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Register a new userRelationship 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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Tishreen University ورقة بحثية
Publication date
2020
fields
Medicine
and research's language is
العربية
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تهدف هذه الدراسة لإثبات وجود علاقة بين البيليروبين والـRDW والعوامل الإنذارية لسرطان المعدة (مرحلة الورم – الواسمات الورمية). الطرق: شملت الدراسة 112 فرداً ممن راجعوا مشفى تشرين الجامعي ومركز الأورام التابع له في اللاذقية خلال الفترة الممتدة بين تموز 2018 وكانون الأول 2019. تم توزيعهم في مجموعتين كالتالي: مجموعة مرضى سرطان المعدة شملت 56 مريضاً (33 ذكراً و23 أنثى) تتراوح أعمارهم بين 37 و83 سنة, ومجموعة الشواهد شملت 56 فرداً (34 ذكراً و22 أنثى) تتراوح أعمارهم بين 37 و80 سنة. تم تقييم مرحلة سرطان المعدة اعتماداً على نظام التصنيف AJCC (اللجنة الأمريكية المشتركة لمكافحة السرطان). تم استجواب المرضى والحصول على المعلومات الاجتماعية والسلوكية, تم من ثم الحصول على عينات الدم الوريدي للتقييم الطبي الحيوي. أجري التحليل الإحصائي للنتائج باستخدام البرنامج SPSS الإصدار 25. النتائج: ارتبط البيليروبين والـRDW مع العوامل الإنذارية لسرطان المعدة بشكل هام إحصائياً. ارتبط الـ RDW بشكل إيجابي مع مرحلة الورم والواسمين الورميين CEA و9-9CA1 بينما ارتبط البييلروبين الكلي وغير المباشر بشكل سلبي مع هذه العوامل, في حين لم يبد البيليروبين المباشر أي ارتباط هام. كانت قيم الـRDW لدى مرضى سرطان المعدة أعلى من قيمه لدى الشواهد. بينما انخفضت قيم البيليروبين الكلي وغير المباشر بشكل ملحوظ عند مرضى سرطان المعدة مقارنة مع الشواهد. تشير النتائج التي توصلت اليها دراستنا إلى أنه من الممكن أن يكون كل من الـRDW والبيليروبين عاملاً إنذارياً محتملاً لسرطان المعدة.
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.
Artificial intelligence review:
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
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ما هو الهدف الرئيسي من هذه الدراسة؟
الهدف الرئيسي هو استكشاف العلاقة بين عرض توزع الكريات الحمر (RDW)، البيليروبين، والعوامل الإنذارية لسرطان المعدة.
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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.
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ما هي التوصيات التي قدمتها الدراسة؟
أوصت الدراسة بإجراء دراسات حشدية أكبر لتأكيد القيمة الإنذارية لكل من RDW والبيليروبين لدى مرضى سرطان المعدة.
-
ما هي نقاط الضعف في هذه الدراسة؟
نقاط الضعف تشمل حجم العينة الصغير، الطبيعة المستقطعة للدراسة، وعدم أخذ بعض العوامل المؤثرة الأخرى بعين الاعتبار.
References used
Jemal, A., et al., Global cancer statistics. CA Cancer J Clin, 2011. 61(2): p. 69 - 90.
Williams, S.M.J.L., ed. Clinical Laboratory Hematology ,second edition . ed. E. Zeibig.
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
Danese, E., G. Lippi, and M. Montagnana, Red blood cell distribution width and cardiovascular diseases. J Thorac Dis, 2015. 7(10): p. E402 - 11.
Hu, Z., et al., Red blood cell distribution width is a potential prognostic index for liver disease. Clin Chem Lab Med, 2013. 51(7): p. 1403 - 8.
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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