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Marin AG, Filipescu AG, Petca RC, Vlădăreanu R, Petca A. Clinical Correlations between Serological Markers and Endometrial Cancer. Cancers (Basel) 2024; 16:1935. [PMID: 38792013 PMCID: PMC11120108 DOI: 10.3390/cancers16101935] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2024] [Revised: 05/14/2024] [Accepted: 05/17/2024] [Indexed: 05/26/2024] Open
Abstract
Background: Endometrial cancer is associated with changes in blood cell counts and with high levels of inflammatory markers, thus reflecting the tumor's impact on various biological processes and suggesting their potential as biomarkers for endometrial cancer diagnosis, prognosis, and treatment response. The neutrophil-to-lymphocyte ratio, platelet-to-lymphocyte ratio, and monocyte-to-lymphocyte ratio in peripheral blood sampled preoperatively from patients have been reported to be independently associated with the prognosis of different types of malignancies. Objectives: This study aimed to compare several blood markers-red blood cells, white blood cells, platelet parameters, neutrophil-to-lymphocyte ratio, platelet-to-lymphocyte ratio, monocyte-to-lymphocyte ratio, C-reactive protein, and fibrinogen-in patients with benign or malignant endometrial tumors. Material and methods: Our retrospective study included 670 patients (192 diagnosed with endometrial cancer and 478 with endometrial hyperplasia), and we compared the serological parameters discussed above with those sampled the day before surgery. Results: Analysis of complete blood count indices revealed no significant differences in red blood cell or total white blood cell parameters between the endometrial cancer group and the endometrial hyperplasia group. However, a distinct pattern emerged in the white blood cell differential. The endometrial cancer group showed a statistically significant decrease in lymphocyte count compared with the endometrial hyperplasia group. In contrast, the endometrial cancer group showed significantly higher mean platelet counts and increased mean platelet volume compared with controls. Furthermore, the endometrial cancer group demonstrated a marked inflammatory response, as evidenced by significantly elevated levels of C-reactive protein, fibrinogen, neutrophil-to-lymphocyte ratio, platelet-to-lymphocyte ratio, and monocyte-to-lymphocyte ratio compared with the endometrial hyperplasia group. Conclusions: The current research revealed statistically significant differences in multiple serological biomarkers between the two groups. These findings support the initial hypothesis regarding the potential utility of these biomarkers in endometrial cancer diagnosis, prognosis, and treatment response, highlighting the existence of biomarkers affordable for analysis under any health system, regardless of the country's level of development.
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Affiliation(s)
- Alina-Gabriela Marin
- “Carol Davila” Faculty of Medicine, Department of Obstetrics and Gynecology, University of Medicine and Pharmacy, 050474 Bucharest, Romania; (A.-G.M.); (A.G.F.); (R.V.), (A.P.)
- Department of Obstetrics and Gynaecology, Elias Emergency University Hospital, 011461 Bucharest, Romania
| | - Alexandru George Filipescu
- “Carol Davila” Faculty of Medicine, Department of Obstetrics and Gynecology, University of Medicine and Pharmacy, 050474 Bucharest, Romania; (A.-G.M.); (A.G.F.); (R.V.), (A.P.)
- Department of Obstetrics and Gynaecology, Elias Emergency University Hospital, 011461 Bucharest, Romania
| | - Răzvan Cosmin Petca
- “Carol Davila” Faculty of Medicine, Department of Obstetrics and Gynecology, University of Medicine and Pharmacy, 050474 Bucharest, Romania; (A.-G.M.); (A.G.F.); (R.V.), (A.P.)
- Department of Urology, “Prof. Dr. Th. Burghele” Clinical Hospital, 20 Panduri Street, 050659 Bucharest, Romania
| | - Radu Vlădăreanu
- “Carol Davila” Faculty of Medicine, Department of Obstetrics and Gynecology, University of Medicine and Pharmacy, 050474 Bucharest, Romania; (A.-G.M.); (A.G.F.); (R.V.), (A.P.)
- Department of Obstetrics and Gynaecology, Elias Emergency University Hospital, 011461 Bucharest, Romania
| | - Aida Petca
- “Carol Davila” Faculty of Medicine, Department of Obstetrics and Gynecology, University of Medicine and Pharmacy, 050474 Bucharest, Romania; (A.-G.M.); (A.G.F.); (R.V.), (A.P.)
- Department of Obstetrics and Gynaecology, Elias Emergency University Hospital, 011461 Bucharest, Romania
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Coradduzza D, Medici S, Chessa C, Zinellu A, Madonia M, Angius A, Carru C, De Miglio MR. Assessing the Predictive Power of the Hemoglobin/Red Cell Distribution Width Ratio in Cancer: A Systematic Review and Future Directions. MEDICINA (KAUNAS, LITHUANIA) 2023; 59:2124. [PMID: 38138227 PMCID: PMC10744746 DOI: 10.3390/medicina59122124] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/13/2023] [Revised: 11/20/2023] [Accepted: 11/29/2023] [Indexed: 12/24/2023]
Abstract
Background and Objectives: The hemoglobin (Hb)/red cell distribution width (RDW) ratio has emerged as an accessible, repeatable, and inexpensive prognostic factor that may predict survival in cancer patients. The focus of this systematic review is to investigate the prognostic role of the Hb/RDW ratio in cancer and the implications for clinical practice. Materials and Methods: A literature search of PubMed, Scopus, and Web of Science databases was performed by an independent author between 18 March and 30 March 2023 to collect relevant literature that assessed the prognostic value of the Hb/RDW ratio in cancer. Overall survival (OS), progression-free survival (PFS), and the association of these with the Hb/RDW ratio were considered to be the main endpoints. Results: Thirteen retrospective studies, including 3818 cancer patients, were identified and involved in this review. It was observed that, when patients with a high vs. low Hb/RDW ratio were compared, those with a lower Hb/RDW ratio had significantly poorer outcomes (p < 0.05). In lung cancer patients, a one-unit increase in the Hb/RDW ratio reduces mortality by 1.6 times, whilst in esophageal squamous-cell carcinoma patients, a lower Hb/RDW ratio results in a 1.416-times greater risk of mortality. Conclusions: A low Hb/RDW ratio was associated with poor OS and disease progression in patients with cancer. This blood parameter should be considered a standard biomarker in clinical practice for predicting OS and PFS in cancer patients. Future searches will be necessary to determine and standardize the Hb/RDW cut-off value and to assess whether the Hb/RDW ratio is optimal as an independent prognostic factor or if it requires incorporation into risk assessment models for predicting outcomes in cancer patients.
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Affiliation(s)
- Donatella Coradduzza
- Department of Biomedical Sciences, University of Sassari, 07100 Sassari, Italy; (D.C.); (A.Z.)
| | - Serenella Medici
- Department of Chemical, Physical, Mathematical and Natural Sciences, University of Sassari, 07100 Sassari, Italy;
| | - Carla Chessa
- Department of Medicine, Surgery and Pharmacy, University of Sassari, 07100 Sassari, Italy; (C.C.); (M.M.)
| | - Angelo Zinellu
- Department of Biomedical Sciences, University of Sassari, 07100 Sassari, Italy; (D.C.); (A.Z.)
| | - Massimo Madonia
- Department of Medicine, Surgery and Pharmacy, University of Sassari, 07100 Sassari, Italy; (C.C.); (M.M.)
| | - Andrea Angius
- Istituto di Ricerca Genetica e Biomedica (IRGB), Consiglio Nazionale delle Ricerche (CNR), Cittadella Universitaria di Cagliari, 09042 Cagliari, Italy;
| | - Ciriaco Carru
- Department of Biomedical Sciences, University of Sassari, 07100 Sassari, Italy; (D.C.); (A.Z.)
- Control Quality Unit, Azienda-Ospedaliera Universitaria (AOU), 07100 Sassari, Italy
| | - Maria Rosaria De Miglio
- Department of Medicine, Surgery and Pharmacy, University of Sassari, 07100 Sassari, Italy; (C.C.); (M.M.)
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