RDW: A New Predictive Indicator in Pancreatic Cystic Neoplasms.

Abstract

Abstract Background The incidence of pancreatic cystic neoplasms (PCN) is increasing over time. However, identifying between benign and malignant cysts remains difficult. The final diagnosis is always made by postoperative pathology, even with recommendations for cytology and endosonography.This study aimed to investigate the malignancy probability of PCNs using simple clinical and biochemical parameters. Method A retrospective analysis was conducted on 70 patients who underwent surgery for pancreatic cystic neoplasms. Based on postoperative pathology, patients were divided into two groups: Group A, which included those with benign or low-grade dysplasia and Group B which included those with dysplasia malignancy or high-grade dysplasia. A comparison was made between pathology results and clinical and laboratory data. Results Out of the 70 patients, 42 (60%) were in Group A,and 28 (40%) were in Group B. Univariate analysis revealed that age, diabetes mellitus, red cell distribution width (RDW), and albumin were examined as potential predictors of malignancy in pancreatic cystic neoplasms. In the multivariate analysis, age and RDW were established as independent variables. The AUC values of age, RDW, and the combination of age and RDW for malignancy or high-grade dysplasia were 0.798 (95% CI: 0.695-0.900), 0.801 (95% CI: 0.692-0.911), and 0.858 (95% CI: 0.771-0.944), respectively. Conclusion The differentiation between benign and malignant PCN can only be achieved through advanced and specialized investigations. Postoperative pathology is still the most precise means of diagnosis. Age and RDW can be used as additional criteria to select patients for endosonography and cytological evaluation, and to precisely identify patients who might need surgical intervention.