Abstract
Background: Red cell distribution width (RDW) is a routinely examined parameter with the complete blood count. In recent studies, RDW levels have been associated with cardiovascular, liver and renal diseases and solid tumors. The aim of this study was to evaluate the alterations of RDW levels in benign and malignant causes of postmenopausal bleeding and to investigate the association of RDW levels with clinicopathological parameters of endometrial cancer (EC) patients.
Methods: A retrospective study was made of a total of 884 females who were admitted to hospital for postmenopausal bleeding between May 2009 and December 2013. After inclusion and exclusion criteria were applied, 222 patients remained. Complete blood count data was obtained from the recorded computerized database. After pathological evaluation, the patients were divided into two groups, benign and malignant (EC).
Results: The EC group (n=113) had significantly higher RDW levels compared to the benign group (14.78±2.02 vs. 13.88±1.05; p=0.000). Grade II and above EC patients had higher levels of RDW than Grade I patients (15.2±2.3 vs. 14.1±1.00; p=0.005). Correlation analyses also revealed a negative correlation between RDW and hemoglobin levels (p=0.000), RDW and mean corpuscular volume (p=0.000), RDW and lymphocyte count (p=0.035) but a positive correlation between RDW and platelet to lymphocyte ratio (p=0.030).
Conclusions: The results of the current study revealed the potential predicitve role of RDW in patients with postmenopausal bleeding. Significant associations were also determined between RDW and clinicopathological characteristics in EC patients.
References
1. International Agency for Research on Cancer. GLOBALCAN 2008: cancer incidence and mortality worldwide. Lyon, France: IARC Press, 2010.Search in Google Scholar
2. Amant F, Moerman P, Neven P, Timmerman D, Van Limbergen E, Vergote I. Endometrial cancer. Lancet 2005;366:491–505.10.1016/S0140-6736(05)67063-8Search in Google Scholar
3. Förhécz Z, Gombos T, Borgulya G, Pozsonyi Z, Prohászka Z, Jánoskuti 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;158:659–66.10.1016/j.ahj.2009.07.024Search in Google Scholar PubMed
4. Allen LA, Felker GM, Mehra MR, Chiong JR, Dunlap SH, Ghali JK, et al. Validation and potential mechanisms of red cell distribution width as a prognostic marker in heart failure. J Card Fail 2010;16:230–8.10.1016/j.cardfail.2009.11.003Search in Google Scholar PubMed PubMed Central
5. Lippi G, Targher G, Montagnana M, Salvagno GL, Zoppini G, Guidi GC. Relationship between red blood cell distribution width and kidney function tests in a large cohort of unselected outpatients. Scand J Clin Lab Invest 2008;68:745–8.10.1080/00365510802213550Search in Google Scholar PubMed
6. Felker GM, Allen LA, Pocock SJ, Shaw LK, McMurray JJ, Pfeffer MA, et al. Red cell distribution width as a novel prognostic marker in heart failure: data from the CHARM Program and the Duke Databank. J Am Coll Cardiol 2007;50:40–7.10.1016/j.jacc.2007.02.067Search in Google Scholar PubMed
7. Lippi G, Plebani M. Red blood cell distribution width (RDW) and human pathology. One size fits all. Clin Chem Lab Med 2014;52:1247–9.Search in Google Scholar
8. Jo YH, Kim K, Lee JH, Kang C, Kim T, Park HM, et al. Red cell distribution width is a prognostic factor in severe sepsis and septic shock. Am J Emerg Med 2013;31:545–8.10.1016/j.ajem.2012.10.017Search in Google Scholar PubMed
9. Seyhan EC, Özgül MA, Tutar N, Ömür I, Uysal A, Altin S. Red blood cell distribution and survival in patients with chronic obstructive pulmonary disease. COPD 2013;10:416–24.10.3109/15412555.2012.758697Search in Google Scholar PubMed
10. Lou Y, Wang M, Mao W. Clinical usefulness of measuring red blood cell distribution width in patients with hepatitis B. PLoS One 2012;7:e37644.10.1371/journal.pone.0037644Search in Google Scholar PubMed PubMed Central
11. de Gonzalo-Calvo D, de Luxan-Delgado B, Rodriguez-Gonzalez S, Garcia-Macia M, Suarez FM, Solano JJ, et al. Interleukin 6, soluble tumor necrosis factor receptor I and red blood cell distribution width as biological markers of functional dependence in an elderly population: a translational approach. Cytokine 2012;58:193–8.10.1016/j.cyto.2012.01.005Search in Google Scholar PubMed
12. Rhodes CJ, Howard LS, Busbridge M, Ashby D, Kondili E, Gibbs JS, et al. Iron deficiency and raised hepcidin in idiopathic pulmonary arterial hypertension: clinical prevalence, outcomes, and mechanistic insights. J Am Coll Cardiol 2011;58:300–9.10.1016/j.jacc.2011.02.057Search in Google Scholar PubMed
13. Duffy TP. Approach to the patient with anemia. In: Duffy TP, Kelley WN, Dupont HL, Glick JH, Harris ED, Hathaway DR, et al., editors. Kelley’s textbook of ınternal medicine. Philadelphia, PA: Lippincott Williams and Wilkins, 1997:1295–9.Search in Google Scholar
14. Cakal B, Akoz AG, Ustundag Y, Yalinkilic M, Ulker A, Ankarali H. Red cell distribution width for assessment of activity of inflammatory bowel disease. Dig Dis Sci 2009;54:842–7.10.1007/s10620-008-0436-2Search in Google Scholar
15. Clarke K, Sagunarthy R, Kansal S. RDW as an additional marker in inflammatory bowel disease/undifferentiated colitis. Dig Dis Sci 2008;53:2521–3.10.1007/s10620-007-0176-8Search in Google Scholar
16. Günay E, Sarınç Ulaşlı S, Akar O, Ahsen A, Günay S, Koyuncu T. Neutrophil-to-lymphocyte ratio in chronic obstructive pulmonary disease: a retrospective study. Inflammation 2014;37:374–80.10.1007/s10753-013-9749-1Search in Google Scholar
17. Mantovani A, Allavena P, Sica A, Balkwill F. Cancer-related inflammation. Nature 2008;454:436–44.10.1038/nature07205Search in Google Scholar
18. Kim DK, Oh SY, Kwon HC, Lee S, Kwon KA, Kim BG, et al. Clinical significances of preoperative serum interleukin-6 and C-reactive protein level inoperable gastric cancer. BMC Cancer 2009;9:155.10.1186/1471-2407-9-155Search in Google Scholar
19. McMillan DC. Systemic inflammation, nutritional status and survival in patients with cancer. Curr Opin Clin Nutr Metab Care 2009;12:223–6.10.1097/MCO.0b013e32832a7902Search in Google Scholar
20. Evans TC, Jehle D. The red blood cell distribution width. J Emerg Med 1991;9:71–4.10.1016/0736-4679(91)90592-4Search in Google Scholar
21. Koma Y, Onishi A, Matsuoka H, Oda N, Yokota N, Matsumoto Y, et al. Increased red blood cell distribution width associates with cancer stage and prognosis in patients with lung cancer. PLoS One 2013;8:e80240.10.1371/journal.pone.0080240Search in Google Scholar PubMed PubMed Central
22. Hu Z, Sun Y, Wang Q, Han Z, Huang Y, Liu X, et al. Red blood cell distribution width is a potential prognostic index for liver disease. Clin Chem Lab Med 2013;51:1403–8.10.1515/cclm-2012-0704Search in Google Scholar PubMed
23. Beyazit Y, Kekilli M, Ibis M, Kurt M, Sayilir A, Onal IK. Can red cell distribution width help to discriminate benign from malignant biliary obstruction? A retrospective single center analysis. Hepatogastroenterology 2012;59:1469–73.Search in Google Scholar
24. 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;59:951–5.10.2310/JIM.0b013e31822467a3Search in Google Scholar PubMed
25. Seretis C, Seretis F, Lagoudianakis E, Gemenetzis G, Salemis NS. Is red cell distribution width a novel biomarker of breast cancer activity? Data from a pilot study. J Clin Med Res 2013;5:121–6.10.4021/jocmr1214wSearch in Google Scholar PubMed PubMed Central
26. Spell DW, Jones DV, Harper WF, David BJ. The value of a complete blood count in predicting cancer of the colon. Cancer Detect Prev 2004;28:37–42.10.1016/j.cdp.2003.10.002Search in Google Scholar PubMed
27. Speights VO, Johnson MW, Stoltenberg PH, Rappaport ES, Helbert B, Riggs MW. Complete blood count indices in colorectal carcinoma. Arch Pathol Lab Med 1992;116:258–60.Search in Google Scholar
28. Weiss G, Goodnough LT. Anemia of chronic disease. N Engl J Med 2005;352:1011–23.10.1056/NEJMra041809Search in Google Scholar PubMed
29. Patel KV, Ferrucci L, Ershler WB, Longo DL, Guralnik JM. Red blood cell distribution width and the risk of death in middle-aged and older adults. Arch Intern Med 2009;169:515–23.10.1001/archinternmed.2009.11Search in Google Scholar PubMed PubMed Central
30. Ferrucci L, Guralnik JM, Bandinelli S, Semba RD, Lauretani F, Corsi A, et al. Unexplained anaemia in older persons is characterised by low erythropoietin and low levels of pro-inflammatory markers. Br J Haematol 2007;136:849–55.10.1111/j.1365-2141.2007.06502.xSearch in Google Scholar PubMed PubMed Central
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