Riedl Julia, Kaider Alexandra, Reitter Eva-Maria, Marosi Christine, Jäger Ulrich, Schwarzinger Ilse, Zielinski Christoph, Pabinger Ingrid, Ay Cihan
Cihan Ay, MD, Clinical Division of Haematology and Haemostaseology, Department of Medicine I, Comprehensive Cancer Center, Medical University of Vienna, Waehringer Guertel 18-20, A-1090 Vienna, Austria, Tel.: +43 1 40400 4410, Fax: +43 1 40400 4030, E-mail:
Thromb Haemost. 2014 Apr 1;111(4):670-8. doi: 10.1160/TH13-07-0603. Epub 2013 Dec 5.
Venous thromboembolism (VTE) is a frequent complication in cancer patients. Mean platelet volume (MPV) has been associated with arterial and venous thrombosis in patients without cancer. We analysed MPV in cancer patients and investigated the association of MPV with risk of VTE and mortality. MPV was routinely determined in the Vienna Cancer and Thrombosis Study, a prospective, observational cohort study of patients with newly diagnosed or progressive cancer after remission. Study endpoints were occurrence of symptomatic VTE or death during a maximum follow-up of two years. Out of 1,544 included patients, 114 (7.4%) developed VTE and 573 (37.1%) died during a median observation time of 576 days. High MPV ≥75th percentile of the study population; ≥10.8 fL) was associated with decreased risk of VTE compared to MPV below the 75th percentile (HR [95% CI]: 0.59 [0.37-0.95], p=0.031). In multivariable analysis, including age, sex, cancer groups, newly diagnosed vs recurrent disease, platelet count and soluble P-selectin, this association remained statistically significant (0.65 [0.37-0.98], p=0.041). Mortality of patients with MPV (≥75th percentile was significantly decreased compared to those with lower MPV (0.72 [0.59-0.88], p=0.001). Two-year probability of VTE and overall survival was 5.5% and 64.7% in patients with high MPV compared to 9% and 55.7% in those with lower MPV. In conclusion, high MPV is associated with decreased VTE risk and improved survival in cancer patients. This finding is contrary to results observed in patients without cancer. Further studies are needed to confirm our results and elucidate underlying mechanisms.
静脉血栓栓塞症（VTE）是癌症患者常见的并发症。平均血小板体积（MPV）与非癌症患者的动脉和静脉血栓形成有关。我们分析了癌症患者的MPV，并研究了MPV与VTE风险和死亡率之间的关联。在维也纳癌症与血栓形成研究中常规测定MPV，这是一项对新诊断或缓解后病情进展的癌症患者进行的前瞻性观察队列研究。研究终点是在最长两年的随访期间出现有症状的VTE或死亡。在纳入的1544例患者中，114例（7.4%）发生了VTE，573例（37.1%）在中位观察时间576天内死亡。与MPV低于第75百分位数相比，高MPV（≥研究人群的第75百分位数；≥10.8 fL）与VTE风险降低相关（HR [95% CI]：0.59 [0.37 - 0.95]，p = 0.031）。在多变量分析中，包括年龄、性别、癌症组、新诊断与复发疾病、血小板计数和可溶性P选择素，这种关联仍然具有统计学意义（0.65 [0.37 - 0.98]，p = 0.041）。与MPV较低的患者相比，MPV（≥第75百分位数）患者的死亡率显著降低（0.72 [0.59 - 0.88]，p = 0.001）。高MPV患者的VTE两年发生率和总生存率分别为5.5%和64.7%，而低MPV患者分别为9%和55.7%。总之，高MPV与癌症患者VTE风险降低和生存率提高相关。这一发现与在非癌症患者中观察到的结果相反。需要进一步研究来证实我们的结果并阐明潜在机制。
