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

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.

Effect of Baseline Characteristics and Tumor Burden on Vaspin Expression and Progressive Disease in Operable Colorectal Cancer

“…Consistent with previous findings [ 21 , 22 ], tumor markers including CEA and vaspin can predict colorectal cancer progression. CEA is a promising tumor marker of the prognosis of colorectal cancer; a high level of CEA usually indicates a poor prognosis or survival outcome [ 21 , 22 ].…”

“…Consistent with previous findings [ 21 , 22 ], tumor markers including CEA and vaspin can predict colorectal cancer progression. CEA is a promising tumor marker of the prognosis of colorectal cancer; a high level of CEA usually indicates a poor prognosis or survival outcome [ 21 , 22 ]. Unlike CEA, vaspin is a novel biomarker of the risk of the development and progression of certain cancers; however, it has been seldom discussed in progressive disease in colorectal cancer [ 12 , 23 ].…”

Prognostic evaluation of colorectal cancer using three new comprehensive indexes related to infection, anemia and coagulation derived from peripheral blood

“…Our study supported the view that indicators including HGB, MCV, and MCHC were worse in colon cancers. Previous reports, including ours, had highlighted the adverse prognostic warning of CRC at excessive RDW-CV level [17,54] . Based on the previous conclusions, the results of this study again utilized and expanded the significance of high RDW-CV in peripheral blood of CRC.…”

“…Compared with the traditional pathological test of tumor lesions, peripheral blood biochemical test has the great advantages of quick and simple sample acquisition, low collection cost, minimal trauma and preoperative detection, which should be paid more attention to in research. We reported that RDW-CV (Red Cell Distribution Width-CV) combined with CEA can effectively predict the poor prognosis of CRC [17] . Similarly, it was observed that LY, HGB, MCV (Mean Corpuscular Volume), MCH (Mean Corpuscular Hemoglobin), MCHC (Mean Corpuscular Hemoglobin Concentration), PDW (Platelet Distribution Width) and some other indicators in peripheral blood of CRCs often presented comprehensive abnormalities, which aroused our strong interest.…”

Prognostic value of red cell distribution width (RDW) in colorectal cancer. Results from a single-center cohort on 591 patients

“…On multivariate analysis, they also found RDW to be an independent prognostic factor of poor disease free survival. Li et al 22 , in a retrospective analysis of 168 patients with colo-rectal cancer, found a linear correlation between RDW levels and both 3-and 5-years disease free and overall survival. They also found that the H-RDW patients were more likely to have serosa infiltration, nodal metastases and higher TNM stages.…”