Reduced mean platelet volume is associated with poor prognosis in esophageal cancer

A preliminary investigation of blood cell counts for esophageal cancer screening: differentiating esophageal cancer from gastroesophageal reflux disease

Esophageal Cancer (EC) ranks as the eleventh most prevalent malignancy globally and the seventh leading cause of cancer-related mortality. There is growing evidence to suggest that blood routine parameters have diagnostic and prognostic value in oncology. This study was designed to analyze whether there are any significant differences in complete blood count (CBC) parameters between patients with EC, patients with gastroesophageal reflux disease (GERD), and healthy controls (HC). We retrospectively analyzed selected blood parameters from 209 HC, 209 patients diagnosed with EC, and 198 patients suffering from GERD. We found significant differences in platelet count (PLT), mean platelet volume (MPV), plateletcrit (PCT), platelet distribution width (PDW), neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and lymphocyte-to-monocyte ratio (LMR) among the EC, GERD, and HC groups. Of note, PDW and LMR exhibited significant differences specifically between the EC and GERD groups. In conclusion, the LMR holds diagnostic significance and can differentiate patients with EC from those with GERD. The integration of hematological parameters and clinical manifestations serves as a guiding principle for both medical practitioners and patients in determining the necessity for upper gastrointestinal endoscopy, thereby potentially enhancing the early detection rate of EC.

A prognostic nomogram that includes MPV in esophageal squamous cell carcinoma

BACKGROUND

Mean platelet volume (MPV), as a marker of platelet activity, has been shown to be an efficient prognostic biomarker in several types of cancer. Using MPV, this study aimed to create and validate a prognostic nomogram to the overall survival in esophageal squamous cell carcinoma (ESCC) patients.

METHODS

The nomogram was constructed and tested using data from a retrospective study of 1893 patients who were randomly assigned to the training and testing cohorts with a 7:3 randomization. In order to screen out the optimal predictors for overall survival (OS), we conducted the LASSO-cox regression, univariate, and multivariate cox regression analyses. Subsequently, the predictive accuracy of the nomogram was validated in both the training and the testing cohorts. Finally, decision curve analysis (DCA) was used to confirm clinical validity.

RESULTS

Age, MPV, nerve invasion, T stage, and N stage were found as independent prognostic variables for OS and were further developed into a nomogram. The nomogram's prediction accuracy for 1-, 3-, and 5-year OS was 0.736, 0.749, 0.774, and 0.724, 0.719, 0.704 in the training and testing cohorts, respectively. Furthermore, DCA results indicated that nomograms outperformed the AJCC 8th and conventional T, N staging systems in both the training and testing cohorts.

CONCLUSIONS

The nomogram, in conjunction with MPV and standard clinicopathological markers, could improve the accuracy of prediction of OS in ESCC patients.

Adjuvant chemotherapy for lymph node positive esophageal squamous cell cancer: The prediction role of low mean platelet volume

Background

This study aimed to examine whether MPV is a useful prognostic marker and investigated whether MPV is a risk factor that helps identify patients with locally advanced-stage ESCC who will most likely benefit from adjuvant chemotherapy.

Methods

Patients (n =1690) with histologically confirmed ESCC were diagnosed with locally advanced stage (pT3-4N0M0 and pT1-4N+M0) at Sichuan Cancer Hospital from 2009 to 2017. Clinicopathological factors and platelet-related values were tested for their associations with survival using univariate and multivariate Cox regression analyses. The optimal cut-off value for continuous variables was determined using the 'maxstat' R package. The KM curve continuous variable analysis was performed to identify the optimal cut-off value for MPV. Cumulative survival rates were determined using the Kaplan-Meier estimator and compared using the log-rank test. The survival analysis was performed using the 'survival' R package. All statistical analyses were performed using R software 4.1.3 (https://www.r-project.org/), and a two-sided p-value <0.05 was considered to indicate statistical significance.

Results

Multivariate analysis indicated that low MPV was an important risk factor for overall survival in locally advanced ESCC, independent of classic clinicopathological factors. The optimal cut-off value of MPV (11.8 fL) was used to stratify high-risk patients. Patients with low mean platelet volumes had a worse prognosis than those with larger platelet volumes, according to Kaplan-Meier analysis and the log-rank test. Patients diagnosed with a pathological lymph node-positive stage with a low MPV (≤11.8 fL) benefited from postoperative chemotherapy, but not those with a high-level MPV (>11.8 fL).

Conclusion

MPV served as an independent predictor of prognosis of locally advanced-stage ESCC and predicted a survival benefit conferred by postoperative adjuvant chemotherapy in lymph node-positive ESCC.

Utility of Blood Markers for Predicting Outcomes of Fertility Preservation in Patients With Breast Cancer

This study aimed to investigate the usability of blood markers for predicting controlled ovarian stimulation (COS) outcomes in patients with breast cancer undergoing fertility preservation (FP). In total, 91 patients with breast cancer who had undergone COS using a letrozole-combined gonadotropin-releasing hormone (GnRH) antagonist protocol before chemotherapy were enrolled retrospectively in a single tertiary hospital. FP outcomes were compared in terms of the mean platelet volume (MPV), MPV/platelet count (PC), neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and lymphocyte-to-monocyte ratio (LMR). The cutoff values for obtaining 10 or more mature oocytes as favorable prognoses were obtained for each parameter, and the COS outcomes were compared based on the cutoff values. The optimal cutoff levels for MPV and MPV/PC were 10.15 [sensitivity: 90.0%; specificity: 45.1%; AUC: 0.687; 95% CI (0.563, 0.810)] and 0.41 [sensitivity: 65.0%; specificity: 67.6%; AUC: 0.682; 95% CI (0.568, 0.796)], respectively. The oocyte numbers did not significantly differ with respect to the cutoff values of NLR, PLR, and LMR (p > 0.05). However, the total number of acquired and mature oocytes were significantly lower in the group with MPV<10.15 than in that with MPV≥10.15 (8.0 ± 5.1 vs. 12.6 ± 9.1, p=0.003; 4.0 ± 3.7 vs. 7.3 ± 6.3, p=0.002, respectively). Similarly, considering the cutoff of MPV/PC as 0.41, the low-MPV/PC group showed a significantly lower total oocyte yield than the high-MPV/PC group (9.5 ± 7.1 vs. 13.1 ± 9.1, p=0.048), whereas the number of mature oocytes showed similar patterns with no statistical significance (5.3 ± 5.4 vs. 7.3 ± 6.1, p=0.092). From logistic regression analysis, age, anti-Müllerian hormone (AMH) level, MPV, and MPV/PC≥0.41 were found to be significant factors for the acquisition of 10 or more MII oocytes (p=0.049, OR: 0.850; p<0.001, OR: 1.622; p=0.018, OR: 3.184; p=0.013, OR: 9.251, respectively). MPV or MPV/PC can be a reliable marker for predicting FP outcome in patients with breast cancer. Protocols to acquire more mature oocytes, such as the dual-trigger approach, could be recommended for patients with breast cancer with MPV<10.15. Furthermore, a higher dose of gonadotropins was considered to obtain more oocytes in patients with MPV/PC<0.41.

The clinical significance of preoperative serum fibrinogen levels and platelet counts in patients with gallbladder carcinoma

Background

Gallbladder carcinoma (GBC) was the most common malignancy of biliary tract. Patients with malignancies frequently present with activated coagulation pathways, which might potentially related to tumor progression and prognosis. The purpose of the study was to investigate the clinical significance of preoperative serum fibrinogen levels and platelet counts in GBC patients.

Methods

The preoperative fasting serum fibrinogen levels and platelet counts of 58 patients with GBC were measured by AUV2700 automatic biochemical analyzer, as well as 60 patients with cholesterol polyps and 60 healthy volunteers. Kaplan–Meier survival analysis was applied to show the correction between fibrinogen levels and outcome after surgery.

Results

The fibrinogen levels of patients with GBC were significantly higher than healthy gallbladder and cholesterol polyp of gallbladder (p < 0.001 and p < 0.001, respectively). In GBC, fibrinogen levels were associated with tumor depth (p = 0.001), lymph node metastasis (p = 0.002), distant metastasis (p < 0.001) and Tumor Node Metastasis (TNM) stage (p < 0.001). The levels in TNM stage IV disease were significantly higher than stage III or stage I + II disease (p = 0.048 and p < 0.001, respectively), and in TNM stage III disease were significantly higher than stage I + II disease (p = 0.002). Furthermore, the overall survival was better in low fibrinogen level group than in high fibrinogen level group (p < 0.001). However, thrombocytosis was not significantly associated with overall survivals (p > 0.05) in multivariate analysis.

Conclusions

The preoperative serum fibrinogen levels and platelet counts might be reliable biomarkers for the occurance of disease, tumor depth, lymph node metastasis, distant metastasis and advanced TNM stage in patients with GBC. The serum fibrinogen levels might be a prognostic factor to predict outcome for GBC patients suffering from surgery treatment. Anticoagulation therapy might be considered to control cancer progression in future studies.

Platelets: The Emerging Clinical Diagnostics and Therapy Selection of Cancer Liquid Biopsies

Due to the inherent molecular heterogeneity of metastatic tumours and the dynamic evolution ability of tumour genomes, tumour tissues obtained through biopsy and other methods cannot capture all of the features of tumour genomes. A new diagnostic concept called “liquid biopsy” has received widespread attention in recent years. Liquid biopsy has changed the clinical practice of oncology and is widely used to guide targeted drug utilization, monitor disease progression and track drug resistance. The latest research subject in liquid biopsy is platelets. Platelets originate from multifunctional haematopoietic stem cells in the bone marrow haematopoietic system. They are small cells from the cytoplasm of bone marrow megakaryocytes. Their main physiological functions are to participate in the processes of physiological haemostasis and coagulation. Tumour cells transfer biomolecules (such as RNA) to platelets through direct contact and release of exosomes, which changes the platelet precursor RNA. Under the stimulation of tumour cells and the tumour microenvironment, platelet precursor mRNA is spliced into mature RNA and converted into functional protein to respond to external stimuli, forming tumour-educated platelets (TEPs). The detection of TEPs in the peripheral blood of patients is expected to be used in clinical tumour diagnosis. This emerging liquid biopsy method can replace and supplement the current tumour detection methods. Further research on the role of platelets in tumour diagnosis will help provide a novel theoretical basis for clinical tumour diagnosis.

Prognostic value of platelet distribution width and mean platelet volume in patients with laryngeal cancer

Aims: To investigate the prognostic relevance of platelet volume indices for survival in laryngeal cancer. Patients & methods: The study included 640 patients with laryngeal cancer. We analyzed the optimal cutoff values through receiver operating characteristic analysis, then analyzed the univariate factor and multivariate variables. Kaplan-Meier curves and log-rank tests were conducted to compare the overall survival (OS) and recurrence-free survival rates between the groups. Results: In multivariate analysis, elevated platelet distribution width (PDW) and PDW/platelet count ratio were significantly correlated with poor prognosis for OS; however, elevated mean platelet volume (MPV) and MPV/platelet count ratio suggested a notable correlation with favorable prognosis for OS. Meanwhile, elevated PDW and decreased MPV were significantly correlated with poor prognosis for recurrence-free survival. Conclusions: Our findings indicate that elevated PDW and decreased MPV could serve as independent biomarkers for worse survival in laryngeal cancer.

Economical and easily detectable markers of digestive tumors: platelet parameters

Aim: This study aimed to evaluate the clinical values of platelet parameters in patients with digestive tumors. Patients & methods: A total of 974 people were classified into three groups: malignant group, patients with digestive malignant tumors; benign group, patients with benign tumors; and normal group: healthy individuals. Results: Compared with the benign and normal groups, the malignant group showed significantly increased platelet count (PLT) and plateletcrit (PCT) and significantly reduced mean platelet volume (MPV) and platelet-large cell rate (P-LCR, p < 0.001). Elevated PLT and PCT and reduced MPV and P-LCR indicated poor overall survival in patients with digestive tumors. Conclusion: PLT, PCT, MPV and P-LCR were proven to be predictive biomarkers for patients with digestive malignant tumors. Elevated PLT and PCT or decreased MPV and P-LCR indicated poor overall survival.

Prognostic and clinicopathological significance of pretreatment mean platelet volume in cancer: a meta-analysis

OBJECTIVE

Our study aimed to evaluate the prognostic and clinicopathological significance of pretreatment mean platelet volume (MPV) on cancer by using meta-analysis of published studies.

DESIGN

Meta-analysis.

DATA SOURCES

Relevant studies available before 22 December 2019 were identified by searching MEDLINE, EMBASE.

ELIGIBILITY CRITERIA

All published studies that assessed the prognostic and clinicopathological significance of pretreatment MPV on cancer were included.

DATA EXTRACTION AND SYNTHESIS

Studies were identified and extracted by two reviewers independently. The HR/OR and its 95% CIs of survival outcomes and clinicopathological parameters were calculated.

RESULTS

A total of 38 eligible studies (41 subsets) with 9894 patients with cancer were included in the final meta-analysis. MPV level was not significantly associated with both overall survival (HR 0.98, 95% CI 0.84 to 1.14) and disease-free survival (HR 1.22, 95% CI 0.86 to 1.73) of patients with cancer. Neither advanced nor mixed-stage tumour patients showed significant association between MPV and overall survival (HR 1.36, 95% CI 0.96 to 1.94, HR 0.90, 95% CI 0.74 to 1.09). However, high MPV had the strongest relationship with poor overall survival (HR 2.01; 95% CI 1.08 to 3.41) in gastric cancer, followed by pancreatic cancer (HR 1.54; 95% CI 1.31 to 1.82). Whereas in the subgroup using receiver operating characteristic curve method to define cut-off values, low MPV was significantly related to poor overall survival (HR 0.78, 95% CI 0.64 to 0.95). In addition, MPV had no significant association with age (OR 0.96, 95% CI 0.90 to 1.02), sex (OR 1.04, 95% CI 1.00 to 1.09), depth of cancer invasion (OR 0.90, 95% CI 0.77 to 1.04) and tumour stage (OR 0.91, 95% CI 0.78 to 1.07).

CONCLUSIONS

Pretreatment MPV level is of no clearly prognostic significance in cancers and no significant association with clinicopathological parameters of patients with cancers.

Mean Platelet Volume Has Prognostic Value in Chronic Lymphocytic Leukemia

PURPOSE

Mean platelet volume (MPV) is a readily accessible and commonly tested hematological indicator. Recent studies revealed a significant impact of MPV on the course and prognosis of many diseases, including some types of cancer, as well as on the incidence of atrial fibrillation and bleeding. The study aimed to perform a retrospective analysis of MPV in terms of time to first treatment (TTFT) and to determine its prognostic value in the group of patients with chronic lymphocytic leukemia (CLL). Moreover, the study includes a retrospective analysis of platelet parameters in patients treated with ibrutinib concerning bleeding and atrial fibrillation.

PATIENTS AND METHODS

The study included 523 patients with CLL, for 344 the most important cytogenetic aberrations were reported. The Mann-Whitney, Kruskal-Wallis, Kaplan-Meier, chi-squared, log‑rank tests and multivariate Cox proportional hazard regression model were used to analyze collected data.

RESULTS

The receiver operating characteristic curve analysis was performed to identify optimal cut-off value for MPV. The analysis of survival curves showed that in the group of patients with higher values of MPV TTFT was significantly longer than in the group with lower MPV (17.9 vs 36 months, p=0.0015, cut-off value for MPV= 10.4 fl). In multivariate Cox proportional hazard regression model low MPV, the presence of del11q and del13q provided independent prognostic value for TTFT (HR=0.69, 95%-CI, 0.5293 to 0.9081; p=0.0078; HR=1.76, 95%-CI, 1.3000 to 2.3882, p=0.0003, HR=0.74, 95%-Cl, 0.5674 to 0.9588, p=0.0229, respectively). In the group treated with ibrutinib, 59 patients had no significant correlation between MPV level and the incidence of therapy complications, although in the group of patients with low MPV there was a tendency for more frequent occurrence of atrial fibrillation (p=0.259).

CONCLUSION

Low MPV values are associated with unfavorable prognosis and might represent a novel, independent prognostic factor in CLL.

Tumor marker index based on preoperative SCC and CYFRA 21-1 is a significant prognostic factor for patients with resectable esophageal squamous cell carcinoma

OBJECTIVE

The aim of this study was to evaluate the prognostic value of a novel tumor marker index (TMI) based on preoperative serum levels of squamous cell carcinoma antigen (SCC) and cytokeratin 19 fragment (CYFRA 21-1) for patients with resectable esophageal squamous cell carcinoma (ESCC).

METHODS

A total of 315 ESCC patients who had underwent curative surgery between 2008 and 2012 were retrospectively included in this study. The TMI was defined as the geometric mean of normalized SCC and CYFRA21-1 levels. Univariate and multivariate survival analyses were performed to confirm the clinical and prognostic significance of preoperative SCC and CYFRA 21-1 levels and TMI.

RESULTS

Elevated preoperative SCC was associated with histological grade, pT status, lymph node status and TNM stage. Elevated preoperative CYFRA 21-1 was correlated with tumor size, lymph node status and TNM stage. The overall survival of patients with elevated SCC and CYFRA 21-1 levels was significantly poorer than that of patients with normal levels. Multivariate survival analysis identified that preoperative SCC (P= 0.353) and CYFRA 21-1 (P= 0.139) were not independent prognostic factors. The cut-off value of TMI based on SCC and CYFRA 21-1 was 0.531, and the patients were subdivided into high and low TMI groups. The 5-year survival rate of patients with high TMI was 30.9%, which was significantly lower than that of patients with low TMI (50.4%, P< 0.05). Multivariate analysis identified the TMI (HR 1.371; 95% CI 1.024-1.836; P= 0.034) as an independent prognostic factor.

CONCLUSIONS

Elevated preoperative SCC and CYFRA 21-1 levels were associated with aggressive cancer behavior in ESCC. The TMI based on preoperative SCC and CYFRA 21-1 might serve as a novel marker that can be used to predict the prognosis of ESCC patients.

Elevated platelet distribution width predicts poor prognosis in hepatocellular carcinoma

BACKGROUND

Previous studies have demonstrated that platelets play an important role in growth, invasion, and angiogenesis of a variety of tumors. Nevertheless, the prognostic role of platelet indices in hepatocellular carcinoma (HCC) has not been explored. The aim of this study was to explore the association between platelet indices and prognosis in HCC.

METHOD

A total of 260 patients with HCC between January 2009 and December 2015 were retrospectively analyzed. The optimal platelet distribution width (PDW) cutoff value is identified by the receiver operating characteristic curve (ROC) curve. The relationship between PDW and clinicopathological features was assessed. The prognostic effects of PDW were assessed by using the Kaplan-Meier method and Cox regression model.

RESULT

Elevated PDW level was significantly associated with portal hypertension, vascular invasion, and Child-Pugh grade. In addition, survival curve indicates that patients with high PDW levels have a worse prognosis than patients with low PDW levels (P< 0.001). Multivariate Cox regression analysis identified PDW as an independent factor of prognosis in HCC patients (hazard ratio: 4.460, 95% confidence interval: 2.308-8.619, P< 0.001).

CONCLUSION

Elevated PDW may be a novel marker for predicting the prognosis of HCC, but further research is needed to validate our conclusions.

Prognostic value of mean platelet volume/platelet count ratio in patients with resectable esophageal squamous cell carcinoma: a retrospective study

Background

Mean platelet volume (MPV) to platelet count (PC) ratio (MPV/PC) is a useful indicator in several cancers. However, the role for MPV/PC ratio in esophageal squamous cell carcinoma (ESCC) is still controversial.

Methods

A retrospective study was conducted including 277 resectable ESCC patients. The optimal cut-off values were calculated by the X-tile program. The receiver operator characteristic (ROC) curves were also created to show the candidate cut-off points. The comparisons between the X-tile plot and ROC curve were performed. The Kaplan-Meier method was utilized to analyze the cancer-specific survival (CSS). Prognostic factors for CSS were calculated with Cox regression univariate and multivariate analyses.

Results

According to the X-tile program, the cut-off values for MPV, PC and MPV/PC ratio were 8.5 (fl), 200 (giga/l) and 0.04, respectively. However, the cut-off values for MPV, PC and MPV/PC ratio by the ROC curves were 8.25 (fl), 243.5 (giga/l) and 0.0410, respectively. The cut-off values were similar between the X-tile and ROC curve. A low MPV/PC ratio level (≤0.04) was associated with poor CSS (22.4% vs. 43.1%, P < 0.001). In multivariate analyses, we found that MPV/PC ratio was an independent predictor for CSS (P < 0.001). When we set the cut-off point using ROC curve, the MPV/PC ratio was still an independent predictor for CSS (P < 0.001).

Conclusion

The MPV/PC ratio is a useful predictive indicator in patients with ESCC.

Lower mean platelet volume is a risk indicator of hepatocellular carcinoma recurrence following liver transplantation

BACKGROUND

Lower mean platelet volume (MPV) is an indicator of platelet activity in the setting of tumor development. This study was to assess the relationship between preoperative MPV and survival outcomes of patients with hepatocellular carcinoma (HCC) following liver transplantation (LT).

METHODS

The demographic and clinical characteristics of 304 HCC patients following LT were retrieved from an LT database. All the patients were divided into the normal and lower MPV groups according to the median MPV. The factors were first analyzed using a Kaplan-Meier survival analysis, then the factors with P < 0.10 were selected for multivariate Cox regression analysis and were used to define the independent risk factors for poor prognosis.

RESULTS

The 1-, 3-, and 5-year tumor free survival was 95.34%, 74.67% and 69.29% in the normal MPV group, respectively, and 95.40%, 59.97% and 42.94% in the lower MPV group, respectively (P < 0.01). No significant difference was observed in post-LT complications between the normal and lower MPV groups. Portal vein tumor thrombosis (PVTT) [hazard ratio (HR = 2.24; 95% confidence interval: 1.46-3.43; P < 0.01) and lower MPV (HR = 1.58; 95% confidence interval: 1.05-2.36; P = 0.03) were identified as independent prognostic risk factors for recipient survival.

CONCLUSION

Preoperative lower MPV is a risk indicator of HCC patients survival outcomes after LT.

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

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.

Prognostic Significance of Mean Platelet Volume on Local Advanced Non-Small Cell Lung Cancer Managed with Chemoradiotherapy

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.

Prognostic value of mean platelet volume to plateletcrit ratio in patients with osteosarcoma

Objective

The objective of this study was to investigate the prognostic value of preoperative mean platelet volume to plateletcrit (MPV/PCT) ratio in patients with osteosarcoma.

Materials and methods

The retrospective study included 188 consecutive osteosarcoma patients who experienced neoadjuvant chemotherapy and surgical resection of tumor. The relationships between MPV/PCT and clinicopathological characteristics were analyzed. The Kaplan-Meier analysis and Cox regression proportional hazard model were applied to assess the prognostic value of MPV/PCT ratio.

Results

MPV/PCT ratio was found to be significantly associated with platelet count, platelet distribution width, and PCT (all P<0.001). Kaplan-Meier analysis showed that high MPV/PCT ratio (≥43.58) was associated with a prolonged disease-free survival (DFS, P=0.035). The multivariate Cox revealed that only good chemotherapy response was an independent predictor of better DFS in the overall population. However, the stratification analysis showed that a high MPV/PCT ratio (≥43.58) was indicated as an independent prognostic factor for a favorable DFS (HR =0.137, 95%CI =0.029-0.644, P=0.012) in the male osteosarcoma patients but not in female patients.

Conclusion

The high preoperative MPV/PCT ratio may serve as an independent prognostic factor for a favorable prognosis in male osteosarcoma patients. Further studies are needed to confirm the findings.

Implications of mean platelet volume in health and disease: A large population study on data from National Health and Nutrition Examination Survey

INTRODUCTION

Mean platelet volume (MPV) is a measure of platelet size and activity. We conducted a population study with National Health and Nutrition Examination Survey (NHANES) data to understand the relationship of MPV with health and diseases.

MATERIALS AND METHODS

The NHANES is a cross-sectional survey of non-institutionalized adult population, administered every 2 years by the Centers for Disease Control and Prevention. Participants answer a questionnaire, receive a physical examination, and undergo laboratory tests. Values of MPV were collected over 6 years (2011-2016). Logistic regression was used to predict likelihood of being in categories with MPV < 10th percentile or >90th percentile. Statistical analysis was performed using Stata/SE 15.1.

RESULTS

In our study with 17,969 individuals, the mean MPV was 8.40 [SD = 0.92] femtoliter. Individuals with male sex, age 45-64 years, and recent hospital-stay were more likely to have MPV < 10th percentile. Obese, Blacks and Mexican Americans had higher odds of having MPV > 90th percentile. Individuals with emphysema had significantly higher adjusted Odds [OR 1.92, 95% CI: 1.11-3.31, p = 0.021] of MPV < 10th percentile. Individuals with cancer were less likely to have MPV > 90th percentile [OR 0.74, 95% CI: 0.55-0.99, p = 0.042]. A diagnosis of coronary artery disease, asthma, and chronic obstructive pulmonary disease did not have significant associations with MPV.

CONCLUSIONS

Obese individuals are more likely to have higher MPV. Individuals with emphysema had higher odds of having MPV < 10th percentile and those with cancer were less likely to have MPV > 90th percentile.