title: Utility of routine hematological and inflammation parameters for the diagnosis of cancer in involuntary weight loss.
abstract: BACKGROUND
  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.
  
  
  METHODS
  A total of 253 consecutive patients with IWL admitted in a secondary care university hospital were included. Routine hematological and inflammatory parameters (hemoglobin level, mean corpuscular volume, RDW, serum iron level, erythrocyte sedimentation rate, C-reactive protein level, and ferritin level) were recorded for all patients. The investigative workup was not standardized, but the patients were followed up for 6 months to avoid misclassification concerning the final diagnosis.
  
  
  RESULTS
  All parameters, excepting mean cellular volume, were statistically associated with cancer. The areas under the curve were 0.708 (95% confidence interval [CI], 0.627-0.790) for C-reactive protein level, 0.690 (95% CI: 0.620-0.760) for erythrocyte sedimentation rate, 0.651 (95% CI, 0.566-0.735) for serum iron level, 0.607 (95% CI, 0.526-0.687) for hemoglobin level, 0.598 (95% CI, 0.518-0.679) for ferritin level, 0.594 (95% CI, 0.517-0.671) for RDW, and 0.561 (95% CI, 0.474-0.649) for mean cellular volume. In the multivariable analysis, only erythrocyte sedimentation rate remained associated with cancer.
  
  
  CONCLUSIONS
  In patients with IWL, 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.
authors.affiliation: Departments of Internal Medicine and Gastroenterology, Colentina University Hospital, Carol Davila University of Medicine, Bucharest, Romania. cbaicus@clicknet.ro
authors.forename: Cristian
authors.initials: C
authors.lastname: Baicus
authors.forename: Simona
authors.initials: S
authors.lastname: Caraiola
authors.forename: Mihai
authors.initials: M
authors.lastname: Rimbas
authors.forename: Ruxandra
authors.initials: R
authors.lastname: Patrascu
authors.forename: Anda
authors.initials: A
authors.lastname: Baicus
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D019540:Area Under Curve; D001799:Blood Sedimentation; D002097:C-Reactive Protein / Q000096:biosynthesis; D016022:Case-Control Studies; D004912:Erythrocytes / Q000166:cytology*; D005260:Female; D006454:Hemoglobins / Q000096:biosynthesis; D006801:Humans; D007249:Inflammation / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000097:blood* / Q000175:diagnosis*; D011446:Prospective Studies; D015431:Weight Loss
chemical_list: D006454:Hemoglobins; D002097:C-Reactive Protein