The value of hemoglobin-to-red blood cell distribution width ratio (Hb/RDW), neutrophil-to-lymphocyte ratio (NLR), and platelet-to-lymphocyte ratio (PLR) for the diagnosis of nasopharyngeal cancer

Abstract Background: The clinical significance of hemoglobin-to-red blood cell distribution width (Hb/RDW) for the diagnosis of nasopharyngeal cancer (NPC) has not been reported yet. This study aimed to evaluate the value of preoperative Hb/RDW, neutrophil-to-lymphocyte ratio (NLR), and platelet-to-lymphocyte ratio (PLR) for the diagnosis of NPC.Methods: A total of 180 NPC patients (NPC group) and 149 healthy subjects (control group) were recruited to assess the value of Hb/RDW, NLR, and PLR for the diagnosis of NPC. Results: It was noted that NLR and PLR were significantly higher in the NPC group than those in the control group (P<0.001), however, Hb/RDW was lower in the NPC group compared with that in the control group (P<0.001). NLR was also remarkably different between patients of stageⅠ+Ⅱ and those of stage Ⅲ+Ⅳ (P=0.043), and that was different in patients with lymph node metastases or not(P=0.030). Besides, PLR was significantly different in patients with serosal invasion or not (P=0.031).Compared with Hb/RDW alone (sensitivity, 66.67%; specificity, 85.23%), the sensitivity (67.78%, 72.78%) and specificity (89.62%, 90.6%) of Hb/RDW with NLR and PLR were both increased. Furthermore, Hb/RDW combined with NLR (area under the receiver operating characteristic curve (ROC) (AUC), 0.824; 95% confidence interval (CI):0.779-0.864, P=0.0080) or PLR (AUC:0.851, 95%CI:0.808-0.888, P=0.0002) had a greater AUC value for the diagnosis of NPC compared with Hb/RDW alone (AUC: 0.781, 95% CI: 0.732-0.824).Conclusion: Hb/RDW can be used as a valuable indicator for the diagnosis of NPC. Preoperative Hb/RDW combined with NLR or PLR had higher value for the diagnosis of NPC.