Clinical Utility of Red Blood Cell Distribution Width for the Diagnosis and Prognosis of Cervical Cancer

Background: The width of red blood cell distribution (RDW) is correlated with some diseases, but its clinical value and prognostic role in cervical cancer is unclear. Methods: We used receiver operating characteristic curves to evaluate the diagnostic ability of RDW and other clinical parameters in cervical cancer based on a case-control design. Using retrospective data, we explored the correlation of RDW with overall (OS) and progression-free (PFS) survival using Kaplan-Meier analysis and univariate and multivariate Cox regression with the hazard ratio (HR) and 95% confidence interval (CI). A restricted cubic plot was used to evaluate the nonlinear association between RDW and prognosis risk. Results: RDW was significantly higher in cases than in controls (14.6 +/- 1.7 vs 12.5 +/- 1.8, P<0.001). It showed high diagnostic accuracy for cervical cancer, with a sensitivity of 79.3%, specificity of 65.6%, and area under the curve of 0.802 (95% CI, 0.775-0.827) with a cutoff value of 13.88. There was a significant positive correlation between RDW and C-reactive protein (r=0.434, P=0.023). Multivariate Cox regression indicated that it was independently associated with a poorer PFS (HR, 2.05; 95% CI, 1.25-3.18, P<0.001) and OS (HR, 2.73; 95% CI, 1.61-4.64, P<0.001). RDW>14.66 showed a nonlinear increased risk for a poor PFS and OS. Conclusion: RDW is an easy, quick, and inexpensive tool for the early detection and risk management of cervical cancer. A greater RDW is associated with a poor prognosis in cervical cancer.