Introduction: There is growing interest in the prognostic value of routinely performed pre-treatment blood test indices, such as the RDW or SII, with the latter combining the neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR). These indices were shown to be prognostic for survival in some malignancies. The purpose of this study was to evaluate the association between pre-treatment RDW and SII, and OS in patients treated with radiotherapy for primary localised cervical cancer. Material and Methods: This retrospective analysis included patients treated with definitive CRT between 2011 and 2017 for histopathologically confirmed FIGO 2018 stage IB2-IVA cervical cancer. Statistical analysis was performed using the Kaplan–Meier method, two-sided log-rank tests, and Cox proportional hazards models, with the AIC serving as a prediction error estimator. Results: The study group included 249 patients with a median age of 57.2 years and a median follow-up of 75.8 months. The majority were diagnosed with squamous cell carcinoma (237; 95.2%) and had FIGO stage III (211; 84.7%). Approximately half of the patients (116; 46.4%) had regional lymph node metastases. Patients with a low RDW (≤13.4%) and low SII (≤986.01) had a significantly longer OS (p= 0.001 andp= 0.002). The RDW remained as an independent prognostic factor in the multivariable model (high vs. low; HR = 2.04; 95% CI: 1.32–3.16;p= 0.001). Including RDW in the model decreased the Akaike Information Criterion from 1028.25 to 1018.15. Conclusions: The RDW is a cheap and widely available index that is simultaneously an independent prognostic factor for survival and could be used to improve pre-treatment prognosis assessments in patients with cervical cancer undergoing CRT. Available data encourage assessing the RDW as a prognostic factor in prospective trials to aid the identification of candidates for treatment escalation.
引言：常规治疗前血液检测指标，如红细胞分布宽度（RDW）或全身免疫炎症指数（SII，该指数结合了中性粒细胞与淋巴细胞比值[NLR]和血小板与淋巴细胞比值[PLR]）的预后价值日益受到关注。已有研究表明这些指标对某些恶性肿瘤的生存预后具有预测作用。本研究旨在评估接受放疗的原发性局部宫颈癌患者治疗前RDW和SII与总生存期（OS）之间的关联。 材料与方法：本回顾性分析纳入2011年至2017年间接受根治性放化疗（CRT）、经组织病理学确诊为2018年FIGO分期IB2-IVA期宫颈癌的患者。采用Kaplan-Meier法、双侧对数秩检验和Cox比例风险模型进行统计分析，并以赤池信息量准则（AIC）作为预测误差估计量。 结果：研究队列共纳入249例患者，中位年龄57.2岁，中位随访时间75.8个月。大多数患者被诊断为鳞状细胞癌（237例；95.2%），FIGO分期为III期（211例；84.7%）。约半数患者（116例；46.4%）存在区域淋巴结转移。低RDW（≤13.4%）和低SII（≤986.01）患者的OS显著延长（p=0.001和p=0.002）。在多变量模型中，RDW仍保持独立预后因素地位（高值vs.低值；HR=2.04；95%CI：1.32–3.16；p=0.001）。将RDW纳入模型后，赤池信息量准则从1028.25降至1018.15。 结论：RDW作为经济易得的检测指标，同时是生存预后的独立影响因素，可用于改善接受放化疗的宫颈癌患者治疗前的预后评估。现有数据支持在前瞻性试验中将RDW作为预后指标进行评估，以辅助识别需要强化治疗的候选患者。
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