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红细胞分布宽度——中国结直肠癌患者根治性切除术后的一项潜在预后指标

Red cell distribution width-a potential prognostic indicator for colorectal cancer patients after radical resection in China.

作者信息

Zhao Weiwei, Shen Xuefang, Hua Qing, Yang Liu, Zhou Ru, Zhou Changming, Xu Pingbo

机构信息

Department of Integrated Therapy, Fudan University Shanghai Cancer Center, Shanghai, China.

Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China.

出版信息

J Gastrointest Oncol. 2023 Aug 31;14(4):1746-1758. doi: 10.21037/jgo-23-54. Epub 2023 Jul 26.

Abstract

BACKGROUND

Red cell distribution width (RDW) can signal poor prognosis in inflammatory medical conditions. The purpose of the study was to investigate the relationship between preoperative RDW and colorectal cancer (CRC) in a large cohort of patients.

METHODS

A total of 6,224 CRC patients who underwent radical resection at the Fudan University Shanghai Cancer Center were evaluated retrospectively. The prognostic significance of RDW for overall survival (OS) and disease-free survival (DFS) was analyzed using Cox proportional hazards models and Kaplan-Meier method. Propensity score matching (PSM) was used based on survival confounding factors.

RESULTS

The mean age of the study participants was 59.5±12.0 years and the study cohort was 44% female. The overall median and mean RDW values were 13.3% and 14.0%, respectively. Patients were stratified into three groups based on their RDW value (≤13.3%, 13.4-14.0%, and >14.0%). OS and DFS were shown to significantly deteriorate with increasing RDW category. In the PSM population, OS and DFS were significantly lower in the high RDW group compared with matched controls. However, the differences vanished in the comparisons between the middle RDW group and the control group.

CONCLUSIONS

Our findings demonstrate that preoperative RDW may represent a simple and powerful prognostic factor for CRC patients after radical resection. Integrating RDW into clinical practice may better inform the prognosis and optimize therapeutic approaches for patients with CRC.

摘要

背景

红细胞分布宽度(RDW)可提示炎症性疾病预后不良。本研究旨在调查一大群患者术前RDW与结直肠癌(CRC)之间的关系。

方法

回顾性评估复旦大学附属肿瘤医院6224例行根治性切除的CRC患者。采用Cox比例风险模型和Kaplan-Meier法分析RDW对总生存期(OS)和无病生存期(DFS)的预后意义。基于生存混杂因素使用倾向评分匹配(PSM)。

结果

研究参与者的平均年龄为59.5±12.0岁,研究队列中44%为女性。总体RDW中位数和平均值分别为13.3%和14.0%。根据RDW值(≤13.3%、13.4 - 14.0%和>14.0%)将患者分为三组。OS和DFS显示随着RDW类别增加而显著恶化。在PSM人群中,高RDW组的OS和DFS显著低于匹配对照组。然而,中RDW组与对照组比较时差异消失。

结论

我们的研究结果表明,术前RDW可能是CRC患者根治性切除术后一个简单而有力的预后因素。将RDW纳入临床实践可能更好地为CRC患者的预后提供信息并优化治疗方法。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b0aa/10502564/13229d0f1590/jgo-14-04-1746-f1.jpg

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