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Correlation of red cell distribution width with tumor location and stage for colorectal cancer
Prasetyo D.
Chirurgia Turin
Q4Abstract
BACKGROUND: Colorectal cancer (CRC) is more common in developed countries. However, with globalization and lifestyle changes, CRC will become more common in developing countries, with an estimated 2.5 million new cases worldwide by 2035. A complete blood count test is one of the most routine tests performed in clinical practice. In recent years, red cell distribution width (RDW) has been used to assess several non-hematological diseases, including cancer. A high RDW may indicate a systemic inflammatory state and several types of cancer progression. In addition, the RDW can be used to determine prognostic factors in cancer. This study aimed to determine the relationships of RDW with CRC tumor location and stage.METHODS: This was an analytical observational cross-sectional study. RDW is part of the complete blood count and reflects variations in erythrocyte size and volume. CRC location can be divided into the left and right colon. CRC stage was based on the eighth edition of the American Joint Committee of Cancer guidelines. Statistical analyses included Kolmogorov-Smirnov tests, Mann-Whitney U tests, Kruskal-Wallis tests, and Spearman’s rank correlation (rs) test, considering a P value <0.05 statistically significant.RESULTS: RDW was not significantly correlated with CRC location (P=0.323). However, RDW was significantly correlated with CRC stage (rs = 0.598, P<0.001).CONCLUSIONS: Almost all patients with CRC had elevated RDW coefficients of variation (RDW-CVs). The RDW-CV was significantly correlated with CRC stage but not with CRC location. This finding demonstrates that RDW examination could be used as an early predictor for the CRC stage, with an increased RDW being an indicator for immediate colonoscopy for early CRC diagnosis.