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 Oral submucous fibrosis (OSMF) is associated with nutritional deficiencies—primarily of iron and vitamins and usually seem to be associated with anemia. Red cell distribution width (RDW) is one of the routinely assessed parameters in complete blood picture analysis of any patient. It measures range of variation in erythrocyte size. A high RDW value has been associated to adverse outcomes in several diseases and risk of death. However, the relationship of RDW and OSMF is yet to be established. Aim To analyze the association of RDW levels and other erythrocytic indices with clinical staging and prognosis of OSMF patients. Materials and Methods Analysis of clinical stage and hematologic status of 86 patients comprising the study group (OSMF cases and OSMF with malignant changes) and control group was performed. It was done using Kruskal–Wallis analysis of variance test. Results The values of mean corpuscular volume, mean corpuscular hemoglobin, and mean corpuscular hemoglobin concentration were below normal from the onset of oral submucous fibrosis and they continued to decrease as the disease progressed. On other hand, RDW values were found to be in normal range in initial stages of disease and they became high in stage IV OSMF and increased further in OSMF patients with malignant changes. Conclusion We observed that higher values of RDW are strongly and independently associated with OSMF and OSCC, suggesting that RDW may contribute as most economic novel biochemical marker for progression and malignant transformation of OSMF.

Association of Increased Red Cell Distribution Width with Malignant Transformation of Oral Submucous Fibrosis