1
|
Schaubaecher JB, Smiljanov B, Haring F, Steiger K, Wu Z, Ugurluoglu A, Luft J, Ballke S, Mahameed S, Schneewind V, Hildinger J, Canis M, Mittmann LA, Braun C, Zuchtriegel G, Kaiser R, Nicolai L, Mack M, Weichert W, Lauber K, Uhl B, Reichel CA. Procoagulant platelets promote immune evasion in triple-negative breast cancer. Blood 2024; 144:216-226. [PMID: 38648571 DOI: 10.1182/blood.2023022928] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2023] [Revised: 04/03/2024] [Accepted: 04/08/2024] [Indexed: 04/25/2024] Open
Abstract
ABSTRACT Triple-negative breast cancer (TNBC) is an aggressive tumor entity in which immune checkpoint (IC) molecules are primarily synthesized in the tumor environment. Here, we report that procoagulant platelets bear large amounts of such immunomodulatory factors and that the presence of these cellular blood components in TNBC relates to protumorigenic immune-cell activity and impaired survival. Mechanistically, tumor-released nucleic acids attract platelets to the aberrant tumor microvasculature, where they undergo procoagulant activation, thus delivering specific stimulatory and inhibitory IC molecules. This concomitantly promotes protumorigenic myeloid leukocyte responses and compromises antitumorigenic lymphocyte activity, ultimately supporting tumor growth. Interference with platelet-leukocyte interactions prevented immune cell misguidance and suppressed tumor progression, nearly as effective as systemic IC inhibition. Hence, our data uncover a self-sustaining mechanism of TNBC by using platelets to misdirect immune-cell responses. Targeting this irregular multicellular interplay may represent a novel immunotherapeutic strategy for TNBC without the adverse effects of systemic IC inhibition.
Collapse
Affiliation(s)
- Johanna B Schaubaecher
- Walter Brendel Centre of Experimental Medicine, Ludwig-Maximilians-Universität University Hospital, Munich, Germany
- Department of Otorhinolaryngology, Ludwig-Maximilians-Universität University Hospital, Munich, Germany
| | - Bojan Smiljanov
- Walter Brendel Centre of Experimental Medicine, Ludwig-Maximilians-Universität University Hospital, Munich, Germany
- Department of Otorhinolaryngology, Ludwig-Maximilians-Universität University Hospital, Munich, Germany
| | - Florian Haring
- Walter Brendel Centre of Experimental Medicine, Ludwig-Maximilians-Universität University Hospital, Munich, Germany
- Department of Otorhinolaryngology, Ludwig-Maximilians-Universität University Hospital, Munich, Germany
| | - Katja Steiger
- Department of Pathology, Technical University Munich, Munich, Germany
| | - Zhengquan Wu
- Walter Brendel Centre of Experimental Medicine, Ludwig-Maximilians-Universität University Hospital, Munich, Germany
- Department of Otorhinolaryngology, Ludwig-Maximilians-Universität University Hospital, Munich, Germany
| | - Anais Ugurluoglu
- Walter Brendel Centre of Experimental Medicine, Ludwig-Maximilians-Universität University Hospital, Munich, Germany
- Department of Otorhinolaryngology, Ludwig-Maximilians-Universität University Hospital, Munich, Germany
| | - Joshua Luft
- Walter Brendel Centre of Experimental Medicine, Ludwig-Maximilians-Universität University Hospital, Munich, Germany
- Department of Otorhinolaryngology, Ludwig-Maximilians-Universität University Hospital, Munich, Germany
| | - Simone Ballke
- Department of Pathology, Technical University Munich, Munich, Germany
| | - Shaan Mahameed
- Walter Brendel Centre of Experimental Medicine, Ludwig-Maximilians-Universität University Hospital, Munich, Germany
- Department of Otorhinolaryngology, Ludwig-Maximilians-Universität University Hospital, Munich, Germany
| | - Vera Schneewind
- Walter Brendel Centre of Experimental Medicine, Ludwig-Maximilians-Universität University Hospital, Munich, Germany
- Department of Otorhinolaryngology, Ludwig-Maximilians-Universität University Hospital, Munich, Germany
| | - Jonas Hildinger
- Walter Brendel Centre of Experimental Medicine, Ludwig-Maximilians-Universität University Hospital, Munich, Germany
- Department of Otorhinolaryngology, Ludwig-Maximilians-Universität University Hospital, Munich, Germany
| | - Martin Canis
- Department of Otorhinolaryngology, Ludwig-Maximilians-Universität University Hospital, Munich, Germany
- Comprehensive Cancer Center, Munich Ludwig-Maximilians-Universität, Ludwig-Maximilians-Universität University Hospital, Munich, Germany
| | - Laura A Mittmann
- Walter Brendel Centre of Experimental Medicine, Ludwig-Maximilians-Universität University Hospital, Munich, Germany
- Department of Otorhinolaryngology, Ludwig-Maximilians-Universität University Hospital, Munich, Germany
| | - Constanze Braun
- Walter Brendel Centre of Experimental Medicine, Ludwig-Maximilians-Universität University Hospital, Munich, Germany
- Department of Otorhinolaryngology, Ludwig-Maximilians-Universität University Hospital, Munich, Germany
| | - Gabriele Zuchtriegel
- Walter Brendel Centre of Experimental Medicine, Ludwig-Maximilians-Universität University Hospital, Munich, Germany
- Department of Otorhinolaryngology, Ludwig-Maximilians-Universität University Hospital, Munich, Germany
| | - Rainer Kaiser
- Walter Brendel Centre of Experimental Medicine, Ludwig-Maximilians-Universität University Hospital, Munich, Germany
- Department of Medicine I, Ludwig-Maximilians-Universität University Hospital, Munich, Germany
- German Centre for Cardiovascular Research, Partner Site Munich Heart Alliance, Berlin, Germany
| | - Leo Nicolai
- Walter Brendel Centre of Experimental Medicine, Ludwig-Maximilians-Universität University Hospital, Munich, Germany
- Department of Medicine I, Ludwig-Maximilians-Universität University Hospital, Munich, Germany
- German Centre for Cardiovascular Research, Partner Site Munich Heart Alliance, Berlin, Germany
| | - Matthias Mack
- Department of Nephrology, University of Regensburg, Regensburg, Germany
| | - Wilko Weichert
- Department of Pathology, Technical University Munich, Munich, Germany
| | - Kirsten Lauber
- Department of Radiation Oncology, Ludwig-Maximilians-Universität University Hospital, Munich, Germany
| | - Bernd Uhl
- Walter Brendel Centre of Experimental Medicine, Ludwig-Maximilians-Universität University Hospital, Munich, Germany
- Department of Otorhinolaryngology, Ludwig-Maximilians-Universität University Hospital, Munich, Germany
| | - Christoph A Reichel
- Walter Brendel Centre of Experimental Medicine, Ludwig-Maximilians-Universität University Hospital, Munich, Germany
- Department of Otorhinolaryngology, Ludwig-Maximilians-Universität University Hospital, Munich, Germany
- Comprehensive Cancer Center, Munich Ludwig-Maximilians-Universität, Ludwig-Maximilians-Universität University Hospital, Munich, Germany
| |
Collapse
|
2
|
Jakab A, Patai ÁV, Darvas M, Tormássi-Bély K, Micsik T. Microenvironment, systemic inflammatory response and tumor markers considering consensus molecular subtypes of colorectal cancer. Pathol Oncol Res 2024; 30:1611574. [PMID: 38645565 PMCID: PMC11026638 DOI: 10.3389/pore.2024.1611574] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/04/2023] [Accepted: 03/12/2024] [Indexed: 04/23/2024]
Abstract
Introduction: Colorectal carcinomas (CRC) are one of the most frequent malignancies worldwide. Based on gene expression profile analysis, CRCs can be classified into four distinct subtypes also known as the consensus molecular subtypes (CMS), which predict biological behaviour. Besides CMS, several other aspects of tumor microenvironment (TME) and systemic inflammatory response (SIR) influence the outcome of CRC patients. TME and inflammation have important role in the immune (CMS1) and mesenchymal (CMS4) subtypes, however, the relationship between these and systemic inflammation has not been assessed yet. Our objective was to evaluate the connection between CMS, TME and SIR, and to analyze the correlation between these markers and routinely used tumor markers, such as CEA (Carcinoembryonic Antigen) and CA19-9 (Carbohydrate Antigen 19-9). Methods: FFPE (Formalin Fixed Paraffin Embedded) samples of 185 CRC patients were collected. TME was described using tumor-stroma ratio (TSR), Klintrup-Makinen (KM) grade, and Glasgow Microenvironment Score (GMS). CMS classification was performed on tissue microarray using MLH1, PMS2, MSH2 and MSH6, and pan-cytokeratin, CDX2, FRMD6, HTR2B and ZEB1 immunohistochemical stains. Pre-operative tumor marker levels and inflammatory markers [C-reactive protein - CRP, albumin, absolute neutrophil count (ANC), absolute lymphocyte count (ALC), absolute platelet count (APC)] and patient history were retrieved using MedSolution database. Results: Amongst TME-markers, TSR correlated most consistently with adverse clinicopathological features (p < 0.001) and overall survival (p < 0.001). Elevated CRP and modified Glasgow Prognostic Score (mGPS) were associated with worse outcome and aggressive phenotype, similarly to tumor markers CEA and CA19-9. Stroma-Tumor Marker score (STM score), a new combined score of CA19-9 and TSR delivered the second best prognostication after mGPS. Furthermore, CMS4 showed association with TSR and several laboratory markers (albumin and platelet derived factors), but not with other SIR descriptors. CMS did not show any association with CEA and CA19-9 tumor markers. Conclusion: More routinely available TME, SIR and tumor markers alone and in combination deliver reliable prognostic data for choosing the patients with higher risk for propagation. CMS4 is linked with high TSR and poor prognosis, but in overall, CMS-classification showed only limited effect on SIR- and tumor-markers.
Collapse
Affiliation(s)
- Anna Jakab
- Department of Pathology and Experimental Cancer Research, Semmelweis University, Budapest, Hungary
- Interdisciplinary Gastroenterology Working Group, Semmelweis University, Budapest, Hungary
| | - Árpád V. Patai
- Interdisciplinary Gastroenterology Working Group, Semmelweis University, Budapest, Hungary
- Department of Surgery, Transplantation and Gastroenterology, Semmelweis University, Budapest, Hungary
| | - Mónika Darvas
- Interdisciplinary Gastroenterology Working Group, Semmelweis University, Budapest, Hungary
- Department of Surgery, Transplantation and Gastroenterology, Semmelweis University, Budapest, Hungary
| | - Karolina Tormássi-Bély
- Department of Pathology and Experimental Cancer Research, Semmelweis University, Budapest, Hungary
- Interdisciplinary Gastroenterology Working Group, Semmelweis University, Budapest, Hungary
| | - Tamás Micsik
- Department of Pathology and Experimental Cancer Research, Semmelweis University, Budapest, Hungary
- Interdisciplinary Gastroenterology Working Group, Semmelweis University, Budapest, Hungary
- Saint George University Teaching Hospital of Fejér County, Székesfehérvár, Hungary
| |
Collapse
|
3
|
El Asmar A, Delcourt M, Kamden L, Khaled C, Bohlok A, Moreau M, Sclafani F, Donckier V, Liberale G. Prognostic Value of Preoperative Serological Biomarkers in Patients Undergoing Curative-Intent Cytoreductive Surgery for Colorectal Cancer Peritoneal Metastases. Ann Surg Oncol 2023; 30:1863-1869. [PMID: 36350459 PMCID: PMC9908702 DOI: 10.1245/s10434-022-12736-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2022] [Accepted: 10/13/2022] [Indexed: 11/11/2022]
Abstract
BACKGROUND Cytoreductive surgery (CRS) for peritoneal metastases of colorectal cancer (PMCRC) is associated with a high risk of postoperative morbidity, thus making patient selection of upmost importance. Further to data showing an association between preoperative serological biomarkers and patient outcome in various solid tumors, in this study we aim to evaluate their prognostic value in patients with PMCRC treated with curative intent. PATIENTS AND METHODS This is a retrospective study including patients with PMCRC treated by complete CRS ± HIPEC at our institution between 2011 and 2020. Preoperative serological biomarkers, along with other standard clinicopathological variables, were studied to determine their prognostic value. RESULTS A total of 94 out of 108 patients met the inclusion criteria. Forty-three patients (46%) presented with synchronous PM. The median peritoneal cancer index (PCI) was 6. On univariate analysis, a higher neutrophil-to-lymphocyte ratio (NLR) was associated with poor prognosis in terms of overall survival (OS) [cutoff 3.567, hazard ratio (HR) 2.8 (1.4-5.3), p = 0.002], whereas a higher platelet-to-lymphocyte ratio (PLR) predicted favorable prognosis in terms of disease-free survival (DFS) [cutoff 185.4, HR 1.9 (1.07-3.53), p = 0.030]. On multivariate analysis, NLR > 3.567, positive lymph nodes (LNs), and PCI > 7 were independent predictive factors for worse OS, whereas NLR > 3.567 and positive LNs were significantly associated with worse DFS. PLR > 185.4 was associated with better DFS. CONCLUSION High preoperative NLR (> 3.567) and PLR (> 185.4) can predict outcome of patients with PMCRC treated by complete CRS ± HIPEC.
Collapse
Affiliation(s)
- Antoine El Asmar
- Department of Surgical Oncology, Institut Jules Bordet, Université Libre de Bruxelles (ULB), Brussels, Belgium.
| | - Martin Delcourt
- Faculty of Medicine, Université Libre de Bruxelles (ULB), Brussels, Belgium
| | - Leonel Kamden
- Department of Surgical Oncology, Institut Jules Bordet, Université Libre de Bruxelles (ULB), Brussels, Belgium
| | - Charif Khaled
- Department of Surgical Oncology, Institut Jules Bordet, Université Libre de Bruxelles (ULB), Brussels, Belgium
| | - Ali Bohlok
- Department of Surgical Oncology, Institut Jules Bordet, Université Libre de Bruxelles (ULB), Brussels, Belgium
| | - Michel Moreau
- Department of Biostatistics, Institut Jules Bordet, Université Libre de Bruxelles (ULB), Brussels, Belgium
| | - Francesco Sclafani
- Department of Surgical Oncology, Institut Jules Bordet, Université Libre de Bruxelles (ULB), Brussels, Belgium
| | - Vincent Donckier
- Department of Surgical Oncology, Institut Jules Bordet, Université Libre de Bruxelles (ULB), Brussels, Belgium
| | - Gabriel Liberale
- Department of Surgical Oncology, Institut Jules Bordet, Université Libre de Bruxelles (ULB), Brussels, Belgium
| |
Collapse
|
4
|
Lee HS, Jung EJ, Kim JM, Kim JY, Kim JR, Kim TH, Jang JY, Woo JW, Lee J, Park T, Jeong SH. The usefulness of red blood cell distribution width and its ratio with platelet count in breast cancer after surgery and adjuvant treatment: a retrospective study. Gland Surg 2022; 11:1864-1873. [PMID: 36654946 PMCID: PMC9840999 DOI: 10.21037/gs-22-410] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2022] [Accepted: 12/06/2022] [Indexed: 12/24/2022]
Abstract
Background To date, red blood cell distribution width (RDW) and RDW-to-platelet count ratio (RPR) have been investigated for their association with cancer. This study aimed to investigate the prognostic value of RDW and RPR in breast cancer before and after treatment. Methods We retrospectively enrolled 395 patients with breast cancer, who were diagnosed between December 2009 and December 2015 and analyzed the association between RDW, RPR, and long-term prognosis. We also compared the RDW and RPR values with the pathologic parameters of breast cancer. The cutoff values for before-treatment RDW, RPR value, after-treatment RDW, and RPR were determined using receiver operating characteristic (ROC) curve analysis by identifying the highest Youden index. Results In the before-treatment state, no significant disease-free survival (DFS) or overall survival (OS) was found in the RPR and RDW values. However, we found that elevated after-treatment RPR and RDW were significant prognostic factors for DFS, with hazard ratios (HRs) of 2.233 [95% confidence interval (CI): 1.073-4.649; P=0.032] and 2.067 (95% CI: 1.085-3.937; P=0.027). Kaplan-Meier analysis indicated that the after-treatment RPR and RDW groups had poor OS (HR =30.461; 95% CI: 5.138-180.575; P<0.001) compared with the lower after-treatment RPR and RDW groups. In particular, when the RPR and RDW were in the lower group before the treatment and became elevated after the treatment, it showed a remarkably significant result for OS, with HR 132.6 (95% CI: 3.689-4,767.341; P=0.007) and 10.119 (95% CI: 1.853-55.249; P=0.008). Conclusions Thus, after-treatment RPR and RDW could have prognostic value for breast cancer after surgery and adjuvant treatment.
Collapse
Affiliation(s)
- Han Shin Lee
- Department of Surgery, Gyeongsang National University Changwon Hospital, Gyeongsang National University College of Medicine, Changwon, Korea
| | - Eun Jung Jung
- Department of Surgery, Gyeongsang National University Changwon Hospital, Gyeongsang National University College of Medicine, Changwon, Korea
| | - Jae Myung Kim
- Department of Surgery, Gyeongsang National University Hospital, Gyeongsang National University School of College, Jinju, Korea
| | - Ju Yeon Kim
- Department of Surgery, Gyeongsang National University Hospital, Gyeongsang National University School of College, Jinju, Korea
| | - Jae Ri Kim
- Department of Surgery, Gyeongsang National University Changwon Hospital, Gyeongsang National University College of Medicine, Changwon, Korea
| | - Tae Han Kim
- Department of Surgery, Gyeongsang National University Changwon Hospital, Gyeongsang National University College of Medicine, Changwon, Korea
| | - Jae Yool Jang
- Department of Surgery, Gyeongsang National University Changwon Hospital, Gyeongsang National University College of Medicine, Changwon, Korea
| | - Jung Woo Woo
- Department of Surgery, Gyeongsang National University Changwon Hospital, Gyeongsang National University College of Medicine, Changwon, Korea
| | - Jinkwon Lee
- Department of Surgery, Gyeongsang National University Changwon Hospital, Gyeongsang National University College of Medicine, Changwon, Korea
| | - Taejin Park
- Department of Surgery, Gyeongsang National University Changwon Hospital, Gyeongsang National University College of Medicine, Changwon, Korea
| | - Sang-Ho Jeong
- Department of Surgery, Gyeongsang National University Changwon Hospital, Gyeongsang National University College of Medicine, Changwon, Korea
| |
Collapse
|
5
|
Chen M, Hou L, Hu L, Tan C, Wang X, Bao P, Ran Q, Chen L, Li Z. Platelet detection as a new liquid biopsy tool for human cancers. Front Oncol 2022; 12:983724. [PMID: 36185270 PMCID: PMC9515491 DOI: 10.3389/fonc.2022.983724] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2022] [Accepted: 08/09/2022] [Indexed: 12/16/2022] Open
Abstract
Cancer is still a leading cause of death worldwide and liquid biopsy is a powerful tool that can be applied to different stages of cancer screening and treatment. However, as the second most abundant cell type in the bloodstream, platelets are isolated through well-established and fast methods in clinic but their value as a BioSource of cancer biomarkers is relatively recent. Many studies demonstrated the bidirectional interaction between cancer cells and platelets. Platelets transfer various proteins (e.g., growth factors, cytokine, chemokines) and RNAs (e.g., mRNA, lncRNA, miRNA, circRNA) into the tumor cells and microenvironment, leading the stimulation of tumor growth and metastasis. In turn, the platelet clinical characteristics (e.g., count and volume) and contents (e.g., RNA and protein) are altered by the interactions with cancer cells and this enables the early cancer detection using these features of platelets. In addition, platelet-derived microparticles also demonstrate the prediction power of being cancer biomarkers. In this review, we focus on the clinical applications of platelet detection using the platelet count, mean platelet volume, platelet RNA and protein profiles for human cancers and discuss the gap in bringing these implementations into the clinic.
Collapse
Affiliation(s)
- Maoshan Chen
- Laboratory of Radiation Biology, Department of Blood Transfusion, Laboratory Medicine Centre, The Second Affiliated Hospital, Army Medical University, Chongqing, China
- *Correspondence: Maoshan Chen, ; Li Chen, ; Zhongjun Li,
| | - Lijia Hou
- Laboratory of Radiation Biology, Department of Blood Transfusion, Laboratory Medicine Centre, The Second Affiliated Hospital, Army Medical University, Chongqing, China
| | - Lanyue Hu
- Laboratory of Radiation Biology, Department of Blood Transfusion, Laboratory Medicine Centre, The Second Affiliated Hospital, Army Medical University, Chongqing, China
| | - Chengning Tan
- Laboratory of Radiation Biology, Department of Blood Transfusion, Laboratory Medicine Centre, The Second Affiliated Hospital, Army Medical University, Chongqing, China
| | - Xiaojie Wang
- Laboratory of Radiation Biology, Department of Blood Transfusion, Laboratory Medicine Centre, The Second Affiliated Hospital, Army Medical University, Chongqing, China
| | - Peipei Bao
- Laboratory of Radiation Biology, Department of Blood Transfusion, Laboratory Medicine Centre, The Second Affiliated Hospital, Army Medical University, Chongqing, China
| | - Qian Ran
- Laboratory of Radiation Biology, Department of Blood Transfusion, Laboratory Medicine Centre, The Second Affiliated Hospital, Army Medical University, Chongqing, China
| | - Li Chen
- Laboratory of Radiation Biology, Department of Blood Transfusion, Laboratory Medicine Centre, The Second Affiliated Hospital, Army Medical University, Chongqing, China
- *Correspondence: Maoshan Chen, ; Li Chen, ; Zhongjun Li,
| | - Zhongjun Li
- Laboratory of Radiation Biology, Department of Blood Transfusion, Laboratory Medicine Centre, The Second Affiliated Hospital, Army Medical University, Chongqing, China
- State Key Laboratory of Trauma, Burns and Combined Injuries, The Second Affiliated Hospital, Army Medical University, Chongqing, China
- *Correspondence: Maoshan Chen, ; Li Chen, ; Zhongjun Li,
| |
Collapse
|
6
|
Associations of Complete Blood Count Parameters with Disease-Free Survival in Right- and Left-Sided Colorectal Cancer Patients. J Pers Med 2022; 12:jpm12050816. [PMID: 35629238 PMCID: PMC9146340 DOI: 10.3390/jpm12050816] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2022] [Revised: 05/12/2022] [Accepted: 05/13/2022] [Indexed: 02/01/2023] Open
Abstract
Colorectal cancer (CRC) is a leading cause of cancer-related deaths worldwide. Some complete blood count (CBC) parameters are found to be associated with CRC prognosis. In this study, ninety-seven pretreated CRC patients were included, and the patients were divided into two groups: left-sided and right-sided, depending on the anatomical location of the tumor. Based on clinicopathologic features including tumor budding, disease stages, and tumor anatomical location, levels of CBC parameters were compared, and disease-free survivals (DFS) were determined. There were differences between patients with different tumor budding scores for only three parameters, including red cell distribution width (RDW), numbers of platelets, and mean platelet volume (MPV). Furthermore, numbers of WBCs, monocytes, and MPV in CRC patients with early disease stages were higher than those with advanced stages. However, levels of eosinophil in CRC patients with advanced stages were higher than those with early stages. Depending on the tumor anatomical location, we observed that numbers of red blood cells (RBCs), hemoglobin (Hgb), and hematocrit (Hct) in CRC patients with left-sided tumors were higher than those with right-sided tumors. We found that low levels of MPV were associated with shorter DFS. However, high levels of eosinophils were associated with shorter DFS in all CRC patients. When patients were divided based on the tumor anatomical location, higher levels of MPV, MCHC, and Hgb were associated with better DFS in the left-sided but not right-sided CRC patients. However, left-sided, but not right-sided, CRC patients with high levels of eosinophil and RDW had shorter DFS. Furthermore, right-sided, but not left-sided, CRC patients with high levels of platelets tended to have a shorter DFS. Our data show that MPV and eosinophils could serve as potential prognostic biomarkers in pre-treatment CRC patients, regardless of the tumor anatomical location. Additionally, lower levels of MPV, MCHC, and Hgb, and high levels of eosinophils and RDW could be negative predictive biomarkers in left-sided CRC patients.
Collapse
|
7
|
Saito H, Shimizu S, Shishido Y, Miyatani K, Matsunaga T, Fujiwara Y. Prognostic significance of the combination of preoperative red cell distribution width and platelet distribution width in patients with gastric cancer. BMC Cancer 2021; 21:1317. [PMID: 34879841 PMCID: PMC8656051 DOI: 10.1186/s12885-021-09043-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2021] [Accepted: 11/15/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Platelet distribution width (PDW) and red cell distribution width (RDW) are readily obtainable data, and are reportedly useful as prognostic indicators in some cancers. However, their prognostic significance is unclear in gastric cancer (GC). METHODS We enrolled 445 patients with histopathological diagnoses of gastric adenocarcinoma who had undergone curative surgeries. RESULTS According to the optimal cut-off value of PDW and RDW by receiver operating characteristic (ROC) analysis, we divided patients into PDWHigh (≥ 16.75%), PDWLow (< 16.75%), RDWHigh (≥ 14.25%), and RDWLow (< 14.25%) subgroups. Overall survival (OS) was significantly worse in patients with PDWHigh than in those with PDWLow (P = 0.0015), as was disease specific survival (P = 0.043). OS was also significantly worse in patients with RDWHigh than in those with RDWLow (P < 0.0001), as was disease specific survival (P = 0.0002). Multivariate analysis for OS revealed that both PDW and RDW were independent prognostic indicators. Patients were then given PDW-RDW score by adding points for their different subgroups (1 point each for PDWHigh and RDWHigh; 0 points for PDWLow and RDWLow). OS significantly differed by PDW-RDW score (P < 0.0001), as did disease specific survival (P = 0.0005). In multivariate analysis for OS, PDW-RDW score was found to be an independent prognostic indicator. CONCLUSIONS The prognosis of GC patients can be precisely predictable by using both PDW and RDW.
Collapse
Affiliation(s)
- Hiroaki Saito
- Department of Surgery, Japanese Red Cross Tottori Hospital, 117 Shotoku-cho, Tottori, 680-8517, Japan. .,Division of Gastrointestinal and Pediatric Surgery, Department of Surgery, School of Medicine, Tottori University Faculty of Medicine, 36-1 Nishi-cho, Yonago, 683-8504, Japan.
| | - Shota Shimizu
- Division of Gastrointestinal and Pediatric Surgery, Department of Surgery, School of Medicine, Tottori University Faculty of Medicine, 36-1 Nishi-cho, Yonago, 683-8504, Japan
| | - Yuji Shishido
- Division of Gastrointestinal and Pediatric Surgery, Department of Surgery, School of Medicine, Tottori University Faculty of Medicine, 36-1 Nishi-cho, Yonago, 683-8504, Japan
| | - Kozo Miyatani
- Division of Gastrointestinal and Pediatric Surgery, Department of Surgery, School of Medicine, Tottori University Faculty of Medicine, 36-1 Nishi-cho, Yonago, 683-8504, Japan
| | - Tomoyuki Matsunaga
- Division of Gastrointestinal and Pediatric Surgery, Department of Surgery, School of Medicine, Tottori University Faculty of Medicine, 36-1 Nishi-cho, Yonago, 683-8504, Japan
| | - Yoshiyuki Fujiwara
- Division of Gastrointestinal and Pediatric Surgery, Department of Surgery, School of Medicine, Tottori University Faculty of Medicine, 36-1 Nishi-cho, Yonago, 683-8504, Japan
| |
Collapse
|
8
|
Adams R, Goey K, Chibaudel B, Koopman M, Punt C, Arnold D, Hinke A, Hegewisch-Becker S, de Gramont A, Labianca R, Diaz Rubio E, Magne Tveit K, Wasan H, Kaplan R, Brown L, Maughan T, Fisher D. Treatment breaks in first line treatment of advanced colorectal cancer: An individual patient data meta-analysis. Cancer Treat Rev 2021; 99:102226. [PMID: 34130171 DOI: 10.1016/j.ctrv.2021.102226] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2021] [Revised: 05/11/2021] [Accepted: 05/15/2021] [Indexed: 12/16/2022]
Abstract
BACKGROUND Intermittent systemic anti-cancer therapy in patients with advanced colorectal cancer (aCRC) may improve quality of life without compromising overall survival (OS). We aimed to use individual patient data meta-analysis (IPDMA) from multiple randomised controlled trials evaluating intermittent strategies to inform clinical practice. We also aimed to validate whether thrombocytosis as a predictive biomarker identified patients with significantly reduced OS receiving a complete treatment break. PATIENTS AND METHODS An IPDMA of intermittent strategy impact on survival was undertaken, including all relevant trials in which data were available. Intermittent strategies were classified into two groups: a planned stopping of all therapy ("treatment break strategy"; 6 trials; 2,907 patients) or to the same treatment omitting oxaliplatin ("maintenance strategy"; 3 trials; 1,271 patients). The primary analysis sample was of patients successfully completing induction therapy. Additionally, a pre-planned analysis of the predictive value of thrombocytosis on survival under a continuous versus an intermittent strategy was undertaken. RESULTS All trials had comparable inclusion criteria. The overall IPDMA of intermittent therapy versus continuous therapy demonstrated no detriment in OS (HR = 1.03 [95% CI 0.93-1.14]), whether from complete break (HR 1.04 [95% CI 0.87-1.26]) or maintenance strategies (HR 0.99 [95% CI 0.87-1.13]). Thrombocytosis was confirmed as a marker of poor prognosis in aCRC, but did not predict for OS detriment from treatment break strategies (interaction HR = 0.97 [95% CI 0.66-1.40] compared to continuous therapy). CONCLUSION The highest levels of evidence from this IPDMA indicate no detriment in survival for patients receiving an intermittent therapy strategy, either for maintenance or complete break strategies. Although, thrombocytosis is confirmed as a marker of poor prognosis, it is not predictive of poor outcome for patients treated with intermittent therapy. An intermittent chemotherapy strategy can therefore be applied irrespective of baseline platelet count and does not result in inferior OS compared to continuous chemotherapy.
Collapse
Affiliation(s)
- Richard Adams
- Cardiff University and Velindre Cancer Centre, United Kingdom.
| | - Kaitlyn Goey
- University Medical Center, Utrecht, the Netherlands.
| | | | | | - Cornelis Punt
- Julius Center for Health Sciences and Primary Care, University Medical Center, Utrecht University, the Netherlands.
| | - Dirk Arnold
- Asklepios Tumorzentrum Hamburg, Germany and Instituto CUF de Oncologia, Lisbon, Portugal.
| | | | | | | | | | | | | | | | | | - Louise Brown
- MRC Clinical Trials Unit at UCL, United Kingdom.
| | | | - David Fisher
- MRC Clinical Trials Unit at UCL, United Kingdom.
| |
Collapse
|
9
|
Erdur E, Yildirim OA, Poyraz K, Aslan F, Yıldız F, Kömek H. The role of inflammatory parameters in predicting disease recurrence in patients with stage IIA colon cancer with no high-risk features. Postgrad Med 2021; 133:694-700. [PMID: 34030576 DOI: 10.1080/00325481.2021.1934493] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
OBJECTIVE We aimed to investigate the roles of inflammatory parameters, including neutrophil/lymphocyte ratio (NLR), platelet/lymphocyte ratio (PLR), lymphocyte/monocyte ratio (LMR), and C-reactive protein/albumin ratio (CAR), in predicting disease recurrence in patients with stage IIA (T3N0M0) high microsatellite instability and microsatellite-stable colon cancer who had no risk factors associated with relapse. MATERIALS AND METHODS We evaluated 155 patients with colon cancer followed in 3 hospitals in Turkey between February 2009 and March 2020. These patients had stage IIA disease and had no risk factors associated with relapse. None of the patients received adjuvant chemotherapy. NLR, PLR, LMR, and CAR parameters were retrospectively obtained from laboratory results at the time of diagnosis, and their associations with disease recurrence were assessed. RESULTS Over a median follow-up period of 38 months (range: 4-98 months), 11 of the 155 patients experienced relapse or developed metastases. Multivariate Cox analyses revealed that NLRs of ≥3.12 (hazard ratio [HR]: 0.041, 95% confidence interval [CI]: 0.048-0.826, p = 0.006) and CARs of ≥0.027 (HR: 0.199, 95% CI: 0.004-0.404, p = 0.026) were independent prognostic markers predicting relapse. The median 5-year recurrence-free survival rate of patients with NLRs of ≥3.12 at the time of diagnosis was 88.0%; this rate was 100% in patients with NLRs of <3.12 (p < 0.001). Similarly, the median 5-year recurrence-free survival rate of patients with CARs of ≥0.027 at the time of diagnosis was 84.7%; this rate was 95.7% in patients with CARs of <0.027 (p = 0.016). CONCLUSION In this study, NLR and CAR were found to be independent prognostic markers predicting disease recurrence in patients with stage IIA colon cancer who did not receive adjuvant chemotherapy due to low clinical risk.
Collapse
Affiliation(s)
- Erkan Erdur
- Department of Internal Medicine, Division of Medical Oncology, Gazi Yasargil Training and Research Hospital, Diyarbakir, Turkey
| | - Ozgen Ahmet Yildirim
- Department of Internal Medicine, Division of Medical Oncology, Gazi Yasargil Training and Research Hospital, Diyarbakir, Turkey
| | - Kerem Poyraz
- Department of Radiation Oncology, Gazi Yasargil Training and Research Hospital, Diyarbakir, Turkey
| | - Ferit Aslan
- Medical Oncology Department, Medical Park Ankara Hospital, Ankara, Turkey
| | - Fatih Yıldız
- Medical Oncology, Abdurrahman Yurtaslan Ankara Oncology Training and Research Hospital, Ankara, Turkey
| | - Halil Kömek
- Department of Nuclear Medicine, Gazi Yasargil Training and Research Hospital, Diyarbakir, Turkey
| |
Collapse
|
10
|
Kong W, Yang M, Zhang J, Cheng Y, Dai T, Zhang J, Wang G, Zhang J. Prognostic value of inflammation-based indices in patients with resected hepatocellular carcinoma. BMC Cancer 2021; 21:469. [PMID: 33906632 PMCID: PMC8077869 DOI: 10.1186/s12885-021-08153-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2020] [Accepted: 04/06/2021] [Indexed: 01/20/2023] Open
Abstract
Background As is well recognized that inflammation plays a crucial role in the genesis and progression of various cancer. Here we investigate the prognostic value of a novel index: the combination of neutrophil to lymphocyte ratio and platelet distribution width (coNLR-PDW) in post-operation patients with resectable hepatocellular carcinoma (HCC). Methods The receiver operating characteristic (ROC) curve was utilized to determine the optimal cutoff values of continuous variables, including the neutrophil-lymphocyte ratio (NLR) and platelet distribution width (PDW). Kaplan-Meier method and the Log-rank test were used to compare survival differences across three groups stratified by the coNLR-PDW score. Univariate and multivariate Cox proportional hazard regression analyses were adopted to identify independent factors of HCC patient’s prognosis. Results 1.59 and 13.0 were perceived as the optimal cutoff value for NLR and PDW based on the ROC curve, respectively. Kaplan-Meier method revealed that a higher coNLR-PDW score predicts poorer overall survival (OS) and disease-free survival (DFS) (P < 0.001). coNLR-PDW was demonstrated as an independent factor for both OS and DFS using Cox regression analysis in training and validation cohort. Conclusion coNLR-PDW is recognized as a valuable biomarker for predicting the survival of patients with HCC. Supplementary Information The online version contains supplementary material available at 10.1186/s12885-021-08153-4.
Collapse
Affiliation(s)
- Weihao Kong
- Department of Emergency Surgery, Department of Emergency Medicine, the First affiliated hospital of Anhui Medical University, 218 Jixi Avenue, Hefei, 230022, China
| | - Mingwei Yang
- Department of Radiation Oncology, the First affiliated hospital of Anhui Medical University, Hefei, China
| | - Jianfeng Zhang
- Department of Hepatic Surgery and Liver Transplantation Center, the Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, 510630, China
| | - Ya Cheng
- Department of Emergency Surgery, Department of Emergency Medicine, the First affiliated hospital of Anhui Medical University, 218 Jixi Avenue, Hefei, 230022, China
| | - Tianxing Dai
- Department of Hepatic Surgery and Liver Transplantation Center, the Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, 510630, China
| | - Jian Zhang
- Department of Hepatic Surgery and Liver Transplantation Center, the Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, 510630, China.,Organ Transplantation Institute of Sun Yat-sen University, Guangzhou, China
| | - Guoying Wang
- Department of Hepatic Surgery and Liver Transplantation Center, the Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, 510630, China. .,Department of Hepatobiliary Surgery, the First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China.
| | - Jianlin Zhang
- Department of Emergency Surgery, Department of Emergency Medicine, the First affiliated hospital of Anhui Medical University, 218 Jixi Avenue, Hefei, 230022, China.
| |
Collapse
|
11
|
Yagyu T, Saito H, Sakamoto T, Uchinaka E, Morimoto M, Hanaki T, Watanabe J, Matsunaga T, Yamamoto M, Tokuyasu N, Honjo S, Fujiwara Y. Decreased mean platelet volume predicts poor prognosis in patients with pancreatic cancer. BMC Surg 2021; 21:8. [PMID: 33407353 PMCID: PMC7788764 DOI: 10.1186/s12893-020-00976-5] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2020] [Accepted: 11/19/2020] [Indexed: 01/05/2023] Open
Abstract
Background Decreased mean platelet volume (MPV) predicts poor prognosis in some cancers. However, its significance as a prognostic indicator in pancreatic cancer (PC) remains unclear. Methods A total of 91 PC patients who underwent pancreatectomy were included in this study. MPV and serum carbohydrate antigen 19-9 (CA19-9) were measured within 1 week before surgery. Results We divided patients into MPVhigh (≥ 8.65; n = 40), MPVlow (< 8.65; n = 51), CA19-9high (≥ 66.3; n = 47), and CA19-9low (< 66.3; n = 44) groups based on the optimal cut-off values determined from receiver operating characteristic curve analysis. The 5-year overall survival (OS) rates were significantly lower in the MPVlow than in the MPVhigh group (16.9% and 56.3%, respectively; P = 0.0038), and the 5-year disease-specific survival (DSS) rates in the MPVlow group and MPVhigh group were 20.5% and 62.2%, respectively (P = 0.0031). Multivariate analysis identified MPV as an independent prognostic indicator for both OS and DSS. The patients were then divided into groups A (MPVhigh and CA19-9low), B (MPVhigh and CA19-9high), C (MPVlow and CA19-9low), and D (MPVlow and CA19-9high), with 5-year OS rates of 73.2%, 40.4%, 25.8%, and 10.3%, respectively (P = 0.0002), and 5-year DSS rates of 80.8%, 44.9%, 27.3%, and 16.4%, respectively (P = 0.0003). Conclusions Classification based on MPV and CA19-9 might be useful for predicting long-term outcomes in patients with PC.
Collapse
Affiliation(s)
- Takuki Yagyu
- Division of Gastrointestinal and Pediatric Surgery, Department of Surgery, School of Medicine, Faculty of Medicine, Tottori University, Tottori, Japan
| | - Hiroaki Saito
- Department of Surgery, Japanese Red Cross Tottori Hospital, 117 Shotoku-cho, Tottori, 680-8517, Japan.
| | - Teruhisa Sakamoto
- Division of Gastrointestinal and Pediatric Surgery, Department of Surgery, School of Medicine, Faculty of Medicine, Tottori University, Tottori, Japan
| | - Ei Uchinaka
- Division of Gastrointestinal and Pediatric Surgery, Department of Surgery, School of Medicine, Faculty of Medicine, Tottori University, Tottori, Japan
| | - Masaki Morimoto
- Division of Gastrointestinal and Pediatric Surgery, Department of Surgery, School of Medicine, Faculty of Medicine, Tottori University, Tottori, Japan
| | - Takehiko Hanaki
- Division of Gastrointestinal and Pediatric Surgery, Department of Surgery, School of Medicine, Faculty of Medicine, Tottori University, Tottori, Japan
| | - Joji Watanabe
- Division of Gastrointestinal and Pediatric Surgery, Department of Surgery, School of Medicine, Faculty of Medicine, Tottori University, Tottori, Japan
| | - Tomoyuki Matsunaga
- Division of Gastrointestinal and Pediatric Surgery, Department of Surgery, School of Medicine, Faculty of Medicine, Tottori University, Tottori, Japan
| | - Manabu Yamamoto
- Division of Gastrointestinal and Pediatric Surgery, Department of Surgery, School of Medicine, Faculty of Medicine, Tottori University, Tottori, Japan
| | - Naruo Tokuyasu
- Division of Gastrointestinal and Pediatric Surgery, Department of Surgery, School of Medicine, Faculty of Medicine, Tottori University, Tottori, Japan
| | - Soichiro Honjo
- Division of Gastrointestinal and Pediatric Surgery, Department of Surgery, School of Medicine, Faculty of Medicine, Tottori University, Tottori, Japan
| | - Yoshiyuki Fujiwara
- Division of Gastrointestinal and Pediatric Surgery, Department of Surgery, School of Medicine, Faculty of Medicine, Tottori University, Tottori, Japan
| |
Collapse
|
12
|
Zabłocka-Słowińska K, Prescha A, Płaczkowska S, Porębska I, Kosacka M, Pawełczyk K. Serum and Whole Blood Cu and Zn Status in Predicting Mortality in Lung Cancer Patients. Nutrients 2020; 13:nu13010060. [PMID: 33375477 PMCID: PMC7824662 DOI: 10.3390/nu13010060] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2020] [Revised: 12/16/2020] [Accepted: 12/22/2020] [Indexed: 12/16/2022] Open
Abstract
Alterations in circulating Cu and Zn are negative predictors of survival in neoplastic patients and are known during lung cancer. However, no data on predicting mortality of lung cancer patients based on the level of these elements in the blood have been presented to date. The aims of this prospective cohort study were as follows: (i) To evaluate the disturbances in serum and whole blood Cu and Zn, (ii) to assess the relationships between serum and whole blood Cu and Zn status and clinical, sociodemographic, and nutritional data, and (iii) to investigate the association of Cu and Zn status with all-cause mortality in lung cancer. Naïve-treatment lung cancer patients (n = 167) were characterized in terms of sociodemographic, clinical, and anthropometric data and dietary intake and compared with sex-matched control subjects (n = 48). Whole blood and serum Cu and Zn status was determined by atomic absorption spectrometry. Cox proportional hazards models adjusted for multiple confounders/mediators were used to estimate the association between all-cause death and Cu and Zn status. Sex, cardiovascular disease, chronic obstructive pulmonary disease, clinical stage, and hemoglobin, platelet, and glucose concentrations significantly differentiated Cu and Zn status. All-cause mortality in lung cancer patients was positively associated with serum Cu levels, Cu:Zn ratio, and whole blood Zn levels. However, an advanced clinical stage of disease was the strongest predictor of all-cause mortality. Circulatory status of Cu and Zn might be included in routine clinical characteristics of patients with lung cancer patients as additional prognostic variables, but only after further more detail studies.
Collapse
Affiliation(s)
- Katarzyna Zabłocka-Słowińska
- Department of Food Science and Dietetics, Wroclaw Medical University, ul. Borowska 211, 50-556 Wroclaw, Poland;
- Correspondence:
| | - Anna Prescha
- Department of Food Science and Dietetics, Wroclaw Medical University, ul. Borowska 211, 50-556 Wroclaw, Poland;
| | - Sylwia Płaczkowska
- Diagnostics Laboratory for Teaching and Research, Department of Laboratory Diagnostics Wroclaw Medical University, ul. Borowska 211a, 50-556 Wroclaw, Poland;
| | - Irena Porębska
- Department and Clinic of Pulmonology and Lung Cancers, Wroclaw Medical University, ul. Grabiszynska 105, 53-439 Wroclaw, Poland; (I.P.); (M.K.)
| | - Monika Kosacka
- Department and Clinic of Pulmonology and Lung Cancers, Wroclaw Medical University, ul. Grabiszynska 105, 53-439 Wroclaw, Poland; (I.P.); (M.K.)
| | - Konrad Pawełczyk
- Department and Clinic of Thoracic Surgery, Wroclaw Medical University, ul. Grabiszynska 105, 53-439 Wroclaw, Poland;
| |
Collapse
|
13
|
Liu S, Fang J, Jiao D, Liu Z. The predictive value of inflammatory markers for pathological response of ipsilateral supraclavicular lymph nodes and for prognosis in breast cancer after neoadjuvant chemotherapy. Gland Surg 2020; 9:1354-1362. [PMID: 33224810 DOI: 10.21037/gs-20-341] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Background Inflammatory tumor microenvironment is closely related to cancer. In this study, we mainly explore the predictive value of inflammatory markers for pathological response of ipsilateral supraclavicular lymph nodes (ISLN) and for prognosis in breast cancer with ISLN metastasis after neoadjuvant chemotherapy (NAC). Methods In this study, 117 breast cancer patients with ISLN metastasis were collected from the Affiliated Hospital of Zhengzhou University. The best cut-off value was determined by using the receiver operating characteristics (ROC) curve. Chi-square test and binary Logistic regression were used to analyze the correlation between clinical pathological data and pathological response of ISLN and to determine independent predictors. Correlation analysis between inflammatory markers and prognosis used time-dependent COX regression. Results The pathological complete response (pCR) rate of ISLN after NAC was 64.4%. Multivariate analysis showed that breast pCR (OR 9.67, 95% CI: 2.64-35.31, P<0.01) was an independent predictor of ISLN pathological response after NAC. After a median follow-up of 25 months, multivariate time-dependent COX results showed that higher platelet levels were correlated with poor disease-free survival (DFS) (HR 1.008, 95% CI: 1.001-1.015, P=0.028). Meanwhile, menopausal status (HR 0.35, 95% CI: 0.15-0.79, P=0.01) and supraclavicular pCR (HR 0.33, 95% CI: 0.15-0.77, P=0.01) were also independent predictors of DFS. Conclusions Peripheral blood inflammatory markers have limited predictive value for pathological response of ISLN after NAC for breast cancer. High platelet count is associated with poor prognosis of breast cancer patients with ISLN metastasis.
Collapse
Affiliation(s)
- Shaoqing Liu
- Department of Breast surgery, Breast Cancer Center, Affiliated Cancer Hospital of Zhengzhou University, Zhengzhou, China
| | - Jing Fang
- Department of Breast surgery, Breast Cancer Center, Affiliated Cancer Hospital of Zhengzhou University, Zhengzhou, China
| | - Dechuang Jiao
- Department of Breast surgery, Breast Cancer Center, Affiliated Cancer Hospital of Zhengzhou University, Zhengzhou, China
| | - Zhenzhen Liu
- Department of Breast surgery, Breast Cancer Center, Affiliated Cancer Hospital of Zhengzhou University, Zhengzhou, China
| |
Collapse
|
14
|
The Mechanisms of Sijunzi Decoction in the Treatment of Chronic Gastritis Revealed by Network Pharmacology. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2020; 2020:8850259. [PMID: 33149755 PMCID: PMC7603597 DOI: 10.1155/2020/8850259] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/13/2020] [Revised: 10/05/2020] [Accepted: 10/14/2020] [Indexed: 02/08/2023]
Abstract
Chronic gastritis is characterized by inflammation in the gastric mucosa with a vicious circle in inflammatory cells and inflammatory mediators. Stomach adenocarcinoma would occur in the metaplastic gastric mucosa of chronic gastritis. Sijunzi decoction is a famous classical formula for the treatment of chronic gastritis. Although previous studies revealed some functions of Sijunzi decoction in treating chronic gastritis, the underlying mechanisms have not been illustrated clearly. In this study, we used network pharmacology to investigate the mechanism of Sijunzi decoction in treating chronic gastritis. Firstly, online datasets TCMSP, SWISS, and DisGeNET were used to investigate the functional mechanism of Sijunzi decoction against chronic gastritis and 18 genes were identified as targets of Sijunzi decoction in chronic gastritis. These 18 genes can be categorized into immunologically related genes and cancer-related genes. GO analysis showed that the 18 target genes were mainly enriched in angiogenesis, nitric oxide biosynthetic process, ERK1 and ERK2 cascade, cellular response to drug, and MAPK cascade. So, Sijunzi decoction alleviated chronic gastritis by inhibiting the local inflammatory response. Furthermore, we also investigated the impact of Sijunzi decoction on the peripheral blood leukocytes with our own RNA sequencing (RNA-seq) data of 11 chronic superficial gastritis patients. 102 differentially expressed genes (DEGs) were identified by comparing RNA-seq data of chronic superficial gastritis patients with healthy control groups. After performing a functional analysis on 102 DEGs and Sijunzi decoction potential targets and taking the intersection of these pathways, we found that platelet activation, angiogenesis, and pathways in cancer were candidate target pathways regulated by Sijunzi decoction. Thus, Sijunzi decoction also alleviates chronic gastritis by suppressing inflammatory response of peripheral blood leukocytes. Our results showed that Sijunzi decoction can ameliorate the local gastric inflammation and inflammations in peripheral blood leukocytes and might also reduce the incidence of stomach cancer in chronic gastritis.
Collapse
|
15
|
Li M, Bai J, Wang S, Zhai Y, Zhang S, Li C, Du J, Zhang Y. Mean platelet volume and platelet distribution width serve as prognostic biomarkers in skull base chordoma: a retrospective study. BMC Cancer 2020; 20:988. [PMID: 33046024 PMCID: PMC7552483 DOI: 10.1186/s12885-020-07497-7] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2020] [Accepted: 10/06/2020] [Indexed: 02/07/2023] Open
Abstract
Background Increasing studies have demonstrated that activated platelets play an essential role in tumour progression. However, the level and prognostic role of platelet indices in chordoma patients remain unclear. The aim of the current study was to characterize the prognostic performance of platelet count (PLT), mean platelet volume (MPV) and platelet distribution width (PDW) in skull base chordoma patients. Methods 187 primary skull base chordoma patients between January 2008 and September 2014 were enrolled in this retrospective study. The optimal cut-off values were determined by X-tile software, and the correlations between PLT, MPV, PDW and clinicopathological features were further analysed. Kaplan-Meier curve and Cox regression analysis were used for survival analysis. Results The values of preoperative PTL, MPV and PDW ranged from 104 to 501 × 109/L, 6.7 to 14.2 fl, and 7.8 to 26.2%, respectively. Elevated PLT was associated with larger tumour volume (p = 0.002). Kaplan-Meier survival analysis revealed that increased MPV and PDW were associated with shorter overall survival (p = 0.022 and 0.008, respectively). Importantly, multivariate Cox analysis demonstrated that elevated PDW was an independent unfavourable predictive factor for overall survival (hazard ratio (HR), 2.154, 95% confidence interval (CI), 1.258–3.688, p = 0.005). Conclusions Our data show that elevated MPV and PDW are associated with poor outcomes in skull base chordoma and that PDW may be helpful to identify patients with high risk.
Collapse
Affiliation(s)
- Mingxuan Li
- Beijing Neurosurgical Institute, Capital Medical University, No.119 South Fourth Ring West Road, Fengtai District, Beijing, 100070, China
| | - Jiwei Bai
- Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Shuai Wang
- Beijing Neurosurgical Institute, Capital Medical University, No.119 South Fourth Ring West Road, Fengtai District, Beijing, 100070, China
| | - Yixuan Zhai
- Department of Neurosurgery, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Shuheng Zhang
- Beijing Neurosurgical Institute, Capital Medical University, No.119 South Fourth Ring West Road, Fengtai District, Beijing, 100070, China.,Department of Neurosurgery, Anshan Central Hospital, Anshan, China
| | - Chuzhong Li
- Beijing Neurosurgical Institute, Capital Medical University, No.119 South Fourth Ring West Road, Fengtai District, Beijing, 100070, China
| | - Jiang Du
- Department of Neuropathology, Beijing Neurosurgical Institute, Capital Medical University, Beijing, China
| | - Yazhuo Zhang
- Beijing Neurosurgical Institute, Capital Medical University, No.119 South Fourth Ring West Road, Fengtai District, Beijing, 100070, China. .,Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China. .,Beijing Institute for Brain Disorders Brain Tumor Center, Beijing, China. .,China National Clinical Research Center for Neurological Diseases, Beijing, China. .,Key Laboratory of Central Nervous System Injury Research, Capital Medical University, Beijing, China.
| |
Collapse
|
16
|
Qu CH, Li T, Tang ZP, Zhu XR, Han JY, Tian H. Platelet Count is Associated with the Rate of Lymph Node Metastasis in Lung Adenocarcinoma. Cancer Manag Res 2020; 12:9765-9774. [PMID: 33116836 PMCID: PMC7548228 DOI: 10.2147/cmar.s273328] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2020] [Accepted: 09/08/2020] [Indexed: 12/14/2022] Open
Abstract
Purpose Emerging studies have revealed that platelets are involved in tumor metastasis in lung adenocarcinoma (ADC). The solid pathological subtype of lung ADC is associated with metastasis, recurrence, and poor prognosis. However, there is no study exploring the relationship between platelets and different lung pathological subtypes. Patients and Methods The association between platelet counts and lymph node metastasis was analyzed in 852 patients with lung ADC who underwent surgery and lymph node dissection. Multivariate logistic analysis was conducted to identify the risk factors of lymph node metastasis. Then, lymph node metastasis and other factors were analyzed to determine their correlation with platelet count and histological subtype. Results We found that the platelet count was associated with lymph node metastasis (P = 0.01) in multivariable analysis, independent of tumor size, predominant subtype, visceral pleural invasion, and microvessel invasion. In patients with a platelet count ≥300 × 109/L, the rate of lymph node metastasis was 38.5%, almost twice as high as that in patients with a platelet count <300 × 109/L (23.2%). Additionally, elevated platelet counts, even those within the normal range, were significantly associated with a higher rate of lymph node metastasis. The mean platelet count in patients with solid-predominant histology (269.70 ± 69.38 × 109/L) was significantly higher than that in patients with other histologies (P < 0.001). Conclusion Elevated platelet counts are significantly associated with a higher rate of lymph node metastasis, even if the platelet counts are within the reference range. Platelet counts were significantly higher in patients with solid-predominant histology than in patients with other histologies. In addition, VEGF-C may play an important role in lymphatic metastasis in patients with lung ADC. We hypothesize that antiplatelet therapy may reduce lymph node metastasis in lung ADC patients.
Collapse
Affiliation(s)
- Cheng-Hao Qu
- Cheeloo College of Medicine, Shandong University, Jinan, Shandong 250012, People's Republic of China.,Department of Thoracic Surgery, Qilu Hospital, Cheeloo College of Medicine, Shandong University, Jinan, Shandong 250012, People's Republic of China
| | - Tong Li
- Cheeloo College of Medicine, Shandong University, Jinan, Shandong 250012, People's Republic of China.,Department of Thoracic Surgery, Qilu Hospital, Cheeloo College of Medicine, Shandong University, Jinan, Shandong 250012, People's Republic of China
| | - Zhan-Peng Tang
- Cheeloo College of Medicine, Shandong University, Jinan, Shandong 250012, People's Republic of China.,Department of Thoracic Surgery, Qilu Hospital, Cheeloo College of Medicine, Shandong University, Jinan, Shandong 250012, People's Republic of China
| | - Xi-Rui Zhu
- Cheeloo College of Medicine, Shandong University, Jinan, Shandong 250012, People's Republic of China.,Department of Thoracic Surgery, Qilu Hospital, Cheeloo College of Medicine, Shandong University, Jinan, Shandong 250012, People's Republic of China
| | - Jing-Yi Han
- Cheeloo College of Medicine, Shandong University, Jinan, Shandong 250012, People's Republic of China.,Department of Thoracic Surgery, Qilu Hospital, Cheeloo College of Medicine, Shandong University, Jinan, Shandong 250012, People's Republic of China
| | - Hui Tian
- Department of Thoracic Surgery, Qilu Hospital, Cheeloo College of Medicine, Shandong University, Jinan, Shandong 250012, People's Republic of China
| |
Collapse
|
17
|
Yin JB, Li N, Cui MM, Wang X, Wang RT. Reduced mean platelet volume levels predict shorter survival in patients with resectable pancreatic ductal adenocarcinoma and type 2 diabetes. BMC Gastroenterol 2020; 20:143. [PMID: 32393273 PMCID: PMC7212560 DOI: 10.1186/s12876-020-01225-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/09/2019] [Accepted: 03/18/2020] [Indexed: 12/19/2022] Open
Abstract
Background Type 2 diabetes mellitus (T2DM) increased the risk of developing pancreatic cancer. Pancreatic ductal adenocarcinoma (PDAC) is the most common neoplastic disease originating from the pancreas. Increasing evidence indicates that platelets activation plays a prominent role in tumor and T2DM. Mean platelet volume (MPV) is an indicator of activated platelets and is altered in several cancers. The current study aimed to evaluate the prognostic role of MPV in resectable PDAC patients with T2DM. Methods Eight hundred and three patients with PDAC were included in this retrospective study. We determined the optimal cutoff value of MPV for 5-year overall survival (OS) using the receiver operating characteristic (ROC) method. The associations between MPV levels and clinical characteristics were analyzed. Kaplan-Meier survival analysis and Cox’s proportional hazard regression model were used to evaluate the prognostic value of MPV for OS. Results Compared to the PDAC patients without T2DM, MPV levels were significantly higher in the PDAC patients with T2DM. Moreover, MPV was significantly associated with the differentiation between T2DM and non-T2DM. In addition, Kaplan-Meier analysis found that patients with low MPV levels had a poorer 5-year OS than patients with high MPV levels in diabetic patients. Multivariate analyses revealed that MPV was an independent prognostic factor for OS in patients with T2DM. However, the independent prognostic role of MPV was not observed in patients without T2DM. Conclusion MPV independently predicts poor survival in PDAC patients with T2DM. Prospective studies are required to confirm the role of MPV in PDAC.
Collapse
Affiliation(s)
- Ji-Bin Yin
- Department of Gastroenterology, The Second Affiliated Hospital of Harbin Medical University, Harbin Medical University, No. 246 Xuefu ST, Nangang District, Harbin, 150086, Heilongjiang, China.
| | - Na Li
- Department of Internal Medicine, Harbin Medical University Cancer Hospital, Harbin Medical University, NO.150 Haping ST, Nangang District, Harbin, 150081, Heilongjiang, China
| | - Ming-Ming Cui
- Department of Internal Medicine, Harbin Medical University Cancer Hospital, Harbin Medical University, NO.150 Haping ST, Nangang District, Harbin, 150081, Heilongjiang, China
| | - Xin Wang
- Department of Internal Medicine, Harbin Medical University Cancer Hospital, Harbin Medical University, NO.150 Haping ST, Nangang District, Harbin, 150081, Heilongjiang, China
| | - Rui-Tao Wang
- Department of Internal Medicine, Harbin Medical University Cancer Hospital, Harbin Medical University, NO.150 Haping ST, Nangang District, Harbin, 150081, Heilongjiang, China.
| |
Collapse
|
18
|
Li B, Lu J, Peng DZ, Zhang XY, You Z. Elevated platelet distribution width predicts poor prognosis in hilar cholangiocarcinoma. Medicine (Baltimore) 2020; 99:e19400. [PMID: 32195935 PMCID: PMC7220385 DOI: 10.1097/md.0000000000019400] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
Although the platelet distribution width (PDW) has been reported as a reliable predictor of prognosis in several types of cancer, to our knowledge the prognostic value of PDW in hilar cholangiocarcinoma (HC) has not been studied. The aim of the study was to investigate the prognostic value of PDW in HC patients. A retrospective analysis of 292 consecutively recruited HC patients undergoing radical resection with at least a 5-year follow-up. The optimal cutoff value of PDW was determined by receiver operating characteristic (ROC) curve. Survival analysis by the Kaplan-Meier method and the difference between the clinico-pathologic variables and survival was evaluated by log-rank analysis. Multivariate analysis identified independent prognostic risk factors of overall survival (OS). ROC curve analysis suggested that the optimal cutoff value for the PDW was 16.55. There were significant associations of high PDW with high white blood cell (P < .001) and high neutril-to-lymph ratio (P < .001). In a multivariate analysis, the PDW was an independent prognostic factor for overall survival (HR = 2.521, 95% CI 1.832-3.470, P < .001). In conclusions, our findings indicate that PDW may have clinical significance in predicting OS after surgery in HC patients.
Collapse
Affiliation(s)
- Bei Li
- Department of Biliary Surgery, West China Hospital of Sichuan University, No. 37 Guo Xue Xiang
- West China-Washington Mitochondria Metabolism Center, West China Hospital of Sichuan University, Chengdu, Sichuan Province, China
| | - Jiong Lu
- Department of Biliary Surgery, West China Hospital of Sichuan University, No. 37 Guo Xue Xiang
| | - Ding-Zhong Peng
- Department of Biliary Surgery, West China Hospital of Sichuan University, No. 37 Guo Xue Xiang
| | - Xin-Yi Zhang
- Department of Biliary Surgery, West China Hospital of Sichuan University, No. 37 Guo Xue Xiang
| | - Zhen You
- Department of Biliary Surgery, West China Hospital of Sichuan University, No. 37 Guo Xue Xiang
| |
Collapse
|
19
|
Meng XZ, Yan B. Prognostic implications of pre-operative platelet count to maximum tumor diameter ratio for colorectal cancer. Shijie Huaren Xiaohua Zazhi 2020; 28:26-32. [DOI: 10.11569/wcjd.v28.i1.26] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Pre-operative platelet count and maximum tumor diameter are useful in predicting the prognosis of colorectal cancer patients, however, it is still largely unknown whether the combination of these two parameters, e.g., the pre-operative platelet count to maximum tumor diameter ratio (PTR), could contribute to prognostic prediction for these patients.
AIM To explore the prognostic role of pre-operative PTR in predicting the 3-year progression free survival (PFS) in colorectal cancer patients.
METHODS A total of 127 patients who were pathologically confirmed with adenocarcinoma and underwent surgery were collected from December 2012 to June 2019 at Hainan Hospital of PLA General Hospital. The PTR was calculated and its prognostic significance for PFS were analyzed.
RESULTS PTR displayed appreciated prediction value for the patients (AUC = 0.66, 95%CI: 0.56-0.76, P < 0.01), and when the cut-off value point was set at 57.27, it had a sensitivity and specificity of 73.30% and 56.10%, respectively. Patients with a high PTR had a better prognosis (log rank = 9.70, P < 0.01) and much longer PFS (50.02 mo ± 22.33 mo vs 38.46 mo ± 24.39 mo, t = -2.76, P < 0.01) than those with a low PTR. Univariate analysis showed that pre-operative carcinoembryonic antigen (CEA), carbohydrate antigen 199, TNM stage, and PTR could influence the PFS (P < 0.01), but only pre-operative CEA, N stage, and M stage were identified to be independent prognostic factors by multivariate analysis.
CONCLUSION PTR is helpful in predicating the 3-year PFS for colorectal cancer patients. An elevated PTR correlates with a good survival, but it is not an independent prognostic factor.
Collapse
Affiliation(s)
- Xian-Ze Meng
- Department of Traditional Chinese Medicine, No. 971 Hospital of PLA, Qingdao 266071, Shandong Province, China
| | - Bing Yan
- Department of Oncology, Hainan Hospital of PLA General Hospital, Sanya 572000, Hainan Province, China
| |
Collapse
|
20
|
Krishnamurthy A, Mittal S, Kothandaraman S, Dhanushkodi M, John A. Exploring the prognostic significance of the pretreatment inflammatory markers in hypopharyngeal cancers: A retrospective analysis. CANCER RESEARCH, STATISTICS, AND TREATMENT 2020. [DOI: 10.4103/crst.crst_152_20] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
|
21
|
Qin L, Li JY, Huang WJ, Zhang ML, Wang RT, Shen W. Higher platelet distribution width is associated with unfavorable prognosis in ovarian cancer. Cancer Biomark 2020; 28:365-370. [PMID: 32417761 DOI: 10.3233/cbm-191190] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Ovarian cancer (OC) is one of the most malignant gynecological cancers. Platelets play a profound role in cancer growth and metastasis. Platelet distribution width (PDW) is an indicator of platelet activation and is altered in malignancies. However, the prognostic value of PDW in OC remains unclear. This present study aimed to investigate the predictive significance of PDW in OC. METHODS 221 OC patients, between January 2013 and December 2013, were included in this study. The correlations between PDW and clinicopathological features were analyzed. Kaplan-Meier method and Cox regression were used to evaluate the prognostic impact of PDW. RESULTS Of the 221 patients, increased PDW levels were observed in 163 (73.6%) patients. Kaplan-Meier analysis revealed that higher PDW levels were associated with poor progression-free survival and overall survival (both p< 0.001). Cox-regression analysis confirmed the independent predictive value of PDW on overall survival (HR = 2.820, 95% CI = 1.776-4.476, p< 0.001). CONCLUSION Higher PDW levels predict poor prognosis in patients with OC. Elevated PDW may be a novel target for therapy.
Collapse
Affiliation(s)
- Ling Qin
- Department of Pathology, Harbin Medical University Cancer Hospital, Harbin Medical University, Harbin, Heilongjiang, China
| | - Jia-Yu Li
- Department of Obstetrics and Gynecology, King Chulalongkorn Memorial Hospital, Chulalongkorn University, Bangkok, Thailand
| | - Wen-Juan Huang
- Department of Internal Medicine, Harbin Medical University Cancer Hospital, Harbin Medical University, Harbin, Heilongjiang, China
| | - Meng-Lin Zhang
- Department of Internal Medicine, Harbin Medical University Cancer Hospital, Harbin Medical University, Harbin, Heilongjiang, China
| | - Rui-Tao Wang
- Department of Internal Medicine, Harbin Medical University Cancer Hospital, Harbin Medical University, Harbin, Heilongjiang, China
| | - Wenjie Shen
- Department of Gynaecology and Obstetrics, The Fourth Medical Center, Chinese PLA General Hospital, Beijing, China
| |
Collapse
|
22
|
Li MM, Yue CX, Fu S, Zhang X, Zhao CJ, Wang RT. Platelet Volume Is Reduced In Metastasing Breast Cancer: Blood Profiles Reveal Significant Shifts. Cancer Manag Res 2019; 11:9067-9072. [PMID: 31695497 PMCID: PMC6817343 DOI: 10.2147/cmar.s221976] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2019] [Accepted: 10/10/2019] [Indexed: 12/17/2022] Open
Abstract
Background Platelets play a crucial role in breast cancer (BC) progression and metastases. Mean platelet volume (MPV) is an indicator of platelet activation. The aim of the present study was to assess whether there is a difference in MPV between patients with metastatic BC with liver metastases and those with BC without liver metastases. Methods Between January 2014 and December 2017, 211 metastatic BC patients with synchronous liver metastases and 215 BC patients without metastases were retrospectively analyzed. Patients’ clinicopathological characteristics data were collected. Results MPV levels were reduced in patients with liver metastases compared with those in patients without liver metastases. There were significant differences in MPV levels according to liver metastases status both in premenopausal and in postmenopausal non-TNBC or non-HER2+ patients. Moreover, in postmenopausal HER2+ or TNBC patients, MPV levels were lower in patients with liver metastases compared with those in patients without liver metastases. In the group with non-liver metastasis, platelet distribution width was significantly associated with tumor N stage. In addition, the prevalence of BC liver metastases decreased as MPV quartiles increased. After adjusting for other risk factors, the odds ratios for liver metastases according to MPV quartiles were 1.000, 0.267 (0.134–0.530), 0.072 (0.034–0.152), and 0.137 (0.066–0.281), respectively. Conclusion MPV is reduced in BC patients with liver metastases compared with that in BC patients without metastases. Moreover, MPV is independently associated with the presence of liver metastases.
Collapse
Affiliation(s)
- Ming-Ming Li
- Department of Internal Medicine, Harbin Medical University Cancer Hospital, Harbin Medical University, Harbin, Heilongjiang 150081, People's Republic of China
| | - Chen-Xi Yue
- Department of Internal Medicine, Harbin Medical University Cancer Hospital, Harbin Medical University, Harbin, Heilongjiang 150081, People's Republic of China
| | - Shuang Fu
- Department of Internal Medicine, Harbin Medical University Cancer Hospital, Harbin Medical University, Harbin, Heilongjiang 150081, People's Republic of China
| | - Xin Zhang
- Department of Internal Medicine, Harbin Medical University Cancer Hospital, Harbin Medical University, Harbin, Heilongjiang 150081, People's Republic of China
| | - Chang-Jiu Zhao
- Department of Nuclear Medicine, The First Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang 150001, People's Republic of China
| | - Rui-Tao Wang
- Department of Internal Medicine, Harbin Medical University Cancer Hospital, Harbin Medical University, Harbin, Heilongjiang 150081, People's Republic of China
| |
Collapse
|
23
|
Platelets and Hepatocellular Cancer: Bridging the Bench to the Clinics. Cancers (Basel) 2019; 11:cancers11101568. [PMID: 31618961 PMCID: PMC6826649 DOI: 10.3390/cancers11101568] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2019] [Revised: 10/10/2019] [Accepted: 10/14/2019] [Indexed: 02/06/2023] Open
Abstract
Growing interest is recently being focused on the role played by the platelets in favoring hepatocellular cancer (HCC) growth and dissemination. The present review reports in detail both the experimental and clinical evidence published on this topic. Several growth factors and angiogenic molecules specifically secreted by platelets are directly connected with tumor progression and neo-angiogenesis. Among them, we can list the platelet-derived growth factor, the vascular endothelial growth factor, the endothelial growth factor, and serotonin. Platelets are also involved in tumor spread, favoring endothelium permeabilization and tumor cells’ extravasation and survival in the bloodstream. From the bench to the clinics, all of these aspects were also investigated in clinical series, showing an evident correlation between platelet count and size of HCC, tumor biological behavior, metastatic spread, and overall survival rates. Moreover, a better understanding of the mechanisms involved in the platelet–tumor axis represents a paramount aspect for optimizing both current tumor treatment and development of new therapeutic strategies against HCC.
Collapse
|
24
|
Yu L, Zhao ZJ. Engineered platelets with antithrombotic and antimetastatic properties. Stem Cell Investig 2019; 6:27. [PMID: 31620474 DOI: 10.21037/sci.2019.08.02] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2019] [Accepted: 07/31/2019] [Indexed: 12/15/2022]
Affiliation(s)
- Liuting Yu
- Scientific Research Center, The Seventh Affiliated Hospital of Sun Yat-sen University, Shenzhen 518107, China
| | - Zhizhuang Joe Zhao
- Scientific Research Center, The Seventh Affiliated Hospital of Sun Yat-sen University, Shenzhen 518107, China.,Department of Pathology, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
| |
Collapse
|
25
|
Shishido Y, Saito H, Shimizu S, Kono Y, Murakami Y, Miyatani K, Matsunaga T, Yamamoto M, Fukumoto Y, Honjo S, Fujiwara Y. Prognostic significance of platelet × C-reactive protein multiplier in patients with esophageal squamous cell carcinoma. Surg Today 2019; 50:185-192. [DOI: 10.1007/s00595-019-01865-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2019] [Accepted: 07/21/2019] [Indexed: 11/24/2022]
|
26
|
Matsunaga T, Saito H, Fukumoto Y, Shimizu S, Kono Y, Murakami Y, Shishido Y, Miyatani K, Yamamoto M, Tokuyasu N, Takano S, Sakamoto T, Honjo S, Fujiwara Y. The postoperative platelet distribution width is useful for predicting the prognosis in patients with esophageal squamous cell carcinoma. Surg Today 2019; 50:123-133. [DOI: 10.1007/s00595-019-01860-3] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2019] [Accepted: 07/11/2019] [Indexed: 12/20/2022]
|
27
|
Cao W, Yao X, Cen D, Zhi Y, Zhu N, Xu L. Prognostic role of pretreatment thrombocytosis on survival in patients with cervical cancer: a systematic review and meta-analysis. World J Surg Oncol 2019; 17:132. [PMID: 31375109 PMCID: PMC6676533 DOI: 10.1186/s12957-019-1676-7] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2019] [Accepted: 07/23/2019] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND This meta-analysis summarized the prognostic role of an elevated platelet count before treatment on survival outcomes in patients with cervical cancer. METHODS The PubMed, Embase, and Cochrane library electronic databases were systematically searched for studies reporting the effect estimates with 95% confidence intervals (CIs) of pretreatment thrombocytosis on survival from the database inceptions to December 2018. The pooled hazard ratios (HRs) with 95% CIs for overall survival (OS), progression-free survival (PFS), and recurrence-free survival (RFS) were calculated using random-effects models. RESULTS Nineteen retrospective studies that recruited 6521 patients with cervical cancer were eligible for this study. The summary results indicated that an elevated platelet count was significantly associated with a poor OS (HR 1.50; 95% CI 1.19-1.88; P = 0.001), PFS (HR 1.33; 95% CI 1.07-1.64; P = 0.010), and RFS (HR 1.66; 95% CI 1.20-2.28; P = 0.002). Sensitivity analysis indicated that the pooled PFS was variable after sequential exclusion of individual studies. The predictive value of pretreatment thrombocytosis on OS differed according to the publication year (P = 0.039), country (P = 0.013), and sample size (P = 0.029), and the role of pretreatment thrombocytosis on PFS could be affected by the study quality (P = 0.046). CONCLUSION The findings of this study indicated that an elevated platelet count before treatment was associated with poor OS, PFS, and RFS. These results require further verification in large-scale prospective studies.
Collapse
Affiliation(s)
- Weijuan Cao
- College of Pharmacy, Zhejiang Pharmaceutical College, Ningbo, 315100, Zhejiang Province, China
| | - Xiaomin Yao
- College of Pharmacy, Zhejiang Pharmaceutical College, Ningbo, 315100, Zhejiang Province, China
| | - Danwei Cen
- College of Pharmacy, Zhejiang Pharmaceutical College, Ningbo, 315100, Zhejiang Province, China
| | - Yajun Zhi
- College of Pharmacy, Zhejiang Pharmaceutical College, Ningbo, 315100, Zhejiang Province, China
| | - Ningwei Zhu
- College of Pharmacy, Zhejiang Pharmaceutical College, Ningbo, 315100, Zhejiang Province, China
| | - Liyong Xu
- Zhejiang Pharmaceutical College, No. 888, East Section of Yinxian Avenue, Higher Education Park, Ningbo, 315100, Zhejiang Province, China.
| |
Collapse
|
28
|
Väyrynen JP, Väyrynen SA, Sirniö P, Minkkinen I, Klintrup K, Karhu T, Mäkelä J, Herzig KH, Karttunen TJ, Tuomisto A, Mäkinen MJ. Platelet count, aspirin use, and characteristics of host inflammatory responses in colorectal cancer. J Transl Med 2019; 17:199. [PMID: 31196200 PMCID: PMC6567577 DOI: 10.1186/s12967-019-1950-z] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2019] [Accepted: 06/05/2019] [Indexed: 02/08/2023] Open
Abstract
Background Platelets not only contribute to hemostasis but also to the regulation of inflammatory reactions and cancer pathogenesis. We hypothesized that blood platelet count would be associated with systemic inflammation, the densities of tumor infiltrating immune cells, and survival in colorectal cancer (CRC), and these relationships could be altered by aspirin use. Methods We measured blood platelet count in a cohort of 356 CRC patients and analyzed its relationships with tumor and patient characteristics including aspirin use, markers of systemic inflammation (modified Glasgow Prognostic Score, mGPS; serum levels of CRP, albumin, and 13 cytokines), blood hemoglobin levels, five types of tumor infiltrating immune cells (CD3, CD8, FoxP3, Neutrophil elastase, mast cell tryptase), and survival. Results Platelet count inversely correlated with blood hemoglobin levels (p < 0.001) and positively correlated with serum levels of CRP and multiple cytokines including IL-1RA, IL-4, IL-6, IL-7, IL-8, IL-12, IFNγ, and PDGF-BB (p < 0.001 for all), while aspirin use was not associated with the levels of systemic inflammatory markers. High platelet count was also associated with high mGPS (p < 0.001) but did not show statistically significant multivariable adjusted associations with the densities of tumor infiltrating immune cells. Higher platelet counts were observed in higher tumor stage (p < 0.001), but platelet count or aspirin use were not associated with patient survival. Conclusions High platelet count is associated with systemic inflammation in CRC. This study could not demonstrate statistically significant associations between platelet count, aspirin use, and the densities of tumor infiltrating immune cells. Electronic supplementary material The online version of this article (10.1186/s12967-019-1950-z) contains supplementary material, which is available to authorized users.
Collapse
Affiliation(s)
- Juha P Väyrynen
- Cancer and Translational Medicine Research Unit, University of Oulu, POB 5000, 90014, Oulu, Finland. .,Department of Pathology, Oulu University Hospital and Medical Research Center Oulu, POB 21, 90029, Oulu, Finland. .,Department of Oncologic Pathology, Dana-Farber Cancer Institute and Harvard Medical School, 450 Brookline Ave, Boston, MA, 02215, USA.
| | - Sara A Väyrynen
- Cancer and Translational Medicine Research Unit, University of Oulu, POB 5000, 90014, Oulu, Finland.,Department of Pathology, Oulu University Hospital and Medical Research Center Oulu, POB 21, 90029, Oulu, Finland.,Department of Medical Oncology, Dana-Farber Cancer Institute and Harvard Medical School, 450 Brookline Ave, Boston, MA, 02215, USA
| | - Päivi Sirniö
- Cancer and Translational Medicine Research Unit, University of Oulu, POB 5000, 90014, Oulu, Finland.,Department of Pathology, Oulu University Hospital and Medical Research Center Oulu, POB 21, 90029, Oulu, Finland
| | - Ilkka Minkkinen
- Cancer and Translational Medicine Research Unit, University of Oulu, POB 5000, 90014, Oulu, Finland.,Department of Pathology, Oulu University Hospital and Medical Research Center Oulu, POB 21, 90029, Oulu, Finland
| | - Kai Klintrup
- Research Unit of Surgery, Anesthesia and Intensive Care, University of Oulu, POB 5000, 90014, Oulu, Finland.,Department of Surgery, Oulu University Hospital and Medical Research Center Oulu, POB 21, 90029, Oulu, Finland
| | - Toni Karhu
- Research Unit of Biomedicine and Biocenter of Oulu, University of Oulu, POB 5000, 90014, Oulu, Finland.,Oulu University Hospital and Medical Research Center Oulu, POB 21, 90029, Oulu, Finland
| | - Jyrki Mäkelä
- Research Unit of Surgery, Anesthesia and Intensive Care, University of Oulu, POB 5000, 90014, Oulu, Finland.,Department of Surgery, Oulu University Hospital and Medical Research Center Oulu, POB 21, 90029, Oulu, Finland
| | - Karl-Heinz Herzig
- Research Unit of Biomedicine and Biocenter of Oulu, University of Oulu, POB 5000, 90014, Oulu, Finland.,Oulu University Hospital and Medical Research Center Oulu, POB 21, 90029, Oulu, Finland.,Department of Gastroenterology and Metabolism, Poznan University of Medical Sciences, ul. Szpitalna 27/33, 60-572, Poznan, Poland
| | - Tuomo J Karttunen
- Cancer and Translational Medicine Research Unit, University of Oulu, POB 5000, 90014, Oulu, Finland.,Department of Pathology, Oulu University Hospital and Medical Research Center Oulu, POB 21, 90029, Oulu, Finland
| | - Anne Tuomisto
- Cancer and Translational Medicine Research Unit, University of Oulu, POB 5000, 90014, Oulu, Finland.,Department of Pathology, Oulu University Hospital and Medical Research Center Oulu, POB 21, 90029, Oulu, Finland
| | - Markus J Mäkinen
- Cancer and Translational Medicine Research Unit, University of Oulu, POB 5000, 90014, Oulu, Finland.,Department of Pathology, Oulu University Hospital and Medical Research Center Oulu, POB 21, 90029, Oulu, Finland
| |
Collapse
|
29
|
Preoperative mean platelet volume predicts survival in breast cancer patients with type 2 diabetes. Breast Cancer 2019; 26:712-718. [PMID: 31087273 DOI: 10.1007/s12282-019-00976-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2018] [Accepted: 05/06/2019] [Indexed: 02/06/2023]
Abstract
PURPOSE Patients with type 2 diabetes mellitus (T2DM) have an increased risk of breast cancer (BC). Furthermore, growing evidence suggests that activated platelets play a crucial role in tumor and T2DM. Mean platelet volume (MPV) is a platelet index and is altered in patients with malignancies. The aim of this study was to determine whether preoperative MPV could predict survival in BC patients with T2DM. METHODS The clinical data of 266 female BC patients with T2DM and 264 female BC patients without T2DM between January 2011 and December 2011 in our center were retrospectively analyzed. Survival analysis was performed using the log-rank test and Cox proportional hazards regression analysis. RESULTS The patients with T2DM had higher MPV levels than the patients without T2DM. Furthermore, MPV was found to be significantly associated with differentiation T2DM from non-T2DM. In addition, survival analysis revealed that the disease-specific survival and overall survival of patients with MPV ≤ 8.0 fL were significantly shorter than that of those with MPV > 8.0 fL in diabetic patients. Multivariate analysis identified MPV as an independent poor prognostic factor for survival only in patients with T2DM not in patients without T2DM. CONCLUSIONS Our study first established a connection between MPV and BC patients with T2DM, suggesting that MPV was an independent prognostic factor and could be the biomarker for prognosis.
Collapse
|
30
|
Čížková J, Erbanová M, Sochor J, Jindrová A, Strnadová K, Horák V. Relationship between haematological profile and progression or spontaneous regression of melanoma in the Melanoma-bearing Libechov Minipigs. Vet J 2019; 249:1-9. [PMID: 31239158 DOI: 10.1016/j.tvjl.2019.04.016] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2018] [Revised: 04/29/2019] [Accepted: 04/29/2019] [Indexed: 12/22/2022]
Abstract
Haematological parameters, plasma iron concentration, and bodyweight were monitored in Melanoma-bearing Libechov Minipigs (MeLiM) from 5 to 18 weeks old. Animals with melanoma progression (P group) and spontaneous regression (SR group) were compared. The P group showed the lowest median values of red blood cell counts (RBC), haematocrit (HCT), haemoglobin concentration (HGB), and bodyweight, whereas the control white (tumour-free) pigs (C group) revealed the highest mean values of these parameters. The mean values of pigs with SR fell between the P and C groups. In addition, a stable concentration of plasma iron was found in the C group, while iron deficiency that increases with age was observed in the MeLiM groups. These results indicate that MeLiM are affected by cancer-related microcytic hypochromic anaemia. The lowest values of HGB, RBC, and HCT, together with the highest number of platelets (PLT) in the P group correspond to melanoma progression. Higher values of these parameters and lower PLT in the MeLiM pigs with SR reflected health improvement due to the destruction of melanoma cells during spontaneous regression. Monitoring of these haematological parameters can help distinguish MeLiM piglets with progression and spontaneous regression of melanoma in the early stages of postnatal development. The findings of this study correspond to findings in human patients in which cancer-related anaemia, thrombocytosis, and iron deficiency are often diagnosed.
Collapse
Affiliation(s)
- J Čížková
- Czech Academy of Sciences, Institute of Animal Physiology and Genetics,v.v.i., Laboratory of Applied Proteome Analyses, and Laboratory of Tumour Biology, Rumburska 89, CZ-277 21 Libechov, Czech Republic; Czech University of Life Sciences Prague, Faculty of Agrobiology, Food and Natural Resources, Department of Veterinary Sciences, Kamycka 129, CZ-165 00 Prague, Czech Republic
| | - M Erbanová
- Czech Academy of Sciences, Institute of Animal Physiology and Genetics,v.v.i., Laboratory of Applied Proteome Analyses, and Laboratory of Tumour Biology, Rumburska 89, CZ-277 21 Libechov, Czech Republic
| | - J Sochor
- Mendel University in Brno, Department of Viticulture and Enology, Valticka 337, CZ-691 44 Lednice, Czech Republic; Department of Chemistry and Biochemistry, Zemedelska 1, CZ-613 00 Brno, Czech Republic
| | - A Jindrová
- Czech University of Life Sciences Prague, Faculty of Economics and Management, Department of Statistics, Prague, Czech Republic
| | - K Strnadová
- Czech Academy of Sciences, Institute of Animal Physiology and Genetics,v.v.i., Laboratory of Applied Proteome Analyses, and Laboratory of Tumour Biology, Rumburska 89, CZ-277 21 Libechov, Czech Republic; Czech University of Life Sciences Prague, Faculty of Agrobiology, Food and Natural Resources, Department of Veterinary Sciences, Kamycka 129, CZ-165 00 Prague, Czech Republic
| | - V Horák
- Czech Academy of Sciences, Institute of Animal Physiology and Genetics,v.v.i., Laboratory of Applied Proteome Analyses, and Laboratory of Tumour Biology, Rumburska 89, CZ-277 21 Libechov, Czech Republic.
| |
Collapse
|
31
|
Gao J, Agizamhan S, Zhao X, Jiang B, Qin H, Chen M, Guo H. Preoperative C-reactive protein/albumin ratio predicts outcome of surgical papillary renal cell carcinoma. Future Oncol 2019; 15:1459-1468. [PMID: 30977386 DOI: 10.2217/fon-2018-0611] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
Aim: To evaluate the prognostic values of some preoperative inflammation-based factors including C-reactive protein/albumin ratio (CRP/Alb) and platelet level in papillary renal cell carcinoma (PRCC). Materials & methods: A total of 108 PRCC patients underwent partial or radical nephrectomy were retrospectively analyzed. The prognostic values were determined with Kaplan-Meier analysis, univariate and multivariate COX regression models. Results: CRP/Alb and platelet level were both significantly associated with subtype, Fuhrman grade, tumor stage, lymph node invasion, perinephric fat extension, shorter overall survival (OS) and disease-free survival (all p < 0.01). Further, CRP/Alb was an independent prognostic factor for OS (hazard ratio: 9.64, 95% CI: 2.17-23.78; p = 0.003). Conclusion: Relatively higher CRP/Alb independently predicted poorer OS of surgical PRCC patients.
Collapse
Affiliation(s)
- Jie Gao
- Department of Urology, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Institute of Urology Nanjing University, Jiangsu, PR China
| | - Sezim Agizamhan
- Department of Urology, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Institute of Urology Nanjing University, Jiangsu, PR China
| | - Xiaozhi Zhao
- Department of Urology, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Institute of Urology Nanjing University, Jiangsu, PR China
| | - Bo Jiang
- Department of Urology, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Institute of Urology Nanjing University, Jiangsu, PR China
| | - Haixiang Qin
- Department of Urology, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Institute of Urology Nanjing University, Jiangsu, PR China
| | - Mengxia Chen
- Department of Urology, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Institute of Urology Nanjing University, Jiangsu, PR China
| | - Hongqian Guo
- Department of Urology, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Institute of Urology Nanjing University, Jiangsu, PR China
| |
Collapse
|
32
|
Życzkowski M, Rajwa P, Burzyński B, Gaździk M, Florczyk I, Slabon-Turska M, Paradysz A. Neutrophil-to-mean platelet volume ratio as a new predictor for overall and cancer-specific survival in patients with localized clear cell renal cell carcinoma. Arch Med Sci 2019; 16:1072-1077. [PMID: 32863996 PMCID: PMC7444721 DOI: 10.5114/aoms.2019.83822] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/04/2018] [Accepted: 02/08/2019] [Indexed: 01/04/2023] Open
Abstract
INTRODUCTION The present study investigated the prognostic value of neutrophil-to-mean platelet volume ratio (NMPVR) for overall (OS) and cancer-specific survival (CSS) in patients treated with nephrectomy for localized clear cell renal cell carcinoma (ccRCC). MATERIAL AND METHODS Medical records of 344 consecutive patients who underwent partial or radical nephrectomy for M0 ccRCC were retrospectively analyzed. Based on the median NMPVR, the study population was divided into two groups: the high NMPVR group with NMPVR higher than or equal to the median, and the low NMPVR group with NMPVR lower than the median. Comparisons of baseline characteristics and laboratory and pathological findings were performed. Kaplan-Meier survival curves and Cox regression model analysis were used to assess the prognostic value of the NMPVR. RESULTS Patients with higher NMPVR values were more frequently diagnosed with advanced disease, tumor necrosis and higher tumor grade. The OS and CSS were significantly shorter in patients with NMPVR ≥ 0.41 compared to patients with NMPVR < 0.41. Inclusion of NMPVR in multivariable models of OS and CSS with other confounding variables determined categorized NMPVR as an independent prognostic factor for both endpoints. CONCLUSIONS Pretreatment NMPVR ≥ 0.41 was associated with lower OS and CSS. NMPVR might be applied as a cheap and uncomplicated prognostic indicator in localized ccRCC patients treated with a primary surgical approach.
Collapse
Affiliation(s)
- Marcin Życzkowski
- Department of Urology, Medical University of Silesia, Zabrze, Poland
| | - Paweł Rajwa
- Department of Urology, Medical University of Silesia, Zabrze, Poland
| | - Bartłomiej Burzyński
- Department of Rehabilitation, School of Health Sciences, Medical University of Silesia, Katowice, Poland
| | - Maciej Gaździk
- Student Scientific Society, Department of Urology, Medical University of Silesia, Zabrze, Poland
| | - Iga Florczyk
- Student Scientific Society, Department of Urology, Medical University of Silesia, Zabrze, Poland
| | - Monika Slabon-Turska
- Student Scientific Society, Department of Urology, Medical University of Silesia, Zabrze, Poland
| | - Andrzej Paradysz
- Department of Urology, Medical University of Silesia, Zabrze, Poland
| |
Collapse
|
33
|
Sakin A, Secmeler S, Arici S, Geredeli C, Yasar N, Demir C, Aksaray F, Cihan S. Prognostic Significance of Mean Platelet Volume on Local Advanced Non-Small Cell Lung Cancer Managed with Chemoradiotherapy. Sci Rep 2019; 9:3959. [PMID: 30850724 PMCID: PMC6408473 DOI: 10.1038/s41598-019-40589-4] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2019] [Accepted: 02/19/2019] [Indexed: 11/10/2022] Open
Abstract
Mean platelet volume (MPV), the most commonly used measure of platelet size, and is altered in patients with malignancies. The aim of this study was to investigate the effect of MPV on overall survival (OS) of patients with locally advanced (Stage IIIA/B) inoperable non-small cell lung cancer (NSCLC). This retrospective study included patients who received concomitant chemoradiotherapy (CCRT) with cisplatin + etoposide regimen due to locally advanced stage IIIA/B NSCLC. The study included a total of 115 cases, consisting of 110 (95.7%) male and 5 (4.2%) female patients. The mean age of the patients was 61.3 ± 10.4 (22-82) years. ROC curve generated by MPV for OS yielded an AUC of 0.746 (95% CI 0.659-0.833), (p < 0.001). MPV was detected as >9 fL with a sensitivity of 74.4% and a specificity of 72.0%. In patients with stage IIIA, median OS was 45.0 months (95% CI 17.3-74.1) and 21 months (95% CI 10.6-31.3) in groups with MPV > 9.0 fL and ≤9.0 fL, respectively (p = 0.013). In patients with stage IIIB, median OS was 44.0 months (95% CI 13.8-60.6) and 16 months (95% CI 9.5-22.4) in groups with MPV > 9.0 fL and ≤9.0 fL, respectively (p = 0.036). ECOG performance score, total platelet count, and MPV were found as the most significant independent factors affecting survival (p < 0.001, p = 0.008, and, p = 0.034, respectively). In this study, we showed that decreased pre-treatment MPV was an independent risk factor for survival in NSCLC patients who were administered CCRT. As part of routine complete blood count panel, MPV may represent one of the easiest measuring tools as an independent prognostic marker for survival in locally advanced NSCLC.
Collapse
Affiliation(s)
- Abdullah Sakin
- Department of Medical Oncology, Yuzuncu Yil University Medical School, 65030, Van, Turkey.
| | - Saban Secmeler
- Department of Medical Oncology, University of Health Sciences, Okmeydani Training and Research Hospital, 34384, Istanbul, Turkey
| | - Serdar Arici
- Department of Medical Oncology, University of Health Sciences, Okmeydani Training and Research Hospital, 34384, Istanbul, Turkey
| | - Caglayan Geredeli
- Department of Medical Oncology, University of Health Sciences, Okmeydani Training and Research Hospital, 34384, Istanbul, Turkey
| | - Nurgul Yasar
- Department of Medical Oncology, University of Health Sciences, Okmeydani Training and Research Hospital, 34384, Istanbul, Turkey
| | - Cumhur Demir
- Department of Medical Oncology, University of Health Sciences, Okmeydani Training and Research Hospital, 34384, Istanbul, Turkey
| | - Ferdi Aksaray
- Department of Radiation Oncology, University of Health Sciences, Okmeydani Training and Research Hospital, 34384, Istanbul, Turkey
| | - Sener Cihan
- Department of Medical Oncology, University of Health Sciences, Okmeydani Training and Research Hospital, 34384, Istanbul, Turkey
| |
Collapse
|
34
|
Huang Y, Cui MM, Huang YX, Fu S, Zhang X, Guo H, Wang RT. Preoperative platelet distribution width predicts breast cancer survival. Cancer Biomark 2019; 23:205-211. [PMID: 30198864 DOI: 10.3233/cbm-181267] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
BACKGROUND Breast cancer is one of the most commonly diagnosed cancers, and the fourth leading cause of cancer deaths in females worldwide. Activated platelets play a key role in tumor growth and tumor metastasis. Platelet distribution width (PDW) is a platelet index, and is altered in patients with malignancies. The aim of this study was to explore whether PDW can effectively predict death outcome of breast cancer patients. STUDY DESIGN The clinical data of 271 breast cancer patients in our hospital between January 2009 and December 2009 were retrospectively analyzed. Survival analysis was performed using the log-rank test and Cox proportional hazards regression analysis. RESULT There were significant correlations between increased PDW and tumor size, molecular subtype, differentiation grade, and cancer stages (T, N, or TNM). Moreover, survival analysis revealed that the overall survival of patients with PDW > 16.8%, which was significantly shorter than those with PDW ⩽ 16.8%. Multivariate analysis indicated that PDW > 16.8% predicts a poor overall survival of breast cancer patients. CONCLUSIONS Elevated PDW may serve as a marker of adverse prognosis in breast cancer. However, these data are preliminary and should be interpreted with caution pending validation by additional clinical and molecular/genomics studies in various populations.
Collapse
Affiliation(s)
- Yiru Huang
- The National Key Clinical Specialty, The Engineering Technology Research Center of Education Ministry of China, Guangdong Provincial Key Laboratory on Brain Function Repair and Regeneration, Department of Neurosurgery, Zhujiang Hospital, Southern Medical University, Guangzhou, Guangdong, 510282, China.,The National Key Clinical Specialty, The Engineering Technology Research Center of Education Ministry of China, Guangdong Provincial Key Laboratory on Brain Function Repair and Regeneration, Department of Neurosurgery, Zhujiang Hospital, Southern Medical University, Guangzhou, Guangdong, 510282, China
| | - Ming-Ming Cui
- Department of Internal Medicine, Harbin Medical University Cancer Hospital, Harbin Medical University, Harbin, Heilongjiang 150081, China.,The National Key Clinical Specialty, The Engineering Technology Research Center of Education Ministry of China, Guangdong Provincial Key Laboratory on Brain Function Repair and Regeneration, Department of Neurosurgery, Zhujiang Hospital, Southern Medical University, Guangzhou, Guangdong, 510282, China
| | - Yuan-Xi Huang
- Department of Breast Surgery, Harbin Medical University Cancer Hospital, Harbin Medical University, Harbin, Heilongjiang 150086, China.,The National Key Clinical Specialty, The Engineering Technology Research Center of Education Ministry of China, Guangdong Provincial Key Laboratory on Brain Function Repair and Regeneration, Department of Neurosurgery, Zhujiang Hospital, Southern Medical University, Guangzhou, Guangdong, 510282, China
| | - Shuang Fu
- Department of Internal Medicine, Harbin Medical University Cancer Hospital, Harbin Medical University, Harbin, Heilongjiang 150081, China
| | - Xin Zhang
- Department of Internal Medicine, Harbin Medical University Cancer Hospital, Harbin Medical University, Harbin, Heilongjiang 150081, China
| | - Hongbo Guo
- The National Key Clinical Specialty, The Engineering Technology Research Center of Education Ministry of China, Guangdong Provincial Key Laboratory on Brain Function Repair and Regeneration, Department of Neurosurgery, Zhujiang Hospital, Southern Medical University, Guangzhou, Guangdong, 510282, China
| | - Rui-Tao Wang
- Department of Internal Medicine, Harbin Medical University Cancer Hospital, Harbin Medical University, Harbin, Heilongjiang 150081, China.,Heilongjiang Academy of Medical Science, Harbin, Heilongjiang 150081, China
| |
Collapse
|
35
|
Belluco C, Forlin M, Delrio P, Rega D, Degiuli M, Sofia S, Olivieri M, Pucciarelli S, Zuin M, De Manzoni G, Di Leo A, Scabini S, Zorcolo L, Restivo A. Elevated platelet count is a negative predictive and prognostic marker in locally advanced rectal cancer undergoing neoadjuvant chemoradiation: a retrospective multi-institutional study on 965 patients. BMC Cancer 2018; 18:1094. [PMID: 30419864 PMCID: PMC6233528 DOI: 10.1186/s12885-018-5022-1] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2018] [Accepted: 10/31/2018] [Indexed: 01/16/2023] Open
Abstract
BACKGROUND In patients with locally advanced rectal cancer treated by neoadjuvant chemoradiation, pathological complete response in the surgical specimen is associated with favourable long-term oncologic outcome. Based on this observation, nonoperative management is being explored in the subset of patients with clinical complete response. Whereas, patients with poor response have a high risk of local and distant recurrence, and appear to receive no benefit from standard neoadjuvant chemoradiation. Therefore, in order to develop alternative treatment strategies for non responding patients, predictive and prognostic factors are highly needed. Accumulating clinical observations indicate that elevated platelet count is associated with poor outcome in different type of tumors. In this study we investigated the predictive and prognostic impact of elevated platelet count on pathological response and long-term oncologic outcome in patients with locally advanced rectal cancer undergoing neoadjuvant chemoradiation. METHODS A total of 965 patients were selected from prospectively maintained databases of seven Centers within the SICO Colorectal Cancer Network. Patients were divided into two groups based on a pre-neoadjuvant chemoradiation platelet count cut-off value of 300 × 109/L identified by receiver operating characteristic curve considering complete pathological response as the outcome. RESULTS Complete pathological response rate was lower in patients with elevated platelet count (12.8% vs. 22.1%, p = 0.001). Mean follow-up was 50.1 months. Comparing patients with elevated platelet count with patients with not elevated platelet count, 5-year overall survival was 69.5% vs.76.5% (p = 0.016), and 5-year disease free survival was 63.0% vs. 68.9% (p = 0.019). Local recurrence rate was higher in patients with elevated platelet count (11.1% vs. 5.3%, p = 0.001), as higher was the occurrence of distant metastasis (23.9% vs. 16.4%, p = 0.007). At multivariate analysis of potential prognostic factors EPC was independently associated with worse overall survival (HR 1.40, 95% CI 1.06-1.86), and disease free survival (HR 1.37, 95% CI 1.07-1.76). CONCLUSIONS In locally advanced rectal cancer elevated platelet count before neoadjuvant chemoradiation is a negative predictive and prognostic factor which might help to identify subsets of patients with more aggressive tumors to be proposed for alternative therapeutic strategies.
Collapse
Affiliation(s)
- Claudio Belluco
- Department of Surgical Oncology, CRO-IRCCS, National Cancer Institute, Aviano Via Franco Gallini 2, 33081, Aviano, Italy.
| | - Marco Forlin
- Department of Surgical Oncology, CRO-IRCCS, National Cancer Institute, Aviano Via Franco Gallini 2, 33081, Aviano, Italy
| | - Paolo Delrio
- Colorectal Surgical Oncology, National Cancer Institute - IRCCS - G. Pascale Foundation, Naples, Italy
| | - Daniela Rega
- Colorectal Surgical Oncology, National Cancer Institute - IRCCS - G. Pascale Foundation, Naples, Italy
| | - Maurizio Degiuli
- School of Medicine, Department of Oncology, Head, Digestive, University of Torino, Torino, Italy.,Surgical Oncology, San Luigi University Hospital, Orbassano, Torino, Italy
| | - Silvia Sofia
- School of Medicine, Department of Oncology, Head, Digestive, University of Torino, Torino, Italy.,Surgical Oncology, San Luigi University Hospital, Orbassano, Torino, Italy
| | - Matteo Olivieri
- Department of Surgical Oncology, CRO-IRCCS, National Cancer Institute, Aviano Via Franco Gallini 2, 33081, Aviano, Italy
| | - Salvatore Pucciarelli
- Department of Surgical, Oncological and Gastroenterological Sciences, University of Padova, Padova, Italy
| | - Matteo Zuin
- Department of Surgical, Oncological and Gastroenterological Sciences, University of Padova, Padova, Italy
| | - Giovanni De Manzoni
- Department of Surgery, General and Upper G.I., Surgery Division, University of Verona, Verona, Italy
| | - Alberto Di Leo
- Department of Surgery, General and Upper G.I., Surgery Division, University of Verona, Verona, Italy
| | - Stefano Scabini
- Oncologic Surgery and Implantable Systems Unit, Department of Emergency, IRCCS San Martino IST, Genoa, Italy
| | - Luigi Zorcolo
- Colorectal Surgery Unit, Department of Surgical Sciences, University of Cagliari, Cagliari, Italy
| | - Angelo Restivo
- Colorectal Surgery Unit, Department of Surgical Sciences, University of Cagliari, Cagliari, Italy
| |
Collapse
|
36
|
Takenaka Y, Oya R, Kitamiura T, Ashida N, Shimizu K, Takemura K, Yamamoto Y, Uno A. Platelet count and platelet-lymphocyte ratio as prognostic markers for head and neck squamous cell carcinoma: Meta-analysis. Head Neck 2018; 40:2714-2723. [PMID: 30102821 DOI: 10.1002/hed.25366] [Citation(s) in RCA: 47] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2017] [Revised: 02/28/2018] [Accepted: 05/18/2018] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Thrombocytosis is associated with the prognosis of various types of cancer. The purpose of this study was to quantify the prognostic impact of platelet count and platelet-lymphocyte ratio (PLR) in head and neck squamous cell carcinoma (HNSCC). METHODS We systematically searched electronic databases and identified articles reporting an association between platelet count or PLR and HNSCC prognosis. Hazard ratios (HRs) and 95% confidence intervals (CIs) for overall survival (OS) were extracted, and the pooled HRs were estimated using random effect models. RESULTS Eight studies that enrolled 4096 patients and 9 studies that enrolled 2327 patients were included in the platelet count and PLR analyses, respectively. A platelet count greater than the cutoff value was associated with poor OS (HR 1.81; 95% CI 1.16-2.82) and any PLR greater than the cutoff value was associated with poor OS (HR 1.64; 95% CI 1.13-2.37). CONCLUSION Elevated platelet count and PLR are associated with poor prognosis in patients with HNSCC.
Collapse
Affiliation(s)
- Yukinori Takenaka
- Department of Otorhinolaryngology - Head and Neck Surgery, Osaka General Medical Center, Osaka, Japan
| | - Ryohei Oya
- Department of Otorhinolaryngology - Head and Neck Surgery, Osaka General Medical Center, Osaka, Japan
| | - Takahiro Kitamiura
- Department of Otorhinolaryngology - Head and Neck Surgery, Osaka General Medical Center, Osaka, Japan
| | - Naoki Ashida
- Department of Otorhinolaryngology - Head and Neck Surgery, Osaka General Medical Center, Osaka, Japan
| | - Kotaro Shimizu
- Department of Otorhinolaryngology - Head and Neck Surgery, Osaka General Medical Center, Osaka, Japan
| | - Kazuya Takemura
- Department of Otorhinolaryngology - Head and Neck Surgery, Osaka General Medical Center, Osaka, Japan
| | - Yoshifumi Yamamoto
- Department of Otorhinolaryngology - Head and Neck Surgery, Osaka General Medical Center, Osaka, Japan
| | - Atsuhiko Uno
- Department of Otorhinolaryngology - Head and Neck Surgery, Osaka General Medical Center, Osaka, Japan
| |
Collapse
|
37
|
Shen W, Cui MM, Wang X, Wang RT. Reduced mean platelet volume is associated with poor prognosis in esophageal cancer. Cancer Biomark 2018; 22:559-563. [PMID: 29843218 DOI: 10.3233/cbm-181231] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Affiliation(s)
- Wenjie Shen
- Department of Gynaecology and Obstetrics, First Affiliated Hospital of Chinese PLA General Hospital, Beijing 100048, China
| | - Ming-Ming Cui
- Department of Internal Medicine, Harbin Medical University Cancer Hospital, Harbin Medical University, Harbin 150081, Heilongjiang, China
| | - Xin Wang
- Department of Internal Medicine, Harbin Medical University Cancer Hospital, Harbin Medical University, Harbin 150081, Heilongjiang, China
| | - Rui-Tao Wang
- Department of Internal Medicine, Harbin Medical University Cancer Hospital, Harbin Medical University, Harbin 150081, Heilongjiang, China
- Heilongjiang Academy of Medical Science, Harbin 150081, Heilongjiang, China
| |
Collapse
|
38
|
Agizamhan S, Qu F, Liu N, Sun J, Xu W, Zhang L, Guo H, Gan W. Preoperative neutrophil-to-lymphocyte ratio predicts the surgical outcome of Xp11.2 translocation/TFE3 renal cell carcinoma patients. BMC Urol 2018; 18:60. [PMID: 29890986 PMCID: PMC5996532 DOI: 10.1186/s12894-018-0374-z] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2018] [Accepted: 05/31/2018] [Indexed: 01/19/2023] Open
Abstract
Background The preoperative neutrophil-to-lymphocyte ratio (NLR), C-reactive protein/albumin ratio (CRP/Alb ratio) and platelet-to-lymphocyte ratio (PLR) have been demonstrated to predict the clinical outcome of various human cancer, including renal cell carcinoma(RCC). The aim of our study was to explore the prognostic values of these ratios in patients with Xp11.2 translocation/TFE3 gene fusions renal cell carcinoma (Xp11.2 tRCC). Methods A retrospective multicentre study was performed in 82 Xp11.2 tRCC patients who underwent radical or partial nephrectomy. The optimal cutoff values of the NLR, CRP/Alb ratio and PLR were determined by the receiver operating characteristic (ROC) analysis. The impact of the NLR, CRP/Alb ratio and PLR, as well as other clinicopathological characteristics, on disease-free survival (DFS) and overall survival (OS) were evaluated using the univariate and multivariate Cox regression analyses. Results The optimal cutoff values of the NLR, CRP/Alb ratio and PLR were set at 2.45, 140 and 0.08, respectively, according to the ROC analysis. Univariate analyses showed that the NLR, CRP/Alb ratio and PLR all were associated with DFS of Xp11.2 tRCC patients (P < 0.001, P = 0.005 and P = 0.001, respectively) and OS of Xp11.2 tRCC patients (P = 0.016, P = 0.003 and P = 0.014, respectively). Multivariate analysis indicated that the NLR was independently associated with DFS of Xp11.2 tRCC patients (hazard ratio [HR]: 4.25; 95% confidence interval [95% CI]: 1.19–15.18; P = 0.026) along with age (P = 0.004), the pT status (P < 0.001) and the pN status (P < 0.019), and the NLR (HR: 26.26; 95% CI: 1.44–480.3; P = 0.028) also was independently associated with OS in patients with Xp11.2 tRCC, along with age (P = 0.016) and a tumour thrombus (P = 0.007). Conclusion Overall, relatively high NLRs, CRP/Alb ratios and PLRs were associated with a poor prognosis of Xp11.2 tRCC patients; among of them, only the NLR independently predicted the progression of Xp11.2 tRCC, and the NLR may help to identify patients with high metastasis or relapse risk.
Collapse
Affiliation(s)
- Sezim Agizamhan
- Department of Urology, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, No. 321 Zhongshan Road, Nanjing, 210008, Jiangsu Province, China
| | - Feng Qu
- Department of Urology, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, No. 321 Zhongshan Road, Nanjing, 210008, Jiangsu Province, China
| | - Ning Liu
- Department of Urology, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, No. 321 Zhongshan Road, Nanjing, 210008, Jiangsu Province, China
| | - Jing Sun
- Department of Oncology, Jiangsu Province Hospital, The First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu, China
| | - Wei Xu
- Department of Pathology, Jiangsu Cancer Hospital, The Affiliated Cancer Hospital of Nanjing Medical University, Nanjing, Jiangsu, China
| | - Lihua Zhang
- Department of Pathology, Zhongda Hospital Southeast University, Nanjing, Jiangsu, China
| | - Hongqian Guo
- Department of Urology, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, No. 321 Zhongshan Road, Nanjing, 210008, Jiangsu Province, China
| | - Weidong Gan
- Department of Urology, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, No. 321 Zhongshan Road, Nanjing, 210008, Jiangsu Province, China.
| |
Collapse
|
39
|
Enblad M, Ghanipour L, Cashin PH. Prognostic scores for colorectal cancer with peritoneal metastases treated with cytoreductive surgery and hyperthermic intraperitoneal chemotherapy. Int J Hyperthermia 2018; 34:1390-1395. [DOI: 10.1080/02656736.2018.1464668] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022] Open
Affiliation(s)
- M. Enblad
- Department of Surgical Sciences, Section of Surgery, Uppsala University, Akademiska Sjukhuset, Uppsala, 75185, Sweden
| | - L. Ghanipour
- Department of Surgical Sciences, Section of Surgery, Uppsala University, Akademiska Sjukhuset, Uppsala, 75185, Sweden
| | - P. H. Cashin
- Department of Surgical Sciences, Section of Surgery, Uppsala University, Akademiska Sjukhuset, Uppsala, 75185, Sweden
| |
Collapse
|
40
|
Zhang H, Liu L, Fu S, Liu YS, Wang C, Liu T, Liu ZP, Wang RT, Yu KJ. Higher platelet distribution width predicts poor prognosis in laryngeal cancer. Oncotarget 2018. [PMID: 28624815 PMCID: PMC5564632 DOI: 10.18632/oncotarget.18306] [Citation(s) in RCA: 37] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
Abstract
BACKGROUND Activated platelets promote cancer progression and metastasis. However, the prognostic value of platelet indices in laryngeal cancer remains poorly understood. The purpose of this study was to investigate the predictive significance of platelet indices in laryngeal cancer. RESULTS Of the 241 patients, high platelet distribution width (PDW) levels were observed in 116 (48.1 %) patients. In the Kaplan-Meier analysis, increased PDW was significantly associated with a poorer overall survival (p < 0.001). In the multivariate Cox model, PDW was an independent prognostic index for overall survival (HR=4.381, 95% CI=2.313-8.298, P < 0.001). METHOD The retrospective study included 241 consecutive patients with laryngeal cancer between January 2009 and December 2009. The relationships between PDW and clinicopathological characteristics were analyzed. Kaplan-Meier method and Cox regression were used to evaluate the prognostic impact of PDW. CONCLUSIONS Elevated PDW might be a novel prognostic marker in laryngeal cancer.
Collapse
Affiliation(s)
- Huan Zhang
- Department of Internal Medicine, Harbin Medical University Cancer Hospital, Harbin Medical University, Harbin, Heilongjiang, 150081, China
| | - Li Liu
- Department of Histology and Embryology, Harbin Medical University, Harbin, Heilongjiang, 150081, China
| | - Shuang Fu
- Department of Internal Medicine, Harbin Medical University Cancer Hospital, Harbin Medical University, Harbin, Heilongjiang, 150081, China
| | - Yan-Song Liu
- Department of Intensive Care Unit, Harbin Medical University Cancer Hospital, Harbin Medical University, Harbin, Heilongjiang, 150081, China
| | - Changsong Wang
- Department of Intensive Care Unit, Harbin Medical University Cancer Hospital, Harbin Medical University, Harbin, Heilongjiang, 150081, China
| | - Tiemin Liu
- Department of Internal Medicine, Harbin Medical University Cancer Hospital, Harbin Medical University, Harbin, Heilongjiang, 150081, China.,Division of Hypothalamic Research, Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas, TX, 75390, USA
| | - Zhi-Ping Liu
- Departments of Internal Medicine and Molecular Biology, University of Texas Southwestern Medical Center, Dallas, TX, 75390, USA
| | - Rui-Tao Wang
- Department of Internal Medicine, Harbin Medical University Cancer Hospital, Harbin Medical University, Harbin, Heilongjiang, 150081, China.,Heilongjiang Academy of Medical Science, Harbin, Heilongjiang, 150081, China
| | - Kai-Jiang Yu
- Department of Intensive Care Unit, Harbin Medical University Cancer Hospital, Harbin Medical University, Harbin, Heilongjiang, 150081, China.,Heilongjiang Academy of Medical Science, Harbin, Heilongjiang, 150081, China
| |
Collapse
|
41
|
Xu XR, Yousef GM, Ni H. Cancer and platelet crosstalk: opportunities and challenges for aspirin and other antiplatelet agents. Blood 2018. [PMID: 29519806 DOI: 10.1182/blood-2017-05-743187] [Citation(s) in RCA: 197] [Impact Index Per Article: 32.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
Platelets have long been recognized as key players in hemostasis and thrombosis; however, growing evidence suggests that they are also significantly involved in cancer, the second leading cause of mortality worldwide. Preclinical and clinical studies showed that tumorigenesis and metastasis can be promoted by platelets through a wide variety of crosstalk between platelets and cancer cells. For example, cancer changes platelet behavior by directly inducing tumor-platelet aggregates, triggering platelet granule and extracellular vesicle release, altering platelet phenotype and platelet RNA profiles, and enhancing thrombopoiesis. Reciprocally, platelets reinforce tumor growth with proliferation signals, antiapoptotic effect, and angiogenic factors. Platelets also activate tumor invasion and sustain metastasis via inducing an invasive epithelial-mesenchymal transition phenotype of tumor cells, promoting tumor survival in circulation, tumor arrest at the endothelium, and extravasation. Furthermore, platelets assist tumors in evading immune destruction. Hence, cancer cells and platelets maintain a complex, bidirectional communication. Recently, aspirin (acetylsalicylic acid) has been recognized as a promising cancer-preventive agent. It is recommended at daily low dose by the US Preventive Services Task Force for primary prevention of colorectal cancer. The exact mechanisms of action of aspirin in chemoprevention are not very clear, but evidence has emerged that suggests a platelet-mediated effect. In this article, we will introduce how cancer changes platelets to be more cancer-friendly and highlight advances in the modes of action for aspirin in cancer prevention. We also discuss the opportunities, challenges, and opposing viewpoints on applying aspirin and other antiplatelet agents for cancer prevention and treatment.
Collapse
Affiliation(s)
- Xiaohong Ruby Xu
- Department of Laboratory Medicine, Keenan Research Centre for Biomedical Science, Li Ka Shing Knowledge Institute, St. Michael's Hospital, and
- Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, ON, Canada
- Guangdong Provincial Hospital of Chinese Medicine, Guangzhou University of Chinese Medicine, Guangzhou, People's Republic of China
| | - George M Yousef
- Department of Laboratory Medicine, Keenan Research Centre for Biomedical Science, Li Ka Shing Knowledge Institute, St. Michael's Hospital, and
- Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, ON, Canada
| | - Heyu Ni
- Department of Laboratory Medicine, Keenan Research Centre for Biomedical Science, Li Ka Shing Knowledge Institute, St. Michael's Hospital, and
- Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, ON, Canada
- Canadian Blood Services Centre for Innovation, Toronto, ON, Canada; and
- Department of Medicine and
- Department of Physiology, University of Toronto, Toronto, ON, Canada
| |
Collapse
|
42
|
Mean platelet volume predicts survival in pancreatic cancer patients with synchronous liver metastases. Sci Rep 2018; 8:6014. [PMID: 29662100 PMCID: PMC5902615 DOI: 10.1038/s41598-018-24539-0] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2017] [Accepted: 04/03/2018] [Indexed: 02/06/2023] Open
Abstract
Most pancreatic cancer (PC) patients manifest multiple liver metastases at the time of diagnosis. Activated platelets play a key role in tumor growth and tumor metastases. Mean platelet volume (MPV) is a platelet index and is altered in patients with malignancies. This study aimed to evaluate whether MPV can effectively predict death in PC patients with synchronous liver metastases. The clinical data of 411 PC patients with synchronous liver metastases between January 1, 2006 and December 31, 2013 were retrospectively analyzed. Subjects were divided into two groups by MPV levels. Clinicopathological data were collected retrospectively and relationships between MPV levels and clinical parameters were evaluated. Survival analysis was performed. Increased MPV was not significantly correlated with tumor location, tumor size, and CA19.9. The Kaplan-Meier analysis showed that the overall survival of patients with MPV > 8.7 fL was significantly shorter than that of those with MPV ≤ 8.7 fL (log-rank p < 0.001). Multivariable Cox proportional hazards model identified MPV as an independent poor prognostic factor for overall survival. In conclusion, elevated MPV is associated with worse survival outcome in PC patients with synchronous liver metastases. Further studies are warranted.
Collapse
|
43
|
Zhou Q, Huang F, He Z, Zuo MZ. Clinicopathological and prognostic significance of platelet count in patients with ovarian cancer. Climacteric 2017; 21:60-68. [PMID: 29231068 DOI: 10.1080/13697137.2017.1406911] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
AIM Increasing evidence indicates that platelet count is a useful biomarker of long-term outcomes in patients with ovarian cancer. However, the prognostic value of platelet count in patients with ovarian cancer remains controversial. We therefore conducted a meta-analysis aimed to investigate the prognostic role of the platelet count in patients with ovarian cancer. METHOD A comprehensive search was performed from the databases of PubMed, Embase and the Cochrane Library until June 20, 2017. A total of 18 studies with 6754 patients were included. Hazard ratios (HRs) and the corresponding 95% confidence intervals (CIs) and odds ratios and 95% CIs from each study were pooled. RESULTS The results demonstrated that elevated pretreatment platelet count was significantly related to poor survival from ovarian cancer; the pooled HRs for overall, progression-free and disease-free survival were 1.81 (95% CI 1.52-2.15), 1.48 (95% CI 1.24-1.75) and 1.39 (95% CI 1.19-1.61), respectively. Subgroup analyses were divided by ethnicity, sample size, FIGO stage, cut-off value of the platelet count, analysis method and Newcastle Ottawa Scale score, but the results did not show any significant change in the main results. Increased platelet count was also significantly associated with the FIGO stage, tumor differentiation, ascites, residual tumor mass, CA125 level, recurrence and metastasis. CONCLUSION This meta-analysis revealed that an elevated platelet count pretreatment denotes a predictive factor of poor prognosis and unfavorable clinicopathological parameters for ovarian cancer patients.
Collapse
Affiliation(s)
- Q Zhou
- a Department of Gynecology and Obstetrics , The People's Hospital of Three Gorges University/The First People's Hospital of Yichang , Yichang , China
| | - F Huang
- a Department of Gynecology and Obstetrics , The People's Hospital of Three Gorges University/The First People's Hospital of Yichang , Yichang , China
| | - Z He
- a Department of Gynecology and Obstetrics , The People's Hospital of Three Gorges University/The First People's Hospital of Yichang , Yichang , China
| | - M-Z Zuo
- a Department of Gynecology and Obstetrics , The People's Hospital of Three Gorges University/The First People's Hospital of Yichang , Yichang , China
| |
Collapse
|
44
|
Zhou LH, Luo XF. Platelet to lymphocyte ratio in biliary tract cancer: Review and meta-analysis. Clin Chim Acta 2017; 474:102-107. [DOI: 10.1016/j.cca.2017.09.006] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2017] [Revised: 09/06/2017] [Accepted: 09/09/2017] [Indexed: 02/07/2023]
|
45
|
Zhang X, Cui MM, Fu S, Li LL, Liu YS, Liu ZP, Liu T, Wang RT, Yu KJ. Platelet distribution width correlates with prognosis of gastric cancer. Oncotarget 2017; 8:20213-20219. [PMID: 28423627 PMCID: PMC5386756 DOI: 10.18632/oncotarget.15561] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2016] [Accepted: 01/17/2017] [Indexed: 11/25/2022] Open
Abstract
Background Activated platelets promote tumor cell growth, aberrant angiogenesis, and invasion. However, the value of platelet indices for predicting survival in gastric cancer remains unknown. The goal of this study was to investigate the predictive significance of platelet indices in gastric cancer. Result Reduced platelet distribution width (PDW) was significantly correlated with age, carcinoembryonic antigen, tumor stage, nodule stage, and tumor-nodule-metastases stage. Moreover, decreased PDW correlated with a shorter overall survival in gastric cancer. Multivariate analysis identified PDW as an independent prognostic factor for overall survival (hazard ratio: 0.493, 95% confidence interval: 0.319-0.761, p = 0.001). Method A total of 294 patients with gastric cancer were retrospectively analyzed between January 2009 and December 2009. The association between platelet indices and overall survival were evaluated. The prognostic analysis was carried out with Cox regression model. Conclusion PDW is easily available with routine blood counts. Our data revealed that reduced PDW is unfavorable prognostic factor in gastric cancer. Further studies are warranted.
Collapse
Affiliation(s)
- Xin Zhang
- Department of Internal Medicine, The Third Affiliated Hospital, Harbin Medical University, Harbin, Heilongjiang, 150081, China
| | - Ming-Ming Cui
- Department of Internal Medicine, The Third Affiliated Hospital, Harbin Medical University, Harbin, Heilongjiang, 150081, China
| | - Shuang Fu
- Department of Internal Medicine, The Third Affiliated Hospital, Harbin Medical University, Harbin, Heilongjiang, 150081, China
| | - Lu-Lu Li
- Department of Geriatrics, The Second Affiliated Hospital, Harbin Medical University, Harbin, Heilongjiang, 150086, China
| | - Yan-Song Liu
- Department of Intensive Care Unit, The Third Affiliated Hospital, Harbin Medical University, Harbin, Heilongjiang, 150081, China
| | - Zhi-Ping Liu
- Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas, TX, 75390, USA
| | - Tiemin Liu
- Division of Hypothalamic Research, Department of Internal Medicine, UT Southwestern Medical Center, Dallas, TX, 75390, USA
| | - Rui-Tao Wang
- Department of Internal Medicine, The Third Affiliated Hospital, Harbin Medical University, Harbin, Heilongjiang, 150081, China
| | - Kai-Jiang Yu
- Department of Intensive Care Unit, The Third Affiliated Hospital, Harbin Medical University, Harbin, Heilongjiang, 150081, China
| |
Collapse
|
46
|
Xu ZS, Zhang FP, Zhang Y, Ou-Yang YP, Yu XW, Wang WL, Xu WJ, Luo ZQ. Prognostic role of the pre-treatment platelet-lymphocyte ratio in pancreatic cancer: a meta-analysis. Oncotarget 2017; 8:99003-99012. [PMID: 29228745 PMCID: PMC5716785 DOI: 10.18632/oncotarget.20871] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2016] [Accepted: 09/03/2017] [Indexed: 12/18/2022] Open
Abstract
Background and Aims Recently, the pre-treatment platelet-lymphocyte ratio (PLR), which is based on blood parameters, was accepted as a prognostic factor for patients with various cancers. Numerous studies have investigated the prognostic role of the PLR in pancreatic cancer; however, it remains unclear. Therefore, we conducted this meta-analysis to evaluate the relationship between the pre-treatment PLR and overall survival (OS) in pancreatic cancer. Materials and Methods We performed a systematic literature search of the PubMed, Embase and Web of Science databases for relevant studies that explored the prognostic role of the pre-treatment PLR in pancreatic cancer. The hazard ratios (HRs) and 95% confidence intervals (CIs) related to OS were pooled using a random effects model. Results Fourteen retrospective cohort studies involving 2,260 patients were included in this meta-analysis. Compared with low PLR, high PLR was a predictor of shorter OS (HR = 1.24, 95% CI: 1.10–1.39, I2 = 74%). Conclusions In this meta-analysis, high pre-treatment PLR was a bio-predictor of short OS in patients with pancreatic cancer, suggesting that PLR could be used to predict prognosis of patients with pancreatic cancer before treatment. However, additional well-designed and large-scale studies are necessary.
Collapse
Affiliation(s)
- Zheng-Shui Xu
- Department of General Surgery, GuangRen Hospital of Xi'an Jiaotong University, 710000, Xi'an, Shaanxi, China
| | - Fa-Peng Zhang
- Department of General Surgery, The Second Affiliated Hospital of Sun Yat-Sen University, 510120, Guangzhou, Guangdong, China
| | - Yin Zhang
- Department of General Surgery, The Second Affiliated Hospital of Nanchang University, 330006, Nanchang, Jiangxi, China
| | - Yong-Peng Ou-Yang
- Department of General Surgery, The Second Affiliated Hospital of Nanchang University, 330006, Nanchang, Jiangxi, China
| | - Xiao-Wen Yu
- Department of General Surgery, The Second Affiliated Hospital of Nanchang University, 330006, Nanchang, Jiangxi, China
| | - Wen-Long Wang
- Department of General Surgery, The Second Affiliated Hospital of Nanchang University, 330006, Nanchang, Jiangxi, China
| | - Wen-Ji Xu
- Department of General Surgery, The Second Affiliated Hospital of Nanchang University, 330006, Nanchang, Jiangxi, China
| | - Zhi-Qiang Luo
- Department of General Surgery, The Second Affiliated Hospital of Nanchang University, 330006, Nanchang, Jiangxi, China
| |
Collapse
|
47
|
Li N, Yu Z, Zhang X, Liu T, Sun YX, Wang RT, Yu KJ. Elevated mean platelet volume predicts poor prognosis in colorectal cancer. Sci Rep 2017; 7:10261. [PMID: 28860547 PMCID: PMC5579290 DOI: 10.1038/s41598-017-11053-y] [Citation(s) in RCA: 42] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2017] [Accepted: 08/18/2017] [Indexed: 01/21/2023] Open
Abstract
Altered mean platelet volume (MPV) is implicated in several malignancies. However, the clinicopathological significance and prognostic value of MPV in colorectal cancer (CRC) is still elusive. The purpose of this study was to elucidate the predictive significance of MPV in CRC. The retrospective study recruited 509 consecutive CRC patients between January 2009 and December 2009. The relationships between MPV and clinicopathological characteristics were analyzed. Kaplan-Meier method and Cox regression were used to evaluate the prognostic impact of MPV. Of the 509 CRC patients, high MPV levels were detected in 150 (29.5%) patients. Elevated MPV was associated with tumor differentiation (p < 0.001). Patients with increased MPV had poor overall survival compared with those with normal level (60.0% vs. 83.6%, log-rank test, p = 0.035). Cox regression analysis showed that MPV was an independent prognostic factor in CRC (HR = 1.452, 95% CI = 1.118-1.884, p = 0.005). In conclusion, MPV is easily available in routine blood test. Elevated MPV might act as a marker of prognosis and therapeutic target for CRC.
Collapse
Affiliation(s)
- Na Li
- Department of Internal Medicine, Harbin Medical University Cancer Hospital, Harbin Medical University, Harbin, Heilongjiang, 150081, China
| | - Zhiwei Yu
- Department of Colorectal Surgery, Harbin Medical University Cancer Hospital, Harbin Medical University, Harbin, Heilongjiang, 150081, China
| | - Xin Zhang
- Department of Internal Medicine, Harbin Medical University Cancer Hospital, Harbin Medical University, Harbin, Heilongjiang, 150081, China
| | - Tiemin Liu
- Department of Internal Medicine, Harbin Medical University Cancer Hospital, Harbin Medical University, Harbin, Heilongjiang, 150081, China.,Division of Hypothalamic Research, Department of Internal Medicine, UT Southwestern Medical Center, Dallas, TX, 75390, USA
| | - Yu-Xiang Sun
- Children's Nutrition Research Center, Huffington Center on Aging, Departments of Pediatrics & Molecular and Cellular Biology, Baylor College of Medicine, Houston, Texas, 77030, USA
| | - Rui-Tao Wang
- Department of Internal Medicine, Harbin Medical University Cancer Hospital, Harbin Medical University, Harbin, Heilongjiang, 150081, China. .,Heilongjiang Academy of Medical Science, Harbin, Heilongjiang, 150081, China.
| | - Kai-Jiang Yu
- Department of Intensive Care Unit, Harbin Medical University Cancer Hospital, Harbin Medical University, Harbin, Heilongjiang, 150081, China. .,Heilongjiang Academy of Medical Science, Harbin, Heilongjiang, 150081, China.
| |
Collapse
|
48
|
Lower mean platelet volume predicts poor prognosis in renal cell carcinoma. Sci Rep 2017; 7:6700. [PMID: 28751781 PMCID: PMC5532284 DOI: 10.1038/s41598-017-07168-x] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2017] [Accepted: 06/23/2017] [Indexed: 01/21/2023] Open
Abstract
Altered mean platelet volume (MPV) is found in several malignancies. Remarkably, there is little consensus on using the value of MPV in the prognostic evaluations of renal cell carcinoma (RCC). The aim of this study is to examine the feasibility of MPV value as a prognostic indicator of RCC. The retrospective study recruited 306 consecutive RCC patients between January 2009 and December 2009. The relationships between MPV and clinicopathological characteristics were analyzed. Kaplan-Meier method and Cox regression were used to evaluate the prognostic impact of MPV. Of the 306 RCC patients, low MPV levels were detected in 61 (19.9%) patients. Reduced MPV was associated with histology types, T classification, UCLA Integrated Scoring System (UISS) category, and Mayo clinic stage, size, grade, and necrosis score (SSIGN) category (P < 0.05). Patients with decreased MPV had significantly shorter survival time than patients with normal MPV (P < 0.001). Cox regression analysis revealed that reduced MPV was an independent prognostic factor for overall survival (hazard ratio, 1.758; 95% confidence interval [CI], 1.083–2.855, P = 0.023). Moreover, the prognostic accuracy of TNM stage, UISS, and SSIGN prognostic models were improved when MPV was added. In conclusion, reduced MPV is identified as an independent predictor of adverse clinical outcome in RCC.
Collapse
|
49
|
Wang X, Cui MM, Xu Y, Liu L, Niu Y, Liu T, Liu ZP, Wang RT, Yu KJ. Decreased mean platelet volume predicts poor prognosis in invasive bladder cancer. Oncotarget 2017; 8:68115-68122. [PMID: 28978101 PMCID: PMC5620241 DOI: 10.18632/oncotarget.19242] [Citation(s) in RCA: 31] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2017] [Accepted: 06/10/2017] [Indexed: 02/06/2023] Open
Abstract
Background Altered mean platelet volume (MPV) is implicated in a wide range of cancers. However, the prognostic role of MPV in muscle-invasive bladder cancer (MIBC) remains largely unknown. The purpose of this study was to elucidate the predictive significance of MPV in MIBC. Method The retrospective study included 218 consecutive MIBC patients between January 2009 and December 2009. The relationships between MPV and clinicopathological characteristics were analyzed. Kaplan-Meier method and Cox regression were used to evaluate the prognostic impact of MPV. Result Of the 218 patients, low MPV levels were detected in 141 (64.7 %) patients. Reduced MPV was associated with T stage and histology grade (p < 0.05). In the Kaplan-Meier analysis, decreased MPV was significantly associated with a poorer overall survival (p = 0.007). In the multivariate Cox model, decreased MPV was an independent prognostic index for overall survival (HR=2.023, 95% CI=1.050-3.897, p = 0.025). Conclusion MPV is easily available in routine blood test. Our results demonstrated that reduced MPV could be regarded as a potential prognosis indicator for clinical outcome in MIBC.
Collapse
Affiliation(s)
- Xin Wang
- Department of Internal Medicine, Harbin Medical University Cancer Hospital, Harbin Medical University, Harbin, Heilongjiang 150081, China
| | - Ming-Ming Cui
- Department of Internal Medicine, Harbin Medical University Cancer Hospital, Harbin Medical University, Harbin, Heilongjiang 150081, China
| | - Yangyang Xu
- Department of Urinary Surgery, Harbin Medical University Cancer Hospital, Harbin Medical University, Harbin, Heilongjiang 150081, China.,Heilongjiang Academy of Medical Science, Harbin, Heilongjiang 150081, China
| | - Li Liu
- Heilongjiang Academy of Medical Science, Harbin, Heilongjiang 150081, China
| | - Ye Niu
- Department of Geriatrics, The Second Affiliated Hospital, Harbin Medical University, Harbin, Heilongjiang 150086, China
| | - Tiemin Liu
- Department of Internal Medicine, Harbin Medical University Cancer Hospital, Harbin Medical University, Harbin, Heilongjiang 150081, China.,Division of Hypothalamic Research, Department of Internal Medicine, UT Southwestern Medical Center, Dallas, TX 75390, USA
| | - Zhi-Ping Liu
- Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas, TX 75390, USA
| | - Rui-Tao Wang
- Department of Internal Medicine, Harbin Medical University Cancer Hospital, Harbin Medical University, Harbin, Heilongjiang 150081, China.,Heilongjiang Academy of Medical Science, Harbin, Heilongjiang 150081, China
| | - Kai-Jiang Yu
- Department of Intensive Care Unit, Harbin Medical University Cancer Hospital, Harbin Medical University, Harbin, Heilongjiang 150081, China.,Heilongjiang Academy of Medical Science, Harbin, Heilongjiang 150081, China
| |
Collapse
|
50
|
The potential role of platelets in the consensus molecular subtypes of colorectal cancer. Cancer Metastasis Rev 2017; 36:273-288. [DOI: 10.1007/s10555-017-9678-9] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
|