Department of Internal Medicine, University of Health Sciences, Van Research and Training Hospital, Van, Turkey.
J BUON. 2020 Jan-Feb;25(1):227-239.
Several platelet indices have been linked to prognosis of various cancers, including metastatic colorectal cancer. The aim of this study was to investigate the prognostic effect of mean platelet volume (MPV) and platelet distribution width (PDW) in early colon cancer (CC) patients.
This retrospective study included early CC patients who were followed up and treated between 2005 and 2017. Relapse free survival (RFS) and overall survival (OS) were determined with respect to several demographic and clinical characteristics of patients, including MPV and PDW. The cut-off value was determined as >8.5 fL for MPV (sensitivity: 67.1%, specificity 54.5%) and ≤16% for PDW (sensitivity: 66.7%, specificity: 60.0%).
The study included 394 patients, 53.3% of which were male. Stage I, II, and III patients constituted 8.9%, 46.4%, and 44.7% of the study population, respectively. Among all patients, RFS and OS were significantly longer in patients with MPV≤8.5 fL and PDW>16 fL (p<0.001 and p=0.011 for MPV, respectively; and p<0.001 and p=0.026 for PDW, respectively). In patients with stage III disease, those with MPV≤8.5 fL had significantly longer RFS and OS compared to those with MPV >8.5 fL (p<0.001 and p=0.001, respectively). On the other hand, those with PDW>16% had significantly longer RFS than that in those with PDW ≤16 fL among stage III patients (p<0.001). In multivariate analysis, stage, perineural invasion, lymphovascular invasion, adjuvant treatment, CEA, CA19-9, PDW, and MPV were found the most significant factors affecting RFS.
Our study suggests that elevated MPV and decreased PDW appear to be unfavorable prognostic factors in early CC, especially in patients with stage III disease. Considering the wide availability and accessibility of these indices, it is reasonable to designate further larger prospective studies to clarify and verify their potential roles in early CC.
多项血小板指标已与包括转移性结直肠癌在内的多种癌症的预后相关。本研究旨在探讨平均血小板体积（MPV）和血小板分布宽度（PDW）对早期结肠癌（CC）患者预后的影响。
本回顾性研究纳入了 2005 年至 2017 年间接受随访和治疗的早期 CC 患者。根据患者的多项人口统计学和临床特征，包括 MPV 和 PDW，确定无复发生存（RFS）和总生存（OS）。MPV 的截断值为>8.5 fL（敏感性：67.1%，特异性：54.5%），PDW 的截断值为≤16%（敏感性：66.7%，特异性：60.0%）。
本研究纳入了 394 名患者，其中 53.3%为男性。Ⅰ期、Ⅱ期和Ⅲ期患者分别占研究人群的 8.9%、46.4%和 44.7%。在所有患者中，MPV≤8.5 fL 和 PDW>16 fL 的患者 RFS 和 OS 明显更长（MPV 分别为 p<0.001 和 p=0.011；PDW 分别为 p<0.001 和 p=0.026）。在Ⅲ期疾病患者中，MPV≤8.5 fL 的患者 RFS 和 OS 明显长于 MPV>8.5 fL 的患者（分别为 p<0.001 和 p=0.001）。另一方面，在Ⅲ期患者中，PDW>16%的患者 RFS 明显长于 PDW≤16 fL 的患者（p<0.001）。多因素分析显示，分期、神经周围侵犯、血管侵犯、辅助治疗、CEA、CA19-9、PDW 和 MPV 是影响 RFS 的最重要因素。
本研究表明，MPV 升高和 PDW 降低似乎是早期 CC 的不利预后因素，尤其是在Ⅲ期疾病患者中。鉴于这些指标的广泛可用性和可及性，有理由进行更大规模的前瞻性研究，以阐明和验证它们在早期 CC 中的潜在作用。
