The Value of Red Cell Distribution Width and Its Correlation with Other Parameters in Ovarian Cancer

Abstract

Abstract Background: The red cell distribution width (RDW) is a measure of the range of variation in the red blood cell size. It reflects red blood cell volume heterogeneity and is a part of the whole blood cell count. The use of the RDW in the diagnosis of malignant tumors has recently attracted much attention. Related research has mainly focused on endometrial cancer, lung cancer, and liver cancer. Aim of the Study: This study investigated the correlation between the RDW and ovarian cancer by observing changes in the RDW in patients with different stages of ovarian cancer. Patients and Methods: A case–control study involving 50 females with ovarian cancer and 50 healthy females conducted at Baghdad Oncology Teaching Hospital, and Al-Imamian Al-Kadhimiyain Medical City from January 1, 2022, to December 30, 2022. Data collection included demographic data, complete blood count with the calculation of platelets to lymphocyte ratio (PLR) and neutrophil-to-lymphocyte ratio (NLR), transferrin saturation, and cancer antigen 125 (CA-125). Adult females with histologically proven ovarian cancer were included in this research. Patients with conditions that affect red blood cells were excluded from the study. Results: The mean age was 52.6 ± 10.4 years old for the cases and 50.0 ± 11.4 years for the control group. Platelets count (PLT), absolute neutrophil count (ANC), PLR, NLR, RDW, and CA-125 were significantly higher in the women with ovarian cancer in comparison to the control group (P < 0.001). RDW values were found to be positively correlated with white blood cell, PLT, ANC, NLR, PLR, and CA-125 values (P < 0.001). RDW values were also positively associated with cancer stage; thus, higher values of RDW are to be expected with a higher stage of cancer (P < 0.001). The optimal cutoff point for RDW was found to be 14.6% with a sensitivity of 92%, specificity of 90%, and an area under the curve of 96%. Conclusion: The RDW is increased with ovarian cancer, and a clear cutoff point for the prediction of ovarian cancer has been observed. Furthermore, RDW was positively correlated with cancer stage and inflammatory markers including PLT, ANC, PLR, NLR, and a tumor marker CA-125.