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. 2019 Jul;18(1):571-580.
doi: 10.3892/ol.2019.10388. Epub 2019 May 21.

Prognostic evaluation of resectable colorectal cancer using platelet-associated indicators

Weihua Qian  1   2 , Xin-Xin Ge  1 , Jing Wu  1 , Fei-Ran Gong  3 , Meng-Yao Wu  1 , Meng-Dan Xu  1 , Lian Lian  1   4   5 , Wen-Jie Wang  1   6 , Wei Li  1   4   7 , Min Tao  1   7
Affiliations

Prognostic evaluation of resectable colorectal cancer using platelet-associated indicators

Weihua Qian et al. Oncol Lett. 2019 Jul.

Abstract

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.

Keywords: colorectal cancer; overall survival; platelet; platelet-associated indicators; prognosis.

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Figures

Figure 1.
Figure 1.
Pre-treatment PLT, PCT, MPV and PDW values are not associated with the outcome of patients with resectable colorectal cancer. The OS according to (A) PLT, (B) PCT, (C) MPV and (D) PDW. OS, overall survival; PLT, platelet count; PCT, plateletcrit; MPV, mean platelet volume; PDW, platelet distribution width.
Figure 2.
Figure 2.
Surgery significantly decreases the MPV value in patients with resectable colorectal cancer. Surgery had no influence on (A) PLT or (B) PCT. (C) Surgery significantly decreased the MPV of patients with colorectal cancer. (D) Surgery had no influence on the PDW. PLT, platelet count; PCT, plateletcrit; MPV, mean platelet volume; PDW, platelet distribution width.
Figure 3.
Figure 3.
Adjuvant chemotherapy significantly decreases the values of PLT and PCT, and increases MPV in patients with resectable CRC. Chemotherapy significantly decreased the (A) PLT and (B) PCT, and significantly increased the (C) MPV of patients with CRC. (D) Chemotherapy had no influence on the PDW of patients with CRC. CRC, colorectal cancer; PLT, platelet count; PCT, plateletcrit; MPV, mean platelet volume; PDW, platelet distribution width.
Figure 4.
Figure 4.
PLT, PCT and PDW values are significantly decreased in patients with CRC following a whole course of treatment. A whole course of treatment (surgery combined with adjuvant chemotherapy) significantly decreased the (A) PLT and (B) PCT of patients with CRC. Combined treatment had no influence on the (C) MPV, but significantly decreased the (D) PDW of patients with CRC. CRC, colorectal cancer; PLT, platelet count; PCT, plateletcrit; MPV, mean platelet volume; PDW, platelet distribution width.
Figure 5.
Figure 5.
Alterations in MPV following a whole course of treatment predict the outcomes of patients with resectable CRC. The OS of patients with CRC according to changes in (A) PLT, (B) PCT, (C) MPV and (D) PDW. CRC, colorectal cancer; PLT, platelet count; PCT, plateletcrit; MPV, mean platelet volume; PDW, platelet distribution width.
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