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

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.

Anahtar Kelimeler:

kolorektal, kanser, prognoz

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

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.

Keywords:

Colorektal, cancer, prognosis,

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