Red Cell Distribution Width as a Predictor of Malignancy in Patients Who Underwent Upper Gastrointestinal System Endoscopy

INTRODUCTION: Red cell distribution width (RDW) has predictive properties in different benign and malignant diseases. AIM: Our aim was to evaluate the predictive value of RDW for malignant gastric lesions by upper gastrointestinal screening. MATERIALS AND METHODS: Data of 91 male patients (Group A) who underwent upper gastrointestinal endoscopy and subsequent surgery for gastric malignancy and age-matched 91 healthy male patients (Group B) with benign disorders were reviewed in this retrospective cohort study. The pathology reports, laboratory parameters, and demographics of the patients were recorded for comparison. Receiver operating characteristic curves were plotted for RDW, and a threshold for prediction of malignancy was calculated. RESULTS: The average age of the patients with gastric cancer was 62 (interquartile range [IQR]: 53–70) years. The difference in RDW levels between Group A and Group B was found to be significant: 14.40% (IQR: 13.40–16.40) versus 13.10% (IQR: 12.55–13.50) for the malignant and benign groups, respectively, P = 0.000. The area under the curve was 0.81 (95% confidence interval [CI]: 0.76–0.86), P = 0.000. For the threshold of 13.45%, the positive predictive value (PPV) for malignancy was found to be 69.15 (95% CI: 61.77–75.67) and negative predictive value (NPV) was 70.45 (95% CI: 62.60–77.26). CONCLUSION: RDW was found to have a PPV for malignancy in nearly two-thirds of the patients and had a similar NPV.