Preoperative Mean Corpuscular Hemoglobin Concentration, Red Cell Distribution Width As Predictive Markers For Pancreatic Cancer Patients Who Underwent Radical Pancreatomy

Abstract Objective: To explore the value of mean corpuscular hemoglobin concentration (MCHC) and red cell distribution width (RDW) for overall survival (OS) and progression-free survival (PFS) in patients with pancreatic cancer (PC) who underwent radical pancreatomy.Background: Inflammatory factors are important factors in promoting the occurrence and metastasis of malignant tumors. RDW and MCHC are suggested to be relevant to the prognosis of several malignancies. Such as gastric cancer, colon cancer. However, there are few studies to explore the correlation between them and PC.Methods: This study included 532 patients with PC who underwent radical resection between March 2011 and May 2019. Kaplan-Meier curve method and Cox proportional hazard regression model were applied to analyze prognosis. Correlations between categorical variables were analyzed using Chi squared tests.Results: Survival curve showed that OS and PFS were significantly favorable for resectable PC patients with high preoperative MCHC (P=0.02) (P=0.005), RDW in the normal range (P<0.001) (P<0.001). Multivariate analysis suggested that MCHC (HR: 0.612, 95%CI: 0.426-0.879, P=0.008), and RDW (HR: 3.969, 95%CI: 2.952-5.338, P<0.001) were independent prognostic factors for resectable PC patients. MCHC (HR: 0.657, 95%CI: 0.458-0.943, P=0.023), RDW (HR: 3.915, 95%CI: 2.923-5.243, P < 0.001) were also independent recurrent factors for resectable PC patients. Correlation analysis showed that MCHC was related to tumor size, nerve invasion, and anemia-related indicators, meanwhile RDW was connected with carcinoma-embryonic antigen (CEA) and carbohydrate antigen199 (CA19-9).Conclusion: The preoperative MCHC and RDW were simple and convenient predictive factors for prognosis and progression of patients with PC.