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Zang T, Luo X, Mo Y, Lin J, Lu W, Li Z, Zhou Y, Chen S. A novel model for predicting immunotherapy response and prognosis in NSCLC patients. Cancer Cell Int 2025; 25:178. [PMID: 40375214 PMCID: PMC12083170 DOI: 10.1186/s12935-025-03800-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2025] [Accepted: 04/24/2025] [Indexed: 05/18/2025] Open
Abstract
BACKGROUND How to screen beneficiary populations has always been a clinical challenge in the treatment of non-small-cell lung cancer (NSCLC) with immune checkpoint inhibitors (ICIs). Routine blood tests, due to their advantages of being minimally invasive, convenient, and capable of reflecting tumor dynamic changes, have potential value in predicting the efficacy of ICIs treatment. However, there are few models based on routine blood tests to predict the efficacy and prognosis of immunotherapy. METHODS Patients were randomly divided into training cohort and validation cohort at a ratio of 2:1. The random forest algorithm was applied to select important variables based on routine blood tests, and a random forest (RF) model was constructed to predict the efficacy and prognosis of ICIs treatment. For efficacy prediction, we assessed receiver operating characteristic (ROC) curves, decision curve analysis (DCA) curves, clinical impact curve (CIC), integrated discrimination improvement (IDI) and net reclassification improvement (NRI) compared with the Nomogram model. For prognostic evaluation, we utilized the C-index and time-dependent C-index compared with the Nomogram model, Lung Immune Prognostic Index (LIPI) and Systemic Inflammatory Score (SIS). Patients were classified into high-risk and low-risk groups based on RF model, then the Kaplan-Meier (K-M) curve was used to analyze the differences in progression-free survival (PFS) and overall survival (OS) of patients between the two groups. RESULTS The RF model incorporated RDW-SD, MCV, PDW, CD3+CD8+, APTT, P-LCR, Ca, MPV, CD4+/CD8+ ratio, and AST. In the training and validation cohorts, the RF model exhibited an AUC of 1.000 and 0.864, and sensitivity/specificity of (100.0%, 100.0%) and (70.3%, 93.5%), respectively, which had superior performance compared to the Nomogram model (training cohort: AUC = 0.531, validation cohort: AUC = 0.552). The C-index of the RF model was 0.803 in the training cohort and 0.712 in the validation cohort, which was significantly higher than Nomogram model, LIPI and SIS. K-M survival curves revealed that patients in the high-risk group had significantly shorter PFS/OS than those in the low-risk group. CONCLUSIONS In this study, we developed a novel model (RF model) to predict the response to immunotherapy and prognosis in NSCLC patients. The RF model demonstrated better predictive performance for immunotherapy responses than the Nomogram model. Moreover, when predicting the prognosis of immunotherapy, it outperformed the Nomogram model, LIPI, and SIS.
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Affiliation(s)
- Ting Zang
- The First Clinical Medical College and the First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, 510405, Guangdong, People's Republic of China
| | - Xiaorong Luo
- The First Clinical Medical College and the First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, 510405, Guangdong, People's Republic of China
| | - Yangyu Mo
- The First Clinical Medical College and the First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, 510405, Guangdong, People's Republic of China
| | - Jietao Lin
- The First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, 510405, Guangdong, People's Republic of China
- Baiyun Hospital of The First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, 510470, Guangdong, People's Republic of China
| | - Weiguo Lu
- The First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, 510405, Guangdong, People's Republic of China
| | - Zhiling Li
- Department of Clinical Laboratory, State Key Laboratory of Oncology in South China, Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy, Guangdong Provincial Clinical Research Center for Cancer, Sun Yat-Sen University Cancer Center, 651 Dongfeng Road East, Guangzhou, 510060, Guangdong, People's Republic of China.
| | - Yingchun Zhou
- The First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, 510405, Guangdong, People's Republic of China.
- Baiyun Hospital of The First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, 510470, Guangdong, People's Republic of China.
| | - Shulin Chen
- Department of Clinical Laboratory, State Key Laboratory of Oncology in South China, Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy, Guangdong Provincial Clinical Research Center for Cancer, Sun Yat-Sen University Cancer Center, 651 Dongfeng Road East, Guangzhou, 510060, Guangdong, People's Republic of China.
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Wang L, Jun L, Jian'an J, Chunmei R, Yuhuan J, Peng L, Huiming L. Elevated platelet distribution width and diabetes may serve as preoperative predictors of microvascular invasion in primary hepatocellular carcinoma. J Cancer Res Clin Oncol 2025; 151:111. [PMID: 40085250 PMCID: PMC11909018 DOI: 10.1007/s00432-025-06157-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2025] [Accepted: 03/04/2025] [Indexed: 03/16/2025]
Abstract
BACKGROUND AND OBJECTIVE Hepatocellular carcinoma (HCC) is one of the malignancies with increasing incidence globally, and microvascular invasion (MVI) is a crucial determinant of prognosis in patients. This study aimed to investigate platelet distribution width (PDW) and diabetes mellitus as indicators for predicting preoperative MVI in HCC, providing more accurate predictive tools for clinicians to guide treatment strategies and improve patient survival and quality of life. METHODS A retrospective study was conducted, including 1357 patients who underwent hepatectomy for HCC between January 2008 and December 2014 at the Eastern Hepatobiliary Surgery Hospital in China. Clinical, pathological, and radiological data, including PDW and diabetes status, were collected. Univariate and multivariate logistic regression analyses were performed to identify risk factors for MVI and establish a predictive model. The predictive performance of the model was evaluated through nomograms and internal validation. RESULTS Univariate analysis revealed significant associations between MVI and diabetes mellitus, presence of liver cirrhosis, prealbumin level, tumor diameter, number of tumors, HBV DNA viral load > 104, and PDW ≥ 17. Multivariate logistic regression analysis identified diabetes mellitus, liver cirrhosis, prealbumin level, tumor diameter, number of tumors, HBV DNA viral load > 104, and PDW ≥ 17 as independent risk factors for MVI. Based on these findings, a predictive model was established, demonstrating high predictive accuracy and stability in both the training and validation cohorts. CONCLUSION This study confirmed PDW and diabetes mellitus as reliable indicators for predicting preoperative MVI in HCC and established a corresponding predictive model. Future research should further explore the underlying mechanisms and enhance clinical validation to advance the field of HCC treatment.
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Affiliation(s)
- Ling Wang
- Department of Laboratory Medicine, The First Affiliated Hospital of Nanchang University, Nanchang, 330006, China
| | - Liu Jun
- Department of Laboratory Medicine, The First Affiliated Hospital of Nanchang University, Nanchang, 330006, China
| | - Jia Jian'an
- Department of Laboratory Medicine, The 901th Hospital of Joint Logistics Support Force of Chinese People's Liberation Army, Hefei, Shanghai, Anhui, 230031, China
| | - Rao Chunmei
- Department of Laboratory Medicine, Eastern Hepatobiliary Surgery Hospital, Naval Medical University, Shanghai, 200438, China
| | - Jiang Yuhuan
- Department of Laboratory Medicine, The First Affiliated Hospital of Nanchang University, Nanchang, 330006, China
| | - Liu Peng
- Department of Laboratory Medicine, The First Affiliated Hospital of Nanchang University, Nanchang, 330006, China
| | - Li Huiming
- Department of Laboratory Medicine, The First Affiliated Hospital of Nanchang University, Nanchang, 330006, China.
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Cao XR, Xu YL, Chai JW, Zheng K, Kong JJ, Liu J, Zheng SZ. Pretreatment red blood cell distribution width as a predictive marker for postoperative complications after laparoscopic pancreatoduodenectomy. World J Gastrointest Oncol 2025; 17:98168. [PMID: 39817125 PMCID: PMC11664621 DOI: 10.4251/wjgo.v17.i1.98168] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/19/2024] [Revised: 09/10/2024] [Accepted: 10/29/2024] [Indexed: 12/12/2024] Open
Abstract
BACKGROUND Red blood cell distribution width (RDW) is associated with the development and progression of various diseases. AIM To explore the association between pretreatment RDW and short-term outcomes after laparoscopic pancreatoduodenectomy (LPD). METHODS A total of 804 consecutive patients who underwent LPD at our hospital between March 2017 and November 2021 were retrospectively analyzed. Correlations between pretreatment RDW and clinicopathological characteristics and short-term outcomes were investigated. RESULTS Patients with higher pretreatment RDW were older, had higher Eastern Cooperative Oncology Group scores and were associated with poorer short-term outcomes than those with normal RDW. High pretreatment RDW was an independent risk factor for postoperative complications (POCs) (hazard ratio = 2.973, 95% confidence interval: 2.032-4.350, P < 0.001) and severe POCs of grade IIIa or higher (hazard ratio = 3.138, 95% confidence interval: 2.042-4.824, P < 0.001) based on the Clavien-Dino classification system. Subgroup analysis showed that high pretreatment RDW was an independent risk factor for Clavien-Dino classification grade IIIb or higher POCs, a comprehensive complication index score ≥ 26.2, severe postoperative pancreatic fistula, severe bile leakage and severe hemorrhage. High pretreatment RDW was positively associated with the neutrophil-to-lymphocyte ratio and platelet-to-lymphocyte ratio and was negatively associated with albumin and the prognostic nutritional index. CONCLUSION Pretreatment RDW was a special parameter for patients who underwent LPD. It was associated with malnutrition, severe inflammatory status and poorer short-term outcomes. RDW could be a surrogate marker for nutritional and inflammatory status in identifying patients who were at high risk of developing POCs after LPD.
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Affiliation(s)
- Xian-Rang Cao
- Department of Liver Transplantation and Hepatobiliary Surgery, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan 250021, Shandong Province, China
| | - Yin-Long Xu
- Department of Liver Transplantation and Hepatobiliary Surgery, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan 250021, Shandong Province, China
| | - Jia-Wei Chai
- Department of Breast and Thyroid Surgery, Shandong Provincial Maternal and Child Health Care Hospital, Jinan 250014, Shandong Province, China
| | - Kai Zheng
- Department of Liver Transplantation and Hepatobiliary Surgery, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan 250021, Shandong Province, China
| | - Jun-Jie Kong
- Department of Liver Transplantation and Hepatobiliary Surgery, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan 250021, Shandong Province, China
| | - Jun Liu
- Department of Liver Transplantation and Hepatobiliary Surgery, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan 250021, Shandong Province, China
| | - Shun-Zhen Zheng
- Department of Liver Transplantation and Hepatobiliary Surgery, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan 250021, Shandong Province, China
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Abstract
Hypertension (HT) is a common chronic disease that often causes target-organ damage and severe complications, contributing to cardiovascular morbidity and mortality worldwide. Accumulating evidence suggests that inflammation plays a prominent role in the initiation and progression of HT. Multiple inflammatory biomarkers have been proposed to predict HT. Several new hematological parameters can reflect the inflammatory response and platelet activation. The major advantage of hematological parameters over conventional inflammatory markers is that they are relatively inexpensive and easily obtained from routine blood tests. Numerous studies have investigated several hematological parameters for their utility as predictive biomarkers for the diagnosis and prognosis of HT. Among them, the neutrophil to lymphocyte ratio (NLR), monocyte to high density lipoprotein cholesterol ratio (MHR), red cell distribution width (RDW), platelet to lymphocyte ratio (PLR), mean platelet volume (MPV), platelet distribution width (PDW), and systemic immune-inflammation index (SII) have recently received attention. We searched PubMed and Embase databases (up to September 18, 2022) to assess the relationships between hematological parameters and HT. This review discusses the diagnostic and prognostic value of these hematological parameters in HT, providing an important basis for early screening, risk stratification, and optimal management of hypertensive patients.
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Affiliation(s)
- Xiangzhu Meng
- Department of Cardiology, Jiangxi Province Hospital of Integrated Chinese and Western Medicine, Nanchang, Jiangxi, China
| | - Hong Sun
- Department of Intensive Care Unit, Ganzhou People's Hospital, Ganzhou, Jiangxi, China
| | - Xiaowen Tu
- Department of Cardiology, Jiangxi Province Hospital of Integrated Chinese and Western Medicine, Nanchang, Jiangxi, China
| | - Wei Li
- Department of Intensive Care Unit, The Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China
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Ruan L, Zhu L, Su L, Hu S, Wang S, Guo Q, Wan B, Qiu S, Zhang Y, Wei Y. Better prognosis in surgical aortic valve replacement patients with lower red cell distribution width: A MIMIC-IV database study. PLoS One 2024; 19:e0306258. [PMID: 39042622 PMCID: PMC11265686 DOI: 10.1371/journal.pone.0306258] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2024] [Accepted: 06/12/2024] [Indexed: 07/25/2024] Open
Abstract
BACKGROUND Surgical aortic valve replacement (SAVR) currently stands as a primary surgical intervention for addressing aortic valve disease in patients. This retrospective study focused on the role of the red blood cell distribution width (RDW) in predicting adverse outcomes among SAVR patients. METHODS The subjects for this study were exclusively derived from the Medical Information Mart for Intensive Care database (MIMIC IV 2.0). Kaplan‒Meier (K-M) curves and Cox proportional hazards regression models were employed to assess the correlation between RDW, one-year mortality, and postoperative atrial fibrillation (POAF). The smooth-fitting curves were used to observe the relative risk (RR) of RDW in one-year mortality and POAF. Furthermore, time-dependent receiver operating characteristic (ROC) curves, the continuous-net reclassification index (NRI), and integrated discrimination improvement (IDI) were employed for comprehensive assessment of the prognostic value of RDW. RESULTS Analysis of RDW revealed a distinctive inverted U-shaped relationship with one-year mortality, while its association with POAF appeared nearly linear. Cox multiple regression models showed that RDW > 14.35%, along with preoperative potassium concentration and perioperative red blood cell transfusion, were significantly linked to one-year mortality (K-M curves, log-rank P < 0.01). Additionally, RDW was associated with both POAF and prolonged hospital stays (P < 0.05). There was no significant difference in length of stay in ICU. Notably, the inclusion of RDW in the predictive models substantially enhanced its performance. This was evidenced by the time-dependent ROC curve (AUC = 0.829), NRI (P< 0.05), IDI (P< 0.05), and K-M curves (log-rank P< 0.01). CONCLUSIONS RDW serves as a robust prognostic indicator for SAVR patients, offering a novel means of anticipating adverse postoperative events.
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Affiliation(s)
- Liancheng Ruan
- Department of Thoracic Surgery, The Second Affiliated Hospital of Jiangxi Medical College of Nanchang University, Nanchang, Jiangxi Province, China
| | - Lingxiao Zhu
- Department of Thoracic Surgery, The Second Affiliated Hospital of Jiangxi Medical College of Nanchang University, Nanchang, Jiangxi Province, China
| | - Lang Su
- Department of Thoracic Surgery, The Second Affiliated Hospital of Jiangxi Medical College of Nanchang University, Nanchang, Jiangxi Province, China
| | - Sheng Hu
- Department of Thoracic Surgery, The Second Affiliated Hospital of Jiangxi Medical College of Nanchang University, Nanchang, Jiangxi Province, China
| | - Silin Wang
- Department of Thoracic Surgery, The Second Affiliated Hospital of Jiangxi Medical College of Nanchang University, Nanchang, Jiangxi Province, China
| | - Qiang Guo
- Department of Thoracic Surgery, The Second Affiliated Hospital of Jiangxi Medical College of Nanchang University, Nanchang, Jiangxi Province, China
| | - Bingen Wan
- Department of Thoracic Surgery, The Second Affiliated Hospital of Jiangxi Medical College of Nanchang University, Nanchang, Jiangxi Province, China
| | - Shengyu Qiu
- Department of Thoracic Surgery, The Second Affiliated Hospital of Jiangxi Medical College of Nanchang University, Nanchang, Jiangxi Province, China
| | - Yang Zhang
- Department of Thoracic Surgery, The Second Affiliated Hospital of Jiangxi Medical College of Nanchang University, Nanchang, Jiangxi Province, China
| | - Yiping Wei
- Department of Thoracic Surgery, The Second Affiliated Hospital of Jiangxi Medical College of Nanchang University, Nanchang, Jiangxi Province, China
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Peng D, Li ZW, Liu F, Liu XR, Wang CY. Predictive value of red blood cell distribution width and hematocrit for short-term outcomes and prognosis in colorectal cancer patients undergoing radical surgery. World J Gastroenterol 2024; 30:1714-1726. [PMID: 38617745 PMCID: PMC11008369 DOI: 10.3748/wjg.v30.i12.1714] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/04/2023] [Revised: 12/26/2023] [Accepted: 03/11/2024] [Indexed: 03/28/2024] Open
Abstract
BACKGROUND Previous studies have reported that low hematocrit levels indicate poor survival in patients with ovarian cancer and cervical cancer, the prognostic value of hematocrit for colorectal cancer (CRC) patients has not been determined. The prognostic value of red blood cell distribution width (RDW) for CRC patients was controversial. AIM To investigate the impact of RDW and hematocrit on the short-term outcomes and long-term prognosis of CRC patients who underwent radical surgery. METHODS Patients who were diagnosed with CRC and underwent radical CRC resection between January 2011 and January 2020 at a single clinical center were included. The short-term outcomes, overall survival (OS) and disease-free survival (DFS) were compared among the different groups. Cox analysis was also conducted to identify independent risk factors for OS and DFS. RESULTS There were 4258 CRC patients who underwent radical surgery included in our study. A total of 1573 patients were in the lower RDW group and 2685 patients were in the higher RDW group. There were 2166 and 2092 patients in the higher hematocrit group and lower hematocrit group, respectively. Patients in the higher RDW group had more intraoperative blood loss (P < 0.01) and more overall complications (P < 0.01) than did those in the lower RDW group. Similarly, patients in the lower hematocrit group had more intraoperative blood loss (P = 0.012), longer hospital stay (P = 0.016) and overall complications (P < 0.01) than did those in the higher hematocrit group. The higher RDW group had a worse OS and DFS than did the lower RDW group for tumor node metastasis (TNM) stage I (OS, P < 0.05; DFS, P = 0.001) and stage II (OS, P = 0.004; DFS, P = 0.01) than the lower RDW group; the lower hematocrit group had worse OS and DFS for TNM stage II (OS, P < 0.05; DFS, P = 0.001) and stage III (OS, P = 0.001; DFS, P = 0.001) than did the higher hematocrit group. Preoperative hematocrit was an independent risk factor for OS [P = 0.017, hazard ratio (HR) = 1.256, 95% confidence interval (CI): 1.041-1.515] and DFS (P = 0.035, HR = 1.194, 95%CI: 1.013-1.408). CONCLUSION A higher preoperative RDW and lower hematocrit were associated with more postoperative complications. However, only hematocrit was an independent risk factor for OS and DFS in CRC patients who underwent radical surgery, while RDW was not.
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Affiliation(s)
- Dong Peng
- Department of Gastrointestinal Surgery, The First Affiliated Hospital of Chongqing Medical University, Chongqing 400016, China
| | - Zi-Wei Li
- Department of Gastrointestinal Surgery, The First Affiliated Hospital of Chongqing Medical University, Chongqing 400016, China
| | - Fei Liu
- Department of Gastrointestinal Surgery, The First Affiliated Hospital of Chongqing Medical University, Chongqing 400016, China
| | - Xu-Rui Liu
- Department of Gastrointestinal Surgery, The First Affiliated Hospital of Chongqing Medical University, Chongqing 400016, China
| | - Chun-Yi Wang
- Department of Gastrointestinal Surgery, The First Affiliated Hospital of Chongqing Medical University, Chongqing 400016, China
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Wen ZL, Zhou X, Peng D. Red blood cell distribution width has a prognostic value for gastric cancer patients after gastrectomy: A pooling-up analysis. Medicine (Baltimore) 2023; 102:e35554. [PMID: 37832121 PMCID: PMC10578666 DOI: 10.1097/md.0000000000035554] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/25/2023] [Accepted: 09/18/2023] [Indexed: 10/15/2023] Open
Abstract
Our study aims to investigate whether preoperative red blood cell distribution width (RDW) has a prognostic value for patients after gastric cancer (GC) surgery. We searched articles in 3 databases including PubMed, Embase, and the Cochrane Library on May 16th, 2022. The prognostic indicators included overall survival (OS) and disease-free survival (DFS). RevMan 5.3 (The Cochrane Collaboration, London, United Kingdom) and Stata V16.0 were used for statistical analysis. The Risk Of Bias In Non-randomized Studies-of Interventions tool was used to assess risk of bias of the included studies. Ten articles involving 2740 patients were included. RDW was a prognostic factor for OS (hazard ratio = 1.81, 95% confidence interval [CI] = 1.38-2.37, P < .01) and DFS (hazard ratio = 1.99, I2 = 26%, 95% CI = 1.53-2.58, P < .01) for GC patients. Meanwhile, there were some differences between the high RDW group and the low RDW group. We found more patients older than 60 years old (OR = 2.58, 95% CI = 1.08-6.13, P = .03), larger tumor diameter (OR = 1.95, 95% CI = 1.33-2.85, P < .01) and later T stage (OR = 1.91, 95% CI = 1.07-3.42, P = .03) in the high RDW group than the low RDW group. No statistic difference was found in gender, N stage, tumor node metastasis stage, vascular invasion, differentiation, and adjuvant therapy between the 2 groups (P > .05). RDW was an independent prognostic factor for both OS and DFS of GC patients. High RDW level were strongly associated with poor survival.
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Affiliation(s)
- Ze-Lin Wen
- Department of Gastrointestinal Surgery, Yongchuan Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Xiong Zhou
- Department of Gastrointestinal Surgery, Yongchuan Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Dong Peng
- Department of Gastrointestinal Surgery, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
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Yan S, Kong J, Zhao ZF, Yao H. The prognostic importance of red blood cell distribution width for gastric cancer: a systematic review and meta-analysis. Transl Cancer Res 2023; 12:1816-1825. [PMID: 37588748 PMCID: PMC10425649 DOI: 10.21037/tcr-23-53] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2023] [Accepted: 05/11/2023] [Indexed: 08/18/2023]
Abstract
Background For cancer patients, red blood cell distribution width (RDW) is a readily accessible and cost-effective preoperative prognostic predictor. This study aimed to determine whether RDW is a predictive factor for individuals undergoing radical surgery for gastric cancer (GC). Methods A literature search was performed to select relevant studies for inclusion in the subsequent meta-analysis. Relevant data were pooled to assess the association between RDW and GC results, including overall survival (OS), disease-free survival (DFS), and cancer-specific survival (CSS), as well as clinicopathological features. Results The meta-analysis and systemic review included data from 8 studies comprising 1,587 individuals diagnosed with GC. In this context, RDW refers to the coefficient of variation of RDW (RDW-CV). A high level of RDW-CV was significantly associated with older age [odds ratio (OR) =2.25; 95% confidence interval (CI): 1.72-2.94; P<0.00001], larger tumor diameter (OR =1.90; 95% CI: 1.42-2.56; P<0.0001), and vascular invasion (OR =2.22; 95% CI: 1.10-4.49; P=0.03). After hazard ratios (HRs) and 95% CIs were pooled, RDW-CV was found to be an independent prognostic factor of OS (HR =1.79; 95% CI: 1.21-2.66; I2=85%; P=0.004), DFS (HR =1.81; 95% CI: 1.37-2.39; I2=0%; P<0.0001), and CSS (HR =2.73; 95% CI: 1.36-5.49; I2=0%; P=0.005) in patients with GC. Conclusions The association between high levels of RDW-CV and poor survival in GC suggests that RDW-CV may be a viable prognostic indicator for patients with GC.
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Affiliation(s)
- Shuai Yan
- Department of Gastrointestinal Surgery, The Affiliated Hospital of Southwest Medical University, Luzhou, China
- School of Clinical Medical Sciences, Southwest Medical University, Luzhou, China
| | - Jian Kong
- Department of Gastrointestinal Surgery, The Affiliated Hospital of Southwest Medical University, Luzhou, China
- School of Clinical Medical Sciences, Southwest Medical University, Luzhou, China
| | - Zheng-Fei Zhao
- Department of Gastrointestinal Surgery, The Affiliated Hospital of Southwest Medical University, Luzhou, China
- School of Clinical Medical Sciences, Southwest Medical University, Luzhou, China
| | - Hui Yao
- Department of Gastrointestinal Surgery, The Affiliated Hospital of Southwest Medical University, Luzhou, China
- School of Clinical Medical Sciences, Southwest Medical University, Luzhou, China
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Jiang HJ, Li HC, Wang Z, Mei JF. Correlation between platelet distribution width and long-term survival in patients with gastric cancer after radical surgery. Shijie Huaren Xiaohua Zazhi 2023; 31:193-200. [DOI: 10.11569/wcjd.v31.i5.193] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/08/2023] Open
Abstract
BACKGROUND Gastric cancer is a common digestive system tumor, and surgery is the first choice of treatment, but the long-term survival of patients after surgery is still not satisfactory. Previous studies have showed that platelet distribution width (PDW) plays an important role in the occurrence and development of tumor. This study aimed to analyze the correlation between PDW and long-term survival of patients with stage Ⅱ-ⅢA gastric cancer after radical surgery.
AIM To explore the relationship between PDW and long-term survival in patients with stage Ⅱ-ⅢA gastric cancer after radical surgery.
METHODS This is a prospective cohort study, in which 124 patients with gastric cancer who received surgical treatment at our hospital from January 2016 to December 2017 were included as the study subjects. All patients were followed for 5 years and their survival time was recorded. The patients were divided into three groups according to whether their PDW increased or not after surgery: PDW decrease group, PDW normal group, and PDW increase group. The clinicopathological characteristics and long-term survival of patients in different groups were compared. Point binary correlation and COX regression were used to test the correlation between postoperative PDW and long-term survival of patients and the impact of PDW on long-term survival. Receiver operating characteristic (ROC) curve analysis was performed to analyze the value of postoperative PDW in predicting long-term survival.
RESULTS The levels of CEA, CA199, and PDW in gastric cancer patients after treatment were significantly lower than those before treatment (P < 0.05). Among 111 patients with gastric cancer, 35 (31.53%) had decreased PDW, 24 (21.62%) had normal PDW, and 52 (46.85%) had increased PDW. The rates of lymph node metastasis and advanced tumor-node-metastasis (TNM) stage (ⅢA) in the PDW increase group were significantly higher than those of the PDW normal group and PDW decrease group (P < 0.05). However, there were no statistical significant differences among the three groups in terms of age, sex, degree of differentiation, tumor diameter, depth of muscle invasion, TNM stage, and lymph node metastasis (P > 0.05). Among 111 cases of gastric cancer, 31 survived, with a survival rate of 27.93%; the survival time was 11-60 mo, and the median survival time was 43.00 (31.00, 60.00) mo. Point binary correlation test showed that PDW, lymph node metastasis, and TNM stage were positively correlated with long-term survival after radical surgery(r > 0, P < 0.05). COX regression analysis showed that after adjusting for TNM stage and lymph node metastasis, taking the normal PDW group as a reference, the increase of PDW was a risk factor for long-term survival of gastric cancer patients. The median survival time of the patients with decreased, normal, and increased PDW was 49.50 (33.00, 60.00) mo, 53.50 (49.25, 58.00) mo, and 29.00 (20.00, 35.00) mo, respectively, and the difference among the three groups was statistically significant (P < 0.05). ROC curve analysis showed that postoperative PDW level had appreciated value in predicting long-term survival of gastric cancer patients (AUC = 0.718, 95%CI: 0.614-0.822, P < 0.001).
CONCLUSION PDW is related to the long-term survival of patients with gastric cancer after radical surgery. Increased PDW indicates that the long-term prognosis of gastric cancer patients is poor and the survival period is short. TNM stage and lymph node metastasis are also closely related to the long-term survival of gastric cancer patients.
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Affiliation(s)
- Hong-Jin Jiang
- Department of General Surgery, Lanxi People's Hospital, Lanxi 321100, Zhejiang Province, China
| | - Hong-Chen Li
- Department of Thoracic Surgery, Lanxi People's Hospital, Lanxi 321100, Zhejiang Province, China
| | - Zheng Wang
- Department of General Surgery, Lanxi People's Hospital, Lanxi 321100, Zhejiang Province, China
| | - Jian-Feng Mei
- Department of General Surgery, Lanxi People's Hospital, Lanxi 321100, Zhejiang Province, China
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Wen ZL, Zhou X, Xiao DC. Is red blood cell distribution width a prognostic factor for colorectal cancer? A meta-analysis. Front Surg 2022; 9:945126. [PMID: 36263092 PMCID: PMC9574073 DOI: 10.3389/fsurg.2022.945126] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2022] [Accepted: 09/16/2022] [Indexed: 11/06/2022] Open
Abstract
Background RDW might be an easy and cost-effective pre-operative prognostic factor for cancer patients. The aim of the current study was to analyze whether red blood cell distribution width (RDW) was a prognostic factor for colorectal cancer (CRC) patients who underwent radical surgery. Methods We conducted the searching strategy in three databases including the PubMed, Embase and Cochrane Library from the inception to May 07, 2022, to find eligible studies. In this meta-analysis, we focused on the prognosis. Pooled hazard ratios (HRs) and 95% confidence intervals (CIs) were calculated for overall survival (OS), disease-free survival (DFS) and cancer-specific survival (CSS). Results A total of seven studies involving 7,541 patients were included in this meta-analysis. After pooling up the HRs, red blood cell distribution width-coefficient of variation (RDW-CV) was not an independent prognostic factor of OS (HR = 1.48, I2 = 90%, 95% CI = 0.93 to 2.36, P = 0.10), however, red blood cell distribution width-standard deviation (RDW-SD) was an independent prognostic factor of OS (HR = 1.99, I2 = 0%, 95% CI = 1.59 to 2.49, P < 0.01). As for DFS, we found that RDW-CV (HR = 1.51, I2 = 83%, 95% CI = 0.94 to 2.43, P = 0.09 < 0.10) and RDW-SD (HR = 1.77, I2 = 56%, 95% CI = 0.91 to 3.43, P = 0.09 < 0.10) were both the independent prognostic factors. In terms of CSS, we found that RDW-CV was not an independent prognostic factor (HR = 1.23, I2 = 95%, 95% CI = 0.72 to 2.10, P = 0.46). Conclusion RDW-SD was an independent prognostic factor of OS and DFS, and RDW-CV was an independent prognostic factor of DFS.
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