Department of Hepatopancreatobiliary Surgery, The First Affiliated Hospital of Ningbo University, Ningbo, China.
Department of Radiotherapy, Ningbo Medical Center Lihuili Hospital, Ningbo University, Ningbo, China.
BMC Gastroenterol. 2024 Aug 27;24(1):288. doi: 10.1186/s12876-024-03381-x.
Previous studies have identified the hemoglobin (Hb) to red blood cell distribution width (RDW) ratio (HRR) is associated with the prognosis of a variety of malignant tumors. However, the relationship between HRR and pancreatic ductal adenocarcinoma (PDAC) prognosis remains unexplored. This study aims to ascertain the prognostic significance of HRR in PDAC patients.
In a retrospective analysis, 128 PDAC patients undergoing initial surgical resection at Ningbo Medical Center Lihuili Hospital between January 2016 and September 2021 were included. Based on receiver operating characteristic curve-derived cut-off values, participants were categorized into low and high HRR groups. The correlation between HRR and patient prognosis was subsequently examined.
Significant disparities in age, Hb levels, RDW, tumor locality, surgical intervention, and postoperative chemotherapy were observed between the two groups (P < 0.05). Notably, the low HRR cohort exhibited inferior disease-free survival (DFS) and overall survival (OS) rates (P = 0.002 for both). Univariate analysis indicated that male gender, adjacent tissue invasion, TNM stages III/IV, non-O blood types, low HRR, and lack of postoperative chemotherapy were linked to adverse DFS and OS outcomes (P < 0.05). Multivariate analysis further delineated low HRR as an independent predictor of poor DFS and OS outcomes (HR: 1.520, 95% CI: 1.028-2.247, P = 0.036; HR: 1.537, 95% CI: 1.034-2.284, P = 0.034, respectively).
Our findings suggest that a lower HRR is indicative of poorer DFS and OS in PDAC patients, underscoring its potential utility as a prognostic biomarker for this population.
先前的研究已经确定血红蛋白（Hb）与红细胞分布宽度（RDW）的比值（HRR）与多种恶性肿瘤的预后相关。然而，HRR 与胰腺导管腺癌（PDAC）预后之间的关系尚未得到探索。本研究旨在确定 HRR 在 PDAC 患者中的预后意义。
在回顾性分析中，纳入了 2016 年 1 月至 2021 年 9 月在宁波医疗中心李惠利医院接受初次手术切除的 128 例 PDAC 患者。根据受试者工作特征曲线（ROC 曲线）衍生的截断值，将患者分为低 HRR 组和高 HRR 组。随后检查了 HRR 与患者预后之间的相关性。
两组间年龄、Hb 水平、RDW、肿瘤部位、手术干预和术后化疗存在显著差异（P<0.05）。值得注意的是，低 HRR 组的无病生存（DFS）和总生存（OS）率较低（P=0.002）。单因素分析表明，男性、邻近组织侵犯、TNM 分期 III/IV、非 O 型血、低 HRR 和缺乏术后化疗与不良 DFS 和 OS 结果相关（P<0.05）。多因素分析进一步表明，低 HRR 是不良 DFS 和 OS 结果的独立预测因子（HR：1.520，95%CI：1.028-2.247，P=0.036；HR：1.537，95%CI：1.034-2.284，P=0.034）。
我们的研究结果表明，较低的 HRR 预示着 PDAC 患者的 DFS 和 OS 更差，这表明其作为该人群预后生物标志物的潜在应用价值。
