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Niger J Surg. 2019 Jul-Dec;25(2):198-202. doi: 10.4103/njs.NJS_22_19.

Red Cell Distribution Width: A Surrogate Biomarker to Predict Tumor Burden in Carcinoma Gallbladder.

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Department of Surgery, AIIMS, Rishikesh, Uttarakhand, India.
Department of Radiation Oncology, AIIMS, Rishikesh, Uttarakhand, India.
Department of Pathology, AIIMS, Rishikesh, Uttarakhand, India.
Department of Biochemistry, AIIMS, Rishikesh, Uttarakhand, India.



To assess the role of red cell distribution width as a marker to predict tumor burden in gallbladder cancer (GBC).


One hundred and twenty-eight patients with newly diagnosed GBC were included in the study. Peripheral blood samples were obtained, and red cell distribution width (RDW) was assessed. Tumor markers and other biochemical parameters were also recorded.

Statistical Analysis:

Quantitative variables were summarized using mean and standard deviation or median and interquartile range based on the normality of the distribution. The association of RDW with stage of tumor was analyzed using Chi-square test. All statistical tests were interpreted for significance using a cutoff value of P < 0.05.


RDW showed a positive correlation with total bilirubin, total leukocyte count, and erythrocyte sedimentation rate (P < 0.002), but not with platelet count (P < 0.643). RDW showed a significant correlation with tumor markers CA 19-9 (P < 0.003), carcinoembryonic antigen (P < 0.003), and CA 125 (P < 0.002). In Stage IVB, there were significantly more patients with high RDW (78%) than normal RDW (21.8%). However, the results were not statistically significant (P < 0.073).


In the present study, we have utilized RDW for correlation with tumor markers in carcinoma gallbladder and as a predictor of stage. We demonstrated higher levels of RDW with advanced stages of GBC. Overall, the study suggested that RDW may be utilized as a surrogate biomarker to predict tumor burden and disease in patients with GBC.


Gallbladder; red cell width; tumor markers

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