红细胞分布宽度（RDW）可以作为炎症性医学状况下的恶化预后的信号。本研究旨在调查术前RDW与结直肠癌（CRC）之间的关系，研究对象为一大批患者。我们回顾性评估了在复旦大学上海肿瘤中心接受根治性手术的6224例CRC患者。使用Cox比例风险模型和Kaplan-Meier方法分析RDW对总体生存率（OS）和无病生存率（DFS）的预后意义，并根据存活混杂因素进行了倾向性评分匹配（PSM）。研究参与者的平均年龄为59.5±12.0岁，研究组中女性占44％。总体RDW的中位数和平均值分别为13.3％和14.0％。根据RDW值将患者分为三组（≤13.3％、13.4-14.0％和>14.0％）。随着RDW类别的增加，OS和DFS明显恶化。在PSM人群中，与匹配对照组相比，高RDW组的OS和DFS明显较低。然而，中等RDW组与对照组之间的差异消失。我们的研究结果表明，术前RDW可能是CRC患者根治手术后的一个简单而强大的预后因素。将RDW纳入临床实践中，可以更好地预测预后和优化CRC患者的治疗策略。2023年《胃肠肿瘤杂志》版权所有。

Red cell distribution width (RDW) can signal poor prognosis in inflammatory medical conditions. The purpose of the study was to investigate the relationship between preoperative RDW and colorectal cancer (CRC) in a large cohort of patients.A total of 6,224 CRC patients who underwent radical resection at the Fudan University Shanghai Cancer Center were evaluated retrospectively. The prognostic significance of RDW for overall survival (OS) and disease-free survival (DFS) was analyzed using Cox proportional hazards models and Kaplan-Meier method. Propensity score matching (PSM) was used based on survival confounding factors.The mean age of the study participants was 59.5±12.0 years and the study cohort was 44% female. The overall median and mean RDW values were 13.3% and 14.0%, respectively. Patients were stratified into three groups based on their RDW value (≤13.3%, 13.4-14.0%, and >14.0%). OS and DFS were shown to significantly deteriorate with increasing RDW category. In the PSM population, OS and DFS were significantly lower in the high RDW group compared with matched controls. However, the differences vanished in the comparisons between the middle RDW group and the control group.Our findings demonstrate that preoperative RDW may represent a simple and powerful prognostic factor for CRC patients after radical resection. Integrating RDW into clinical practice may better inform the prognosis and optimize therapeutic approaches for patients with CRC.2023 Journal of Gastrointestinal Oncology. All rights reserved.