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Relationship between Red Blood Cell Distribution Width (RDW), Bilirubin, and Clinical Characteristics of Patients with Gastric Cancer

دراسة العلاقة بين عرض توزع الكريات الحمر (RDW), البيليروبين, والخصائص السريرية لمرضى سرطان المعدة

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 Publication date 2020
  fields Medicine
and research's language is العربية
 Created by Shamra Editor




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The purpose of the present study was to investigate whether a relationship exists between bilirubin, RDW, and prognostic factors for gastric cancer (tumor stage - tumor markers). Methods: The study included 112 individuals admitted to Tishreen University Hospital and the Oncology Center in Latakia during the period between July 2018 and December 2019. They were distributed into two groups as follow: the group of gastric cancer patients included 56 patients (33 males and 23 females) between the ages of 37 and 83 years, and the control group included 56 individuals (34 males and 22 females) between the ages of 37 and 80 years. The stage of gastric cancer was evaluated based on the AJCC (American Joint Committee on Cancer) cancer staging system. Patients were interrogated, and social and behavioral information were obtained, then venous blood samples were obtained for biomedical evaluation. Statistical analysis was done using SPSS version 25 software. Results: Bilirubin and RDW were significantly associated with the prognostic factors of gastric cancer. RDW was positively associated with the tumor stage and tumor markers (CEA and CA19-9). Total bilirubin (TBIL) and indirect bilirubin (IBIL) were negatively associated with these factors, while direct bilirubin (DBIL) showed no significant association. Patients with gastric cancer had higher RDW than healthy controls, while total bilirubin (TBIL) and indirect bilirubin (IBIL) were significantly decreased. The results of our study indicate that both RDW and bilirubin could be potential prognostic factor for gastric cancer.


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Research summary
تهدف هذه الدراسة إلى استكشاف العلاقة بين عرض توزع الكريات الحمر (RDW)، البيليروبين، والعوامل الإنذارية لسرطان المعدة. شملت الدراسة 112 فردًا، منهم 56 مريضًا بسرطان المعدة و56 فردًا في مجموعة الشواهد. تم تقييم مرحلة سرطان المعدة باستخدام نظام AJCC، وتم جمع عينات الدم لتحليل المؤشرات الحيوية. أظهرت النتائج أن RDW كان مرتبطًا إيجابيًا بمرحلة الورم والواسمات الورمية (CEA وCA19-9)، بينما كان البيليروبين الكلي وغير المباشر مرتبطين سلبيًا بهذه العوامل. لم يظهر البيليروبين المباشر أي ارتباط هام. كانت قيم RDW أعلى لدى مرضى سرطان المعدة مقارنة بالشواهد، بينما كانت قيم البيليروبين الكلي وغير المباشر أقل. تشير النتائج إلى أن RDW والبيليروبين يمكن أن يكونا عوامل إنذارية محتملة لسرطان المعدة. أوصت الدراسة بإجراء دراسات أكبر لتأكيد هذه النتائج.
Critical review
دراسة نقدية: تعتبر هذه الدراسة خطوة هامة في فهم العلاقة بين RDW والبيليروبين وسرطان المعدة. ومع ذلك، هناك بعض النقاط التي يمكن تحسينها. أولاً، حجم العينة صغير نسبيًا مما قد يؤثر على دقة النتائج. ثانيًا، الدراسة كانت مستقطعة (cross-sectional) مما يجعل من الصعب تحديد العلاقة السببية بين المتغيرات. ثالثًا، لم يتم أخذ بعض العوامل المؤثرة الأخرى بعين الاعتبار مثل العوامل الوراثية والبيئية. على الرغم من هذه النقاط، فإن الدراسة تقدم رؤى قيمة وتفتح الباب لمزيد من الأبحاث في هذا المجال.
Questions related to the research
  1. ما هو الهدف الرئيسي من هذه الدراسة؟

    الهدف الرئيسي هو استكشاف العلاقة بين عرض توزع الكريات الحمر (RDW)، البيليروبين، والعوامل الإنذارية لسرطان المعدة.

  2. ما هي النتائج الرئيسية التي توصلت إليها الدراسة؟

    النتائج الرئيسية هي أن RDW كان مرتبطًا إيجابيًا بمرحلة الورم والواسمات الورمية (CEA وCA19-9)، بينما كان البيليروبين الكلي وغير المباشر مرتبطين سلبيًا بهذه العوامل.

  3. ما هي التوصيات التي قدمتها الدراسة؟

    أوصت الدراسة بإجراء دراسات حشدية أكبر لتأكيد القيمة الإنذارية لكل من RDW والبيليروبين لدى مرضى سرطان المعدة.

  4. ما هي نقاط الضعف في هذه الدراسة؟

    نقاط الضعف تشمل حجم العينة الصغير، الطبيعة المستقطعة للدراسة، وعدم أخذ بعض العوامل المؤثرة الأخرى بعين الاعتبار.


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Bessman, J.D., P.R. Gilmer, Jr., and F.H. Gardner, Improved classification of anemias by MCV and RDW. Am J Clin Pathol, 1983. 80(3): p. 322 - 6.
Ellingsen TS, L.J., Skjelbakken T, et al, Impact of red cell distribution width on future risk of cancer and all - cause mortality among cancer patients in the Tromsø Study. Haematologica 2015
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Peng, Y.F., et al., Red blood cell distribution width: a potential maker estimating disease activity of ankylosing spondylitis. Int J Clin Exp Med, 2014. 7(12): p. 5289 - 95.
Doumas, B.T. and T.W. Wu, The measurement of bilirubin fractions in serum. Crit Rev Clin Lab Sci, 1991. 28(5 - 6): p. 415 - 45
Li, N., Xu, M., Cai, M. Y., Zhou, F., Li, C. F., Wang, B. X., Wang, S. Y, Elevated serum bilirubin le vels are associated with improved survival in patients with curatively resected non - small - cell lung cancer. Cancer Epidemiology, 2015. 39(5): p. 763 - 768.
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