The Correlation Of Red Blood Cell Distribution Width And Neutrophil To Lymphocyte Ratio In The Diagnosis And Clinical Manifestations Of Non-small Cell Lung Cancer

Objective: To study the diagnostic significance of red blood cell distribution width(RDW),neutrophil to lymphocyte ratio(NLR)and non-small cell lung cancer(NSCLC)and clinical manifestations of tumor pathology,lymph node metastasis and distant metastasis.Methods: A total of 82 patients diagnosed with NSCLC by lung tissue or lymph node biopsy,pleural effusion cytology and pathological examination were enrolled from September 2020 to September 2022 at the Department of Respiratory Medicine and the Department of Thoracic Surgery,The First Affiliated Hospital of Wannan Medical College,and the participants did not receive chemoradiotherapy,immunotargeted therapy or surgery at the time of admission.There were 30 patients with benign pulmonary nodules,and they were confirmed by histopathology as the control group of pulmonary nodules.Thirty volunteers who underwent physical examination during the same period were selected as the healthy control group.The differences in RDW and NLR levels between the three groups were compared,and the correlations between different stages,lymph node metastasis grade,and distant metastasis and RDW and NLR values were compared in patients with non-small cell lung cancer.Results:1.The RDWs of NSCLC group,benign nodule group and healthy group were13.36± 1.035,12.59± 0.443,12.73± 0.386,respectively.There were significant differences in RDW levels between NSCLC group and benign nodule group and healthy group,P<0.001,and the RDW comparison between benign nodule group and healthy group was P=0.23,and the difference was not statistically significant.The median NLR value of NSCLC group,benign group and healthy group was less than0.05,which was significantly different.2.In the clinical manifestations of non-small cell lung cancer,RDW only differed in pathological classification comparison,P=0.013;in age,gender,smoking history,and tumor side,the P value was greater than 0.05,and the difference was not statistically significant.However,NLR was not significantly different in the clinical manifestations(age,sex,smoking history,tumor lateral,pathological classification)of patients with non-small cell lung cancer.3.Among the patients enrolled in non-small cell lung cancer,there were 5patients in stage I.,6 cases in stage II.,33 cases in stage III.,and 38 cases in stage IV.,among which the RWD values of stage I and stage II were 0.036 and 0.030,respectively,and the differences were statistically significant.There was no significant difference between the RDW values of stages I.,II.,IV.and III.,and P>0.05.NLR levels were not statistically significant in the stage,P>0.05.The RDW level in the early stage(stage I.+II.)of non-small cell lung cancer was significantly lower than that in the advanced stage(stage III.+IV.),with a P<0.05,which was statistically significant,while NLR was not significantly different in the early and late stages,with a P>0.05.4.According to the grade of lymph node metastasis,there were 13 N0,18 N1,33 N2,and 18 N3.Compared with N1 and N3,the RDW level of N0 patients was lower and the difference was statistically significant(P=0.012;P=0.024).Compared with N2,N0 patients had a P>0.05 and no statistically significant difference.NLR levels were greater than 0.05 in the grade of lymph node metastasis in all patients with non-small cell lung cancer,and the difference was not statistically significant.5.According to the eighth edition of TNM staging,43 patients had no distant metastases and 39 patients had distant metastases.The RDW level was significantly higher in M1 than in M0,with a P value of 0.035,which was statistically significant,while the difference in NLR level was not statistically significant with or without distant metastasis(P>0.05).6.According to Spearman’s analysis,there was a positive correlation between RDW and staging,lymph node metastasis grade,and distant metastasis(r=0.312,0.217,0.223 P<0.05).NLR was not associated with staging,lymph node metastasis grade,and distant metastasis,P>0.05,and the difference was not statistically significant.7.The ROC curve is plotted based on the RDW,NLR,and HRR values of NSCLC patients and healthy volunteers.The Youden index(sensitivity + specificity-1)is used to determine the cut-off value.The results showed that the optimal cut-off values of RDW and NLR were 13.15 and 2.225,respectively,and the area under the curve(AUC)of RDW and NLR were 0.771 and 0.641,respectively.Conclusions: 1.Inflammatory indicators have clinical significance for the early screening and diagnosis of non-small cell lung cancer.2.RDW is positively correlated with the clinical manifestations of non-small cell lung cancer.