The Prognostic Roles Of Red Blood Cell(RBC)-associated Indicators In Patients With Resectable Gastric Cancers

Background:This study was designed to investigate the prognostic values of red blood cell(RBC)-associated indicators,including RBC,hemoglobin(HGB),hematocrit(HCT),mean corpuscular volume(MCV),mean corpuscular haemoglobin(MCH),mean corpuscular haemoglobin concentration(MCHC)and red blood cell distribution width(RDW)in resectable gastric cancer patients.Methods:In total,in this retrospective study,104 pathologically confirmed gastric cancer patients were recruited.These cases were divided into two groups according to the median values of pre-treatment RBC,HGB,HCT,MCV,MCH,MCHC or RDW.To evaluate the changes in RBC-associated indicators values after treatment,we introduced the concept of post-/pre-treatment ratios(?1 suggested RBC,HGB,HCT,MCV,MCH,MCHC or RDW values were not increased after therapy,while>1 represented those in increased levels).Kaplan-Meier curves were constructed to show overall survival(OS).?2 was used to explore the relationship between blood parameters and clinical pathological features.T-test was applied to assess the changes in blood parameters before and after surgery or chemotherapy.Multivariate logistic regression model was employed to identify the independent risk factors.Results:The lower pre-treatment MCHC levels were correlated with worse overall survival(OS),while pre-treatment levels of RBC,HGB,HCT,MCV,MCH or RDW were not.Whole course of treatment(surgery plus adjuvant chemotherapy)significantly decreased the values of MCHC,and increased the values of MCV and RDW,whereas had no obvious effects on the values of RBC,HGB,HCT or MCH.Patients with post-/pre-treatment MCV ratio>1 had an increased survival ratio.Whereas,post-/pre-treatment RBC,HGB,HCT,MCH,MCHC or RDW ratios were not correlated with outcomes.Multivariate Cox regression analysis revealed that AJCC stage(?),and lower pre-treatment MCHC levels were independent risk factors affecting OS.The receiver operating characteristic(ROC)curve analysis showed that MCHC value of 341.98 g/L was considered to be the optimal cutoff value for prognosis,the sensitivity was 58.3%and specificity was 75.0%.Conclusion:Pre-treatment MCHC level could become a potential prognostic factor for resectable gastric cancer.