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Abstract：
Background and Objectives. Hepatocellular carcinoma (HCC) and the intrahepatic biliary tract cancers are estimated to rank sixth for incidence among solid cancers worldwide, and third for mortality rates. A critical issue remains the need for accurate biomarkers for risk stratification and overall prognosis. The aim of this study was to investigate the ability of a biomarker of heterogeneity of the size of red blood cells, the red cell distribution width (RDW), to predict survival in patients with HCC. Materials and Methods. A consecutive series of patients with a histologic diagnosis of HCC were included into this study irrespective of their age, stage of the disease, and treatment administered, and followed-up for a period of three years. Demographic, anthropometric [age, sex, body mass index (BMI)], and clinical data (Charlson Comorbidity Index, Child-Pugh score, etc.), along with laboratory tests were retrieved from clinical records. Results. One-hundred and four patients were included in this study. Among them, 54 (69%) were deceased at the end of the follow-up. Higher RDW values, but not other hematological and biochemical parameters, were significantly associated with mortality in both univariate and multivariate analysis. The optimal RDW cut-off value identified with the Youden test for survival was 14.7%, with 65% sensitivity and 74% specificity (AUC = 0.718, 95% CI 0.622-0.802, p < 0.001). Kaplan-Meier survival curves showed significantly lower survival with higher RDW values (HR = 3.5204; 95% CI 1.9680-6.2975, p < 0.0001) with a mean survival of 30.9 ± 9.67 months for patients with RDW ≤ 14.7% and 22.3 ± 11.4 months for patients with RDW > 14.7%. Conclusions. The results of our study showed that RDW can perform better than other blood-based biomarkers in independently predicting prognosis in patients with HCC.
摘要：
背景和目标。肝细胞癌（HCC）和肝内胆道癌估计在全球实体癌中的发病率排名第六。第三是死亡率。一个关键问题仍然是需要准确的生物标志物来进行风险分层和总体预后。这项研究的目的是研究红细胞大小异质性的生物标志物的能力，红细胞分布宽度(RDW)，预测肝癌患者的生存率。材料和方法。连续一系列的肝癌组织学诊断的患者被纳入这项研究，无论他们的年龄。疾病的阶段，和治疗，并随访了三年。人口统计,人体测量[年龄，性别,体重指数（BMI）]，和临床数据(Charlson合并症指数，Child-Pugh评分,等。),从临床记录中检索到实验室检查。结果。本研究包括104名患者。其中,54人（69%）在随访结束时死亡。较高的RDW值，但不是其他血液学和生化参数，在单因素和多因素分析中，均与死亡率显著相关。用Youden检验确定的最佳RDW临界值为14.7%，具有65%的敏感性和74%的特异性(AUC=0.718，95%CI0.622-0.802，p<0.001)。Kaplan-Meier生存曲线显示，RDW值较高（HR=3.5204；95％CI1.9680-6.2975，p<0.0001），RDW≤14.7％患者的平均生存时间为30.9±9.67个月，RDW>14.7％患者的平均生存时间为22.3±11.4个月。Conclusions.我们的研究结果表明，RDW在独立预测HCC患者的预后方面比其他基于血液的生物标志物表现更好。
