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Utility of routine hematological and inflammation parameters for the diagnosis of cancer in involuntary weight loss

Domenii publicaţii > Ştiinţe medicale + Tipuri publicaţii > Articol în revistã ştiinţificã

Autori: Baicus, Cristian; Caraiola, Simona; Rimbas, Mihai; Patrascu, Ruxandra; Baicus, Anda; for Grupul de Studiu al Scaderii Ponderale Involuntare

Editorial: Journal of Investigative Medicine, 59 (6), 2011.


A quarter of patients with involuntary weight loss (IWL) have cancer. Inflammation and anemia are associated with cancer, and recent studies showed that red blood cell distribution width (RDW) is a predictor of mortality, including cancer-related death. The aim of this study was to assess the ability of routine hematological and inflammation parameters to diagnose cancer in patients with IWL.
Material and methods
253 consecutive patients with IWL admitted in a secondary care university hospital were included. Routine hematological and inflammatory parameters (hemoglobin, mean corpuscular volume, RDW, serum iron, erythrocyte sedimentation rate, C reactive protein and ferritin) were recorded for all patients. The investigative work-up was not standardized, but the patients were followed-up for 6 months, in order to avoid misclassification concerning the final diagnosis.
All parameters, excepting mean cellular volume, were statistically associated with cancer. The areas under the curve (AUC) were 0.708 (95% confidence interval [CI]: 0.627-0.790) for C reactive protein, 0.690 (95% CI: 0.620-0.760) for erythrocyte sedimentation rate, 0.651 (95% CI: 0.566-0.735) for serum iron, 0.607 (95% CI: 0.526-0.687) for hemoglobin, 0.598 (95%CI: 0.518, 0.679) for ferritin, 0.594 (95%CI: 0.517-0.671) for RDW and 0.561 (0.474, 0.649) for mean cellular volume. In multivariable analysis, only erythrocyte sedimentation rate remained associated with cancer.
In patients with involuntary weight loss, the hematological and inflammation parameters were statistically different in patients with cancer and in those without cancer. However, in clinical practice they were modest diagnostic tests for cancer.

Cuvinte cheie: cancer, involuntary weight loss, red cell distribution width, hemoglobin, erythrocyte indices, erythrocyte sedimentation rate, C-reactive protein, ferritin, area under curve, sensitivity, specificity