J Cancer 2019; 10(5):1162-1170. doi:10.7150/jca.29018 This issue

Research Paper

Combining Red Blood Cell Distribution Width (RDW-CV) and CEA Predict Poor Prognosis for Survival Outcomes in Colorectal Cancer

Yalun Li1, Chengzhong Xing1, Minjie Wei2, Huizhe Wu2, Xiaoyun Hu2, Shanqiong Li2, Guangwei Sun1, Guangzhe Zhang1, Bo Wu1, Fangxiao Zhang3, Zhuang Li1✉

1. Department of Anorectal Surgery, First Affiliated Hospital of China Medical University, Shenyang, Liaoning, China
2. Department of Pharmacology, School of Pharmacy, China Medical University, Shenyang, Liaoning, China
3. Department of Intensive Care Unit, First Affiliated Hospital of China Medical University, Shenyang, Liaoning, China

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Citation:
Li Y, Xing C, Wei M, Wu H, Hu X, Li S, Sun G, Zhang G, Wu B, Zhang F, Li Z. Combining Red Blood Cell Distribution Width (RDW-CV) and CEA Predict Poor Prognosis for Survival Outcomes in Colorectal Cancer. J Cancer 2019; 10(5):1162-1170. doi:10.7150/jca.29018. Available from https://www.jcancer.org/v10p1162.htm

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Abstract

Background: Colorectal cancer is one of the common tumors that seriously threaten human health worldwide. Serum tumor markers, including CEA and CA19-9, have become the focus of research on colorectal cancer in recent years. As one of the classic blood test results, RDW is related to the pathological features, diagnosis and prognosis of various cancers in recent studies. We hope to search the correlation between RDW and the pathological features of colorectal cancer through the following studies, explore the potential relationship between RDW and the prognosis of colorectal cancer, and find a more effective prognostic evaluation method by combining other blood markers.

Methods: We retrospectively analyzed 168 patients with colorectal cancer included in this study, collected their clinical data, tumor pathological features and their preoperative blood test results including RDW value and tumor markers, and grouped them. After 3 and 5 years of follow-up, the recurrence and survival status were defined, and the above data were statistically analyzed.

Results: The distribution frequency/rate of abnormal RDW-CV in colorectal cancer patients was significantly increased in the elderly (>62), colon cancer, serosal permeability, lymph node metastasis, stage III and IV, peripheral adhesion (P < 0.05). Furthermore, RDW-CV was significantly positively correlated with abnormal high values of tumor serum markers CEA and CA19-9 (P < 0.05). More importantly, ROC curve analysis found that the abnormal increase in RDW-CV in colorectal cancer was associated with the shortening of DFS and OS in patients who were followed up for 3 and 5 years (P < 0.05). Further combined with CEA, it was found that the prognosis and survival of patients with colorectal cancer in 3 and 5 years were more accurate and effective than independent prediction (AUC of DFS in 3/5years=0.630/0.635, AUC of OS in 3/5 years=0.692/0.652).

Conclusion: RDW-CV is correlated with the pathological features of colorectal cancer, indicating a worse malignant tendency of tumor. RDW-CV can independently evaluate the prognosis of colorectal cancer patients, and combined with the high value of CEA, it can effectively indicate the adverse recurrence and survival prognosis.

Keywords: RDW, CEA, prognosis, colorectal cancer