Qian Weihua, Ge Xin-Xin, Wu Jing, Gong Fei-Ran, Wu Meng-Yao, Xu Meng-Dan, Lian Lian, Wang Wen-Jie, Li Wei, Tao Min
Department of Oncology, The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu 215006, P.R. China.
Department of Oncology, Zhangjiagang Hospital of Traditional Chinese Medicine affiliated to Nanjing University of Chinese Medicine, Suzhou, Jiangsu 215006, P.R. China.
Oncol Lett. 2019 Jul;18(1):571-580. doi: 10.3892/ol.2019.10388. Epub 2019 May 21.
Colorectal cancer (CRC) represents the third most common malignancy worldwide. The aim of the present study was to investigate the predictive values of platelet-associated indicators, including platelet count (PLT), plateletcrit (PCT), mean platelet volume (MPV) and platelet distribution width (PDW) in patients with resectable CRC. The current retrospective study included 153 patients who were pathologically diagnosed with resectable CRC. The patients were divided into two groups according to the median value of PLT, PCT, MPV or PDW. To evaluate the changes in PLT, PCT, MPV and PDW following resection and adjuvant chemotherapy, the concept of post-/pre-treatment PLT, PCT, MPV and PDW ratios was introduced, where <1 indicated decreased PLT, PCT, MPV and PDW values after treatment, and where ≥1 suggested stable or increased values. It was revealed that a low MPV prior to treatment correlated with a higher tumor stage. Surgery significantly decreased MPV, but had no impact on PLT, PCT or PDW. Adjuvant chemotherapy significantly decreased PLT and PCT, increased MPV and had no effect on PDW. After the whole course of treatment (surgery combined with adjuvant chemotherapy), PLT, PCT and PDW were significantly decreased. Kaplan-Meier plots illustrated that patients with a post-/pre-treatment MPV ratio <1 had poorer overall survival (OS), whereas the post-/pre-treatment ratios for PLT, PCT and PDW did not correlate with patient outcome. Multivariate Cox regression analysis revealed that sex, tumor size and the post-/pre-treatment MPV ratio were prognostic factors for OS. Therefore, the present results may suggest MPV as a potential prognostic factor in resectable CRC.
结直肠癌（CRC）是全球第三大常见恶性肿瘤。本研究旨在探讨血小板相关指标，包括血小板计数（PLT）、血小板压积（PCT）、平均血小板体积（MPV）和血小板分布宽度（PDW）在可切除CRC患者中的预测价值。本回顾性研究纳入了153例经病理诊断为可切除CRC的患者。根据PLT、PCT、MPV或PDW的中位数将患者分为两组。为了评估切除和辅助化疗后PLT、PCT、MPV和PDW的变化，引入了治疗后/治疗前PLT、PCT、MPV和PDW比值的概念，其中<1表示治疗后PLT、PCT、MPV和PDW值降低，≥1表示值稳定或升高。结果显示，治疗前低MPV与较高的肿瘤分期相关。手术显著降低了MPV，但对PLT、PCT或PDW没有影响。辅助化疗显著降低了PLT和PCT，增加了MPV，对PDW没有影响。在整个治疗过程（手术联合辅助化疗）后，PLT、PCT和PDW显著降低。Kaplan-Meier曲线表明，治疗后/治疗前MPV比值<1的患者总生存期（OS）较差，而PLT、PCT和PDW的治疗后/治疗前比值与患者预后无关。多因素Cox回归分析显示，性别、肿瘤大小和治疗后/治疗前MPV比值是OS的预后因素。因此，本研究结果可能提示MPV是可切除CRC的潜在预后因素。
