Objective: To determine the prognostic value of red cell distribution width (RDW) and circulating tumor cells with epithelial–mesenchymal transition phenotype (M-CTC) in lung adenocarcinoma (LUAD).
Patients and Methods: Clinical and laboratory data of 60 patients with LUAD were collected. CTCs were isolated from their peripheral blood using the CanPatrol^TM CTC enrichment method. The indicators of RDW and neutrophil lymphocyte ratio (NLR) were calculated based on the laboratory standards.
Results: A total of 60 LUAD patients were enrolled, of which 19 (31.7%) had high RDW (> 0.14) and 32 (53.3%) were positive for M-CTCs. There was no significant correlation between RDW and the clinical characteristics. M-CTC was not significantly associated with tumor size and differentiation, age, gender, tumor stage, and histological type but correlated significantly with lymphatic metastasis (P = 0.044), high NLR (> 2.26, P = 0.023), and high RDW (> 0.14, P = 0.036). Furthermore, the M-CTC⁺ LUAD patients had a significantly poor recurrence-free survival (RFS; Log rank P =0.001, HR = 2.749, 95% CI = 1.489– 5.078) and overall survival (OS; Log rank P =0.022, HR = 2.283, 95% CI = 1.128– 4.622) compared to the M-CTC⁻ patients. Similarly, high RDW also correlated with worse RFS (Log rank P = 0.008, HR = 2.331, 95% CI = 1.248– 4.353) and OS (Log rank P = 0.004, HR = 0.004, 95% CI = 1.398– 5.525).
Conclusion: M-CTC is significantly related to RDW and NLR, and an independent prognostic factor in LUAD.
Keywords: circulating tumor cell, epithelial–mesenchymal, red cell distribution width, lung adenocarcinoma, survival