Biomedical Engineering, School of Medicine, Oregon Health and Science University, Portland, OR, USA.
VA Palo Alto Health Care System, Palo Alto, CA, USA.
Sci Rep. 2018 Apr 26;8(1):6564. doi: 10.1038/s41598-018-25019-1.
Platelets, components of hemostasis, when present in excess (>400 K/μL, thrombocytosis) have also been associated with worse outcomes in lung, ovarian, breast, renal, and colorectal cancer patients. Associations between thrombocytosis and cancer outcomes have been made mostly from single-time-point studies, often at the time of diagnosis. Using laboratory data from the Department of Veterans Affairs (VA), we examined the potential benefits of using longitudinal platelet counts in improving patient prognosis predictions. Ten features (summary statistics and engineered features) were derived to describe the platelet counts of 10,000+ VA lung, prostate, and colon cancer patients and incorporated into an age-adjusted LASSO regression analysis to determine feature importance, and predict overall or relapse-free survival, which was compared to the previously used approach of monitoring for thrombocytosis near diagnosis (Postdiag AG400 model). Temporal features describing acute platelet count increases/decreases were found to be important in cancer survival and relapse-survival that helped stratify good and bad outcomes of cancer patient groups. Predictions of overall and relapse-free survival were improved by up to 30% compared to the Postdiag AG400 model. Our study indicates the association of temporally derived platelet count features with a patients' prognosis predictions.
血小板是止血的组成部分，当过量存在（>400K/μL，血小板增多症）时，也与肺癌、卵巢癌、乳腺癌、肾癌和结直肠癌患者的预后更差有关。血小板增多症与癌症结局之间的关联主要来自单次时点研究，通常在诊断时。我们利用退伍军人事务部（VA）的实验室数据，研究了使用纵向血小板计数改善患者预后预测的潜在益处。我们提取了 10000 多名 VA 肺癌、前列腺癌和结肠癌患者的血小板计数的 10 个特征（汇总统计和工程特征），并将其纳入年龄调整的 LASSO 回归分析中，以确定特征的重要性，并预测总生存或无复发生存率，与以前监测诊断附近血小板增多症的方法（Postdiag AG400 模型）进行比较。发现描述急性血小板计数增加/减少的时间特征在癌症生存和复发生存中很重要，有助于对癌症患者群体的良好和不良结局进行分层。与 Postdiag AG400 模型相比，总生存和无复发生存率的预测提高了 30%。我们的研究表明，与患者预后预测相关的血小板计数特征的时间变化。
