkably significant result for OS, with HR 132.6 (95% CI: 3.689-4,767.341; P=0.007) and 10.119 (95% CI: 1.853-55.249; P=0.008).
Thus, after-treatment RPR and RDW could have prognostic value for breast cancer after surgery and adjuvant treatment.
迄今为止，已对红细胞分布宽度（RDW）和RDW与血小板计数比值（RPR）与癌症的相关性进行了研究。本研究旨在探讨RDW和RPR在乳腺癌治疗前后的预后价值。
我们回顾性纳入了395例乳腺癌患者，这些患者于2009年12月至2015年12月期间被诊断，并分析了RDW、RPR与长期预后之间的关联。我们还将RDW和RPR值与乳腺癌的病理参数进行了比较。通过确定最高约登指数，使用受试者工作特征（ROC）曲线分析来确定治疗前RDW、RPR值、治疗后RDW和RPR的临界值。
在治疗前状态下，未发现RPR和RDW值与无病生存期（DFS）或总生存期（OS）有显著关联。然而，我们发现治疗后RPR和RDW升高是DFS的显著预后因素，风险比（HR）分别为2.233[95%置信区间（CI）：1.073 - 4.649；P = 0.032]和2.067（95% CI：1.085 - 3.937；P = 0.027）。Kaplan - Meier分析表明，与治疗后RPR和RDW较低的组相比，治疗后RPR和RDW组的OS较差（HR = 30.461；95% CI：5.138 - 180.575；P < 0.001）。特别是，当治疗前RPR和RDW处于较低组且治疗后升高时，OS显示出非常显著的结果，HR分别为132.6（95% CI：3.689 - 4767.341；P = 0.007）和10.119（95% CI：1.853 - 55.249；P = 0.008）。
因此，治疗后RPR和RDW可能对乳腺癌手术及辅助治疗后的预后具有价值。
