Prognosis of RDW-SD and RDW-CV in breast cancer patients with lymphatic metastasis

doi:10.3969/j.issn.1673-8640.2024.04.011

Abstract

Abstract:

Objective To investigate the relationship between preoperative red blood cell distribution width-standard deviation（RDW-SD） and red blood cell distribution width-coefficient of variation（RDW-CV） and prognosis in breast cancer patients with lymphatic metastasis. Methods From January 2018 to February 2022，156 female breast cancer patients with lymphatic metastasis confirmed by postoperative pathology in Xiamen Hospital of Zhongshan Hospital of Fudan University were enrolled. The RDW-SD，RDW-CV，clinicopathological indicators and prognostic data of patients were collected. Cox regression model was used to look for risk factors for poor prognosis. The predictive values of RDW-SD and RDW-CV in poor prognosis were analyzed by receiver operating characteristic（ROC） curve. According the optimal values of RDW-CV and RDW-SD，the 156 breast cancer patients with lymphatic metastasis were classified into high and low expression groups. Disease-free survival was calculated using Kaplan-Meier survival analysis. Results There was statistical significance in RDW-SD and RDW-CV in patients with different TNM stages（P<0.001）. RDW-CV in diagnosing Ⅳ stage and evaluating poor prognosis [areas under curves（AUC）=0.838 and 0.773，respectively，P<0.001] were more effective than RDW-SD（AUC=0.780 and 0.729，respectively，P<0.05）. Preoperative RDW-CV was an independent risk factor for poor prognosis [hazard ratio（HR）=1.46，95% confidence interval（CI） 1.13-1.89，P=0.004]. Postoperative disease-free survival rate of RDW-CV high expression group and RDW-SD high expression group were lower than those of low expression groups（P<0.001）. Conclusions RDW-CV is superior to RDW-SD in preoperative prognosis assessment of breast cancer patients with lymphatic metastasis，and high RDW-CV is an independent risk factor for poor prognosis.

Key words: Red blood cell distribution width-standard deviation, Red blood cell distribution width-coefficient of variation, Breast cancer, Lymphatic metastasis, Prognosis

CLC Number:

R446.11

HUANG Lei, TANG Wenjia, ZHOU Yan, ZHOU Jiaye, ZHANG Chunyan, YANG Jing, WANG Beili, PAN Baishen, GUO wei. Prognosis of RDW-SD and RDW-CV in breast cancer patients with lymphatic metastasis[J]. Laboratory Medicine, 2024, 39(4): 376-381.

Figures/Tables 6

References 26

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项目	RDW-SD/fL	P值	RDW-CV/%	P值
年龄
≥65岁	41.40（40.55~42.60）	0.580	12.60（12.40~12.85）	0.822
<65岁	41.10（39.40~43.10）		12.50（12.10~13.20）
肿瘤最大直径
≥2 cm	41.30（39.35~43.60）	0.748	12.65（12.10~13.20）	0.633
<2 cm	40.80（39.65~42.95）		12.50（12.20~13.10）
TNM分期
Ⅳ期	46.10（43.45~52.90）	<0.001	14.60（13.75~15.20）	<0.001
Ⅲ期	41.20（39.50~42.90）		12.50（12.10~13.10）
Ⅰ~Ⅱ期	40.55（39.05~42.45）		12.45（12.15~13.05）
肿瘤数量
多灶	40.25（38.70~42.85）	0.256	12.40（11.95~13.05）	0.162
单灶	41.30（39.75~43.10）		12.60（12.20~13.20）
HER-2
阳性	41.30（39.10~43.90）	0.582	12.50（12.20~13.20）	0.929
阴性	41.10（39.80~42.80）		12.55（12.10~13.10）
ER
阳性	40.85（39.30~42.50）	0.055	12.50（12.05~13.10）	0.273
阴性	41.75（39.70~45.50）		12.65（12.25~14.05）
PR
阳性	40.80（39.30~42.50）	0.099	12.60（12.15~13.20）	0.882
阴性	41.65（39.70~44.00）		12.50（12.15~13.25）
Ki-67
≥20%	41.50（39.30~42.85）	0.671	12.60（12.20~13.30）	0.170
<20%	40.75（39.80~43.35）		12.50（11.95~13.05）

项目	RDW-SD/fL	P值	RDW-CV/%	P值
年龄
≥65岁	41.40（40.55~42.60）	0.580	12.60（12.40~12.85）	0.822
<65岁	41.10（39.40~43.10）		12.50（12.10~13.20）
肿瘤最大直径
≥2 cm	41.30（39.35~43.60）	0.748	12.65（12.10~13.20）	0.633
<2 cm	40.80（39.65~42.95）		12.50（12.20~13.10）
TNM分期
Ⅳ期	46.10（43.45~52.90）	<0.001	14.60（13.75~15.20）	<0.001
Ⅲ期	41.20（39.50~42.90）		12.50（12.10~13.10）
Ⅰ~Ⅱ期	40.55（39.05~42.45）		12.45（12.15~13.05）
肿瘤数量
多灶	40.25（38.70~42.85）	0.256	12.40（11.95~13.05）	0.162
单灶	41.30（39.75~43.10）		12.60（12.20~13.20）
HER-2
阳性	41.30（39.10~43.90）	0.582	12.50（12.20~13.20）	0.929
阴性	41.10（39.80~42.80）		12.55（12.10~13.10）
ER
阳性	40.85（39.30~42.50）	0.055	12.50（12.05~13.10）	0.273
阴性	41.75（39.70~45.50）		12.65（12.25~14.05）
PR
阳性	40.80（39.30~42.50）	0.099	12.60（12.15~13.20）	0.882
阴性	41.65（39.70~44.00）		12.50（12.15~13.25）
Ki-67
≥20%	41.50（39.30~42.85）	0.671	12.60（12.20~13.30）	0.170
<20%	40.75（39.80~43.35）		12.50（11.95~13.05）

项目	HR^①（95%CI^②）	P值
年龄≥65岁	2.34（0.92~5.96）	0.074
肿瘤≥2 cm	2.25（1.02~4.97）	0.045
多灶肿瘤	0.53（0.13~2.27）	0.394
TNM分期
Ⅲ期	4.43（1.29~15.24）	0.018
Ⅳ期	15.97（4.11~62.06）	<0.001
HER-2阳性	1.14（0.51~2.57）	0.749
ER阳性	0.82（0.34~1.96）	0.652
PR阳性	0.95（0.43~2.09）	0.894
RDW-SD	1.19（1.10~1.29）	<0.001
RDW-CV	1.66（1.32~2.10）	<0.001
Ki-67≥20%	1.14（0.48~2.72）	0.764
术后化疗	1.42（0.32~6.34）	0.650
术后放疗+化疗	1.81（0.40~8.13）	0.437

项目	HR^①（95%CI^②）	P值
年龄≥65岁	2.34（0.92~5.96）	0.074
肿瘤≥2 cm	2.25（1.02~4.97）	0.045
多灶肿瘤	0.53（0.13~2.27）	0.394
TNM分期
Ⅲ期	4.43（1.29~15.24）	0.018
Ⅳ期	15.97（4.11~62.06）	<0.001
HER-2阳性	1.14（0.51~2.57）	0.749
ER阳性	0.82（0.34~1.96）	0.652
PR阳性	0.95（0.43~2.09）	0.894
RDW-SD	1.19（1.10~1.29）	<0.001
RDW-CV	1.66（1.32~2.10）	<0.001
Ki-67≥20%	1.14（0.48~2.72）	0.764
术后化疗	1.42（0.32~6.34）	0.650
术后放疗+化疗	1.81（0.40~8.13）	0.437

项目	HR（95%CI）	P值
肿瘤≥2 cm	1.44（0.58~3.57）	0.427
TNM分期
Ⅲ期	4.10（1.19~14.17）	0.026
Ⅳ期	8.78（2.11~36.47）	0.003
RDW-SD	1.08（0.97~1.19）	0.149
RDW-CV	1.46（1.13~1.89）	0.004