Background: Red blood cell distribution width (RDW) is a standard parameter of complete blood count and indicates the variability in red blood cell size. This study aimed to determine whether preoperative RDW can be used to predict the recurrence and prognosis of endometrial carcinoma. Methods: The medical records of 431 patients diagnosed with endometrial carcinoma were retrospectively reviewed between May 2006 and June 2018. In addition to RDW, the clinicopathological factors, survival curves, and prognoses of the patients with endometrial carcinoma were compared between the high (n= 213) and low (n= 218) groups according to the median RDW value (12.8%). Results: The patients with high RDW had significantly advanced-stage (p= 0.00) pelvic lymph node metastasis (p= 0.01) and recurrence (p= 0.01) compared to those in the low-RDW group. In univariate analysis with DFS as the endpoint, surgical stage, type II histology, grade, RDW, and lymph node metastasis were independently associated with survival. Patients with high RDW values had significantly shorter disease-free survival and overall survival than those with low RDW values (log-rankp= 0.03, log-rankp= 0.04, respectively). Conclusion: Our results demonstrate that RDW is a simple and convenient indicator of endometrial carcinoma recurrence. Prospective studies are needed to validate the findings of the current study.
背景：红细胞分布宽度（RDW）是血常规的标准参数，反映红细胞大小的变异性。本研究旨在探讨术前RDW能否用于预测子宫内膜癌的复发及预后。方法：回顾性分析2006年5月至2018年6月期间431例子宫内膜癌患者的病历资料。根据RDW中位值（12.8%）将患者分为高RDW组（n=213）和低RDW组（n=218），比较两组患者的临床病理因素、生存曲线及预后情况。结果：与低RDW组相比，高RDW组患者的临床分期更晚（p=0.00）、盆腔淋巴结转移率更高（p=0.01）、复发率更高（p=0.01）。以无病生存期为终点的单因素分析显示，手术分期、II型组织学类型、肿瘤分级、RDW及淋巴结转移均与生存独立相关。高RDW患者的无病生存期和总生存期均显著短于低RDW患者（时序检验p值分别为0.03和0.04）。结论：本研究结果表明RDW是预测子宫内膜癌复发的简便指标，未来需开展前瞻性研究验证当前结果。
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