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Eritrosit Dağılım Genişliği (RDW): Metastatik Kolorektal Kanserde Prognoz Belirleyici Olarak Kullanımı

Year 2019, Volume: 9 Issue: 1, 66 - 72, 28.01.2019
https://doi.org/10.31020/mutftd.466992

Abstract

Giriş: RDW, eritrosit dağılım genişliği, dolaşımdaki eritrositlerin büyüklüğünün değişkenliğini yansıtan eritrosit anizositozun
derecesinin ölçülmesi için yaygın olarak kullanılan bir laboratuvar parametresidir. Kanserin, hem bir neden, hem de kronik
inflamasyonun bir sonucu olduğu yaygın bir şekilde kabul görmesine rağmen, RDW yükselmesi solid kanser aktivitesinin potansiyel
bir biyobelirteci olarak şimdiye kadar çok fazla araştırılmamıştır. Bizim çalışmamız RDW elevasyonunun kolorektal kanser
aktivitesinin bir biyobelirteci olarak potansiyel rolü olup olmadığını değerlendiren ilk sistematik çalışmadır.

Metod: Ocak 2008 ile ağustos 2018 arasındaki Mersin Üniversitesi Tıp Fakültesi Tıbbi Onkoloji Polikliniği’ne başvuran 121
metastatik kolorektal kanserli hastada retrospektif analiz yapıldı. Çalışmanın dışlama kriterleri; başka bir malignite öyküsü olması,
gebelik, böbrek nakli, hematolojik hastalıklar, ciddi anemi, enfeksiyon veya inflamatuar hastalıklar, demir eksikliği tedavisi, yeni
venöz tromboz (son 6 ayda), yeni kan transfüzyonu (son 3 ayda), kronik obstrüktif akciğer hastalığı, hepatit b veya c, kalp yetmezliği,
aritmi, tedavi edilmemiş tiroid hastalığı ve bilinen ciddi karaciğer ve/veya böbrek hastalığı olması.

Bulgular: Metastatik kolorektal kanser hastasının ortalama RDW değeri 15.95 iken, normal popülasyonda 13.5 idi. RDW düzeyi,
diğer yüksek progresyon riski ve düşük progresyon riski olan hastalarda aynıydı. Hastaların ortalama genel sağkalımı, RDW ≤15
olanların 42.5 ay, RDW> 15 olanların 26.3 ay idi. İki grupta istatistiksel olarak anlamlı fark yoktur.

Tartışma: RDW, kolon kanserlerinde anemi oluşumundan önce artan bir parametre olarak dikkat çekmektedir. RDW standart tam
kan sayımında bulunur, herhangi bir ek maliyet getirmez ve kolayca değerlendirilebilir. Bu nedenle RDW, diğer belirteçlerle birlikte,
kolorektal kanser riskini ve ilerlemesini öngörmede yardımcı olabilir. 









 



     


 


References

  • 1.Forhecz Z, Gombos T, Borgulya G, Pozsonyi Z, Prohaszka Z, Janoskuti L. Red cell distribution width in heart failure: prediction of clinical events and relationship with markers of ineffective erythropoiesis, inflammation, renal function, and nutritional state. Am Heart J. 2009;158(4):659-666.
  • 2.Gunebakmaz O, Kaya MG, Duran M, Akpek M, El¬cik D, Eryol NK. Red Blood Cell Distribution Width in ‘Non-Dippers’ versus ‘Dippers’. Cardiology. 2012;123(3):154-159.
  • 3. Nishizaki Y, Yamagami S, Suzuki H, Joki Y, Takahashi S, Sesoko M, Yamashita H, et al. Red blood cell dis¬tribution width as an effective tool for detecting fa-tal heart failure in super-elderly patients. Intern Med. 2012;51(17):2271-2276.
  • 4.Karabulut A, Uzunlar B. Correlation between red cell distribution width and coronary ectasia in the acute myocardial infarction. Clin Appl Thromb Hemost. 2012;18(5):551-552.
  • 5.Yesil A, Senates E, Bayoglu IV, Erdem ED, Demirtunc R, Kurdas Ovunc AO. Red cell distribution width: a novel marker of activity in inflammatory bowel disease. Gut Liver. 2011;5(4):460-467.
  • 6.Lee WS, Kim TY. Relation between red blood cell dis¬tribution width and inflammatory biomarkers in rheuma¬toid arthritis. Arch Pathol Lab Med. 2010;134(4):505- 506.7. Patel KV, Semba RD, Ferrucci L, et al (2009). Red cell distribution width and mortality in older adults: a meta-analysis. J Gerontol A Biol Sci Med Sci, 65, 258-658. Rhodes CJ, Howard LS, Busbridge M, et al (2011). Iron deficiency and raised hepcidin in idiopathic pulmonary arterial hypertension: clinical prevalence, outcomes, and mechanistic insights. J Am Coll Cardiol, 58, 300-9.9. Seretis C, Seretis F, Lagoudianakis E, et al (2013). Is red cell distribution width a novel biomarker of breast cancer activity? data from a pilot study. J Clin Med Res, 5, 121-6.10. Baicus C, Caraiola S, Rimbas M, Patrascu R, Baicus A. Utility of routine hematological and inflammation parameters for the diagnosis of cancer in involuntary weight loss. J Investig Med. 2011;59(6):951-955. 11. Beyazit Y, Kekilli M, Ibis M, Kurt M, Sayilir A, Onal IK, Purnak T, et al. Can red cell distribution width help to discriminate benign from malignant biliary obstruc¬tion? A retrospective single center analysis. Hepatogas¬troenterology. 2012;59(117):1469-1473. 12. Ozkalemkas F, Ali R, Ozkocaman V, Ozcelik T, Ozan U, Ozturk H, Kurt E, et al. The bone marrow aspirate and biopsy in the diagnosis of unsuspected nonhematologic malignancy: a clinical study of 19 cases. BMC Cancer. 2005;5:144. 13. Spell DW, Jones DV, Jr., Harper WF, David Bessman J. The value of a complete blood count in predicting can¬cer of the colon. Cancer Detect Prev. 2004;28(1):37-42. 14. Speights VO, Johnson MW, Stoltenberg PH, Rappa¬port ES, Helbert B, Riggs MW. Complete blood count indices in colorectal carcinoma. Arch Pathol Lab Med. 1992;116(3):258-260.15. P.Qing, S. H. Luo, Y. L. Guo et al., “Evaluation of red blood cell distribution width in patientswith cardiac syndromeX,” Disease Markers, vol. 34, no. 5, pp. 333–339, 2013.
  • 16. Rex DK, Johnson DA, Lieberman DA, et al (2000). Colorectal prevention 2000: screening recommendations of the American college of gastroenterology. Am J Gastroenterol, 95, 868-77.
  • 17. Winawer S, Fletcher R, Rex D, et al (2003). Colorectal cancer screening and surveillance: clinical guidelines and rationale-update based on new evidence. Gastroenterology, 124, 544-60.
  • 18. Albayrak S, Zengin K, Tanik S, et al (2014). Red cell distribution width as a predictor of prostate cancer progression. Asian Pac J Cancer Prev, 15, 7781-4.
  • 19. Agarval S (2012). Red cell distribution width, inflammatory markers and cardiorespiratory fitness: Results from the National Health and Nutrition Examination Survey. Indian Heart J, 64, 380-7.
  • 20. Beyazit Y, Kekilli M, Ibis M, et al (2012). Can red cell distribution width help to discriminate benign from malignant biliary obstruc¬tion? A retrospective single center analysis. Hepatogastroenterology, 59, 1469-73.
  • 21.Kazma R, Mefford JA, Cheng I, et al (2012). Association of the Innate Immunity and Inflammation Pathway with Advanced Prostate Cancer Risk. Plos One, 7.
  • 22 .Klink JC, Banez LL, Gerber L, et al (2013). Intratumoral inflammation is associated with more aggressive prostate cancer. World J Urol, 31, 1497-503.
  • 23. Godsland IF, North BV, Johnston DG (2011). Simple indices of inflammation as predictors of death from cancer or cardiovascular disease in a prospective cohort after two decades of follow-up. Qjm-an Int J Med, 104, 387-94.
  • 24. Borre M, Nerstrom B, Overgaard J (1997). Erythrocyte sedimentation rate-a predictor of malignant potential in early prostate cancer. Acta Oncol, 36, 689-94. 25. Cakal B, Akoz AG, Ustundag Y, et al (2009). Red cell distribution width for assessment of activity of inflammatory bowel disease. Digestive Diseases and Sciences, 54, 842-7. 26. Celikbilek A, Zararsiz G, Atalay T, et al (2013). Red cell distribution width in migraine. Int J Lab Hematol, 35, 620-8.
  • 27. Cheng I, Witte JS, Jacobsen SJ, et al (2010). Prostatitis, sexually transmitted diseases, and prostate cancer: the California men’s health study. PLoS One, 5, 8736.
  • 28. Cho H, Hur HW, Kim SW, et al (2009). Pre-treatment neutrophil to lymphocyte ratio is elevated in epithelial ovarian cancer and predicts survival after treatment. Cancer Immunol Immunother, 58, 15-23. 29. Cho H, Kim JH (2009). Multiplication of neutrophil and monocyte counts (MNM) as an easily obtainable tumour marker for cervical cancer. Biomarkers, 14, 161-70. 30. Cihan YB, Arslan A, Ergul MA (2013). Subtypes of white blood cells in patients with prostate cancer or benign prostatic hyperplasia and healthy individuals. Asian Pac J Cancer Prev, 14, 4779-83.
  • 31. Dennis LK, Dawson DV (2002). Meta-analysis of measures of sexual activity and prostate cancer. Epidemiology, 13, 72-9. 32. Emerging Risk Factors C, Kaptoge S, Di Angelantonio E, et al (2010). C-reactive protein concentration and risk of coronary heart disease, stroke, and mortality: an individual participant meta-analysis. Lancet, 375, 132-40. 33. Felker GM, Allen LA, Pocock SJ, et al (2007). Red cell distribution width as a novel prognostic marker in heart failuredata from the charm program and the duke databank. J Am College Cardiol, 50, 40-7. 34. Ferronika P, Triningsih FX, Ghozali A, et al (2012). p63 cytoplasmic aberrance is associated with high prostate cancer stem cell expression. Asian Pac J Cancer Prev, 13, 1943-8.
  • 35. Fujita K, Imamura R, Tanigawa G, et al (2012). Low serum neutrophil count predicts a positive prostate biopsy. Prostate Cancer Prostatic Dis, 15, 386-90.

Red Blood Cell Distribution Width (RDW): Useful Predictor for Treatment Response in Metastatic Colorectal Cancer

Year 2019, Volume: 9 Issue: 1, 66 - 72, 28.01.2019
https://doi.org/10.31020/mutftd.466992

Abstract

Introduction: Red cell distribution width (RDW) is a widely used labora¬tory parameter for the quantification of the extent of eryth¬rocyte anisocytosis, which reflects the variability of the size of the circulating erythrocytes. Despite the fact that cancer is widely accepted to both as a cause and as a result of chronic inflammation, RDW elevation has scarcely been investigated as a potential biomarker of solid cancer activity. Our study is the first systemat¬ic one to evaluate whether RDW elevation may have a potential role as a biomarker of colorectal cancer activity.

Method: A retrospective analysis was conducted in patients with primary diagnosed or recurrent metastatic disease between January 2008 and August 2017. The exclusion criteria of the study were the presence of medical history of other malignancy, pregnancy, kidney transplantation, hematological disorders, severe anemia, infectious or inflammatory disease, iron supplementation therapy, recent venous thrombosis (past 6 months), recent blood transfusion (past 3 months), chronic obstructive pulmonary disease, hepatitis B or C, heart failure, arrhythmia, untreated thyroid disease, and severe liver and/or renal insufficiency as described previously.

Results: The mean RDW value of the metastatic colorectal cancer patient was 15.95, compared with 13.5 in normal population. The RDW values were same in patients at the high risk of progression and low risk of progression. The median overall survival at patients have RDW ≤15 were 42.5 mounths, patients RDW>15 were 26.3. There is no statically difference in two groups.

Discussion: RDW is found in the standard complete blood count, it does not bring any extra costs and it can be easily evaluated, which strengthens the fact that it can used as a biomarker in the early detection of cancer. Based on the findings of the current study, we recommend that RDW, a very common, easy, and simple marker, should be considered for treatment planning and follow-up of colorectal cancer patients. 

References

  • 1.Forhecz Z, Gombos T, Borgulya G, Pozsonyi Z, Prohaszka Z, Janoskuti L. Red cell distribution width in heart failure: prediction of clinical events and relationship with markers of ineffective erythropoiesis, inflammation, renal function, and nutritional state. Am Heart J. 2009;158(4):659-666.
  • 2.Gunebakmaz O, Kaya MG, Duran M, Akpek M, El¬cik D, Eryol NK. Red Blood Cell Distribution Width in ‘Non-Dippers’ versus ‘Dippers’. Cardiology. 2012;123(3):154-159.
  • 3. Nishizaki Y, Yamagami S, Suzuki H, Joki Y, Takahashi S, Sesoko M, Yamashita H, et al. Red blood cell dis¬tribution width as an effective tool for detecting fa-tal heart failure in super-elderly patients. Intern Med. 2012;51(17):2271-2276.
  • 4.Karabulut A, Uzunlar B. Correlation between red cell distribution width and coronary ectasia in the acute myocardial infarction. Clin Appl Thromb Hemost. 2012;18(5):551-552.
  • 5.Yesil A, Senates E, Bayoglu IV, Erdem ED, Demirtunc R, Kurdas Ovunc AO. Red cell distribution width: a novel marker of activity in inflammatory bowel disease. Gut Liver. 2011;5(4):460-467.
  • 6.Lee WS, Kim TY. Relation between red blood cell dis¬tribution width and inflammatory biomarkers in rheuma¬toid arthritis. Arch Pathol Lab Med. 2010;134(4):505- 506.7. Patel KV, Semba RD, Ferrucci L, et al (2009). Red cell distribution width and mortality in older adults: a meta-analysis. J Gerontol A Biol Sci Med Sci, 65, 258-658. Rhodes CJ, Howard LS, Busbridge M, et al (2011). Iron deficiency and raised hepcidin in idiopathic pulmonary arterial hypertension: clinical prevalence, outcomes, and mechanistic insights. J Am Coll Cardiol, 58, 300-9.9. Seretis C, Seretis F, Lagoudianakis E, et al (2013). Is red cell distribution width a novel biomarker of breast cancer activity? data from a pilot study. J Clin Med Res, 5, 121-6.10. Baicus C, Caraiola S, Rimbas M, Patrascu R, Baicus A. Utility of routine hematological and inflammation parameters for the diagnosis of cancer in involuntary weight loss. J Investig Med. 2011;59(6):951-955. 11. Beyazit Y, Kekilli M, Ibis M, Kurt M, Sayilir A, Onal IK, Purnak T, et al. Can red cell distribution width help to discriminate benign from malignant biliary obstruc¬tion? A retrospective single center analysis. Hepatogas¬troenterology. 2012;59(117):1469-1473. 12. Ozkalemkas F, Ali R, Ozkocaman V, Ozcelik T, Ozan U, Ozturk H, Kurt E, et al. The bone marrow aspirate and biopsy in the diagnosis of unsuspected nonhematologic malignancy: a clinical study of 19 cases. BMC Cancer. 2005;5:144. 13. Spell DW, Jones DV, Jr., Harper WF, David Bessman J. The value of a complete blood count in predicting can¬cer of the colon. Cancer Detect Prev. 2004;28(1):37-42. 14. Speights VO, Johnson MW, Stoltenberg PH, Rappa¬port ES, Helbert B, Riggs MW. Complete blood count indices in colorectal carcinoma. Arch Pathol Lab Med. 1992;116(3):258-260.15. P.Qing, S. H. Luo, Y. L. Guo et al., “Evaluation of red blood cell distribution width in patientswith cardiac syndromeX,” Disease Markers, vol. 34, no. 5, pp. 333–339, 2013.
  • 16. Rex DK, Johnson DA, Lieberman DA, et al (2000). Colorectal prevention 2000: screening recommendations of the American college of gastroenterology. Am J Gastroenterol, 95, 868-77.
  • 17. Winawer S, Fletcher R, Rex D, et al (2003). Colorectal cancer screening and surveillance: clinical guidelines and rationale-update based on new evidence. Gastroenterology, 124, 544-60.
  • 18. Albayrak S, Zengin K, Tanik S, et al (2014). Red cell distribution width as a predictor of prostate cancer progression. Asian Pac J Cancer Prev, 15, 7781-4.
  • 19. Agarval S (2012). Red cell distribution width, inflammatory markers and cardiorespiratory fitness: Results from the National Health and Nutrition Examination Survey. Indian Heart J, 64, 380-7.
  • 20. Beyazit Y, Kekilli M, Ibis M, et al (2012). Can red cell distribution width help to discriminate benign from malignant biliary obstruc¬tion? A retrospective single center analysis. Hepatogastroenterology, 59, 1469-73.
  • 21.Kazma R, Mefford JA, Cheng I, et al (2012). Association of the Innate Immunity and Inflammation Pathway with Advanced Prostate Cancer Risk. Plos One, 7.
  • 22 .Klink JC, Banez LL, Gerber L, et al (2013). Intratumoral inflammation is associated with more aggressive prostate cancer. World J Urol, 31, 1497-503.
  • 23. Godsland IF, North BV, Johnston DG (2011). Simple indices of inflammation as predictors of death from cancer or cardiovascular disease in a prospective cohort after two decades of follow-up. Qjm-an Int J Med, 104, 387-94.
  • 24. Borre M, Nerstrom B, Overgaard J (1997). Erythrocyte sedimentation rate-a predictor of malignant potential in early prostate cancer. Acta Oncol, 36, 689-94. 25. Cakal B, Akoz AG, Ustundag Y, et al (2009). Red cell distribution width for assessment of activity of inflammatory bowel disease. Digestive Diseases and Sciences, 54, 842-7. 26. Celikbilek A, Zararsiz G, Atalay T, et al (2013). Red cell distribution width in migraine. Int J Lab Hematol, 35, 620-8.
  • 27. Cheng I, Witte JS, Jacobsen SJ, et al (2010). Prostatitis, sexually transmitted diseases, and prostate cancer: the California men’s health study. PLoS One, 5, 8736.
  • 28. Cho H, Hur HW, Kim SW, et al (2009). Pre-treatment neutrophil to lymphocyte ratio is elevated in epithelial ovarian cancer and predicts survival after treatment. Cancer Immunol Immunother, 58, 15-23. 29. Cho H, Kim JH (2009). Multiplication of neutrophil and monocyte counts (MNM) as an easily obtainable tumour marker for cervical cancer. Biomarkers, 14, 161-70. 30. Cihan YB, Arslan A, Ergul MA (2013). Subtypes of white blood cells in patients with prostate cancer or benign prostatic hyperplasia and healthy individuals. Asian Pac J Cancer Prev, 14, 4779-83.
  • 31. Dennis LK, Dawson DV (2002). Meta-analysis of measures of sexual activity and prostate cancer. Epidemiology, 13, 72-9. 32. Emerging Risk Factors C, Kaptoge S, Di Angelantonio E, et al (2010). C-reactive protein concentration and risk of coronary heart disease, stroke, and mortality: an individual participant meta-analysis. Lancet, 375, 132-40. 33. Felker GM, Allen LA, Pocock SJ, et al (2007). Red cell distribution width as a novel prognostic marker in heart failuredata from the charm program and the duke databank. J Am College Cardiol, 50, 40-7. 34. Ferronika P, Triningsih FX, Ghozali A, et al (2012). p63 cytoplasmic aberrance is associated with high prostate cancer stem cell expression. Asian Pac J Cancer Prev, 13, 1943-8.
  • 35. Fujita K, Imamura R, Tanigawa G, et al (2012). Low serum neutrophil count predicts a positive prostate biopsy. Prostate Cancer Prostatic Dis, 15, 386-90.
There are 19 citations in total.

Details

Primary Language Turkish
Subjects Clinical Sciences
Journal Section Articles
Authors

Kadir Eser 0000-0001-8666-6177

Emel Sezer This is me 0000-0001-9881-3533

Vehbi Erçolak This is me 0000-0003-1014-1694

Publication Date January 28, 2019
Submission Date October 3, 2018
Published in Issue Year 2019 Volume: 9 Issue: 1

Cite

APA Eser, K., Sezer, E., & Erçolak, V. (2019). Eritrosit Dağılım Genişliği (RDW): Metastatik Kolorektal Kanserde Prognoz Belirleyici Olarak Kullanımı. Mersin Üniversitesi Tıp Fakültesi Lokman Hekim Tıp Tarihi Ve Folklorik Tıp Dergisi, 9(1), 66-72. https://doi.org/10.31020/mutftd.466992
AMA Eser K, Sezer E, Erçolak V. Eritrosit Dağılım Genişliği (RDW): Metastatik Kolorektal Kanserde Prognoz Belirleyici Olarak Kullanımı. Mersin Üniversitesi Tıp Fakültesi Lokman Hekim Tıp Tarihi ve Folklorik Tıp Dergisi. January 2019;9(1):66-72. doi:10.31020/mutftd.466992
Chicago Eser, Kadir, Emel Sezer, and Vehbi Erçolak. “Eritrosit Dağılım Genişliği (RDW): Metastatik Kolorektal Kanserde Prognoz Belirleyici Olarak Kullanımı”. Mersin Üniversitesi Tıp Fakültesi Lokman Hekim Tıp Tarihi Ve Folklorik Tıp Dergisi 9, no. 1 (January 2019): 66-72. https://doi.org/10.31020/mutftd.466992.
EndNote Eser K, Sezer E, Erçolak V (January 1, 2019) Eritrosit Dağılım Genişliği (RDW): Metastatik Kolorektal Kanserde Prognoz Belirleyici Olarak Kullanımı. Mersin Üniversitesi Tıp Fakültesi Lokman Hekim Tıp Tarihi ve Folklorik Tıp Dergisi 9 1 66–72.
IEEE K. Eser, E. Sezer, and V. Erçolak, “Eritrosit Dağılım Genişliği (RDW): Metastatik Kolorektal Kanserde Prognoz Belirleyici Olarak Kullanımı”, Mersin Üniversitesi Tıp Fakültesi Lokman Hekim Tıp Tarihi ve Folklorik Tıp Dergisi, vol. 9, no. 1, pp. 66–72, 2019, doi: 10.31020/mutftd.466992.
ISNAD Eser, Kadir et al. “Eritrosit Dağılım Genişliği (RDW): Metastatik Kolorektal Kanserde Prognoz Belirleyici Olarak Kullanımı”. Mersin Üniversitesi Tıp Fakültesi Lokman Hekim Tıp Tarihi ve Folklorik Tıp Dergisi 9/1 (January 2019), 66-72. https://doi.org/10.31020/mutftd.466992.
JAMA Eser K, Sezer E, Erçolak V. Eritrosit Dağılım Genişliği (RDW): Metastatik Kolorektal Kanserde Prognoz Belirleyici Olarak Kullanımı. Mersin Üniversitesi Tıp Fakültesi Lokman Hekim Tıp Tarihi ve Folklorik Tıp Dergisi. 2019;9:66–72.
MLA Eser, Kadir et al. “Eritrosit Dağılım Genişliği (RDW): Metastatik Kolorektal Kanserde Prognoz Belirleyici Olarak Kullanımı”. Mersin Üniversitesi Tıp Fakültesi Lokman Hekim Tıp Tarihi Ve Folklorik Tıp Dergisi, vol. 9, no. 1, 2019, pp. 66-72, doi:10.31020/mutftd.466992.
Vancouver Eser K, Sezer E, Erçolak V. Eritrosit Dağılım Genişliği (RDW): Metastatik Kolorektal Kanserde Prognoz Belirleyici Olarak Kullanımı. Mersin Üniversitesi Tıp Fakültesi Lokman Hekim Tıp Tarihi ve Folklorik Tıp Dergisi. 2019;9(1):66-72.

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