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Raskov H, Orhan A, Agerbæk MØ, Gögenur I. The impact of platelets on the metastatic potential of tumour cells. Heliyon 2024; 10:e34361. [PMID: 39114075 PMCID: PMC11305202 DOI: 10.1016/j.heliyon.2024.e34361] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2024] [Revised: 07/08/2024] [Accepted: 07/08/2024] [Indexed: 08/10/2024] Open
Abstract
In cancer, activation of platelets by tumor cells is critical to disease progression. Development of precise antiplatelet targeting may improve outcomes from anticancer therapy. Alongside a distinct shift in functionality such as pro-metastatic and pro-coagulant properties, platelet production is often accelerated significantly early in carcinogenesis and the cancer-associated thrombocytosis increases the risk of metastasis formation and thromboembolic events. Tumor-activated platelets facilitate the proliferation of migrating tumor cells and shield them from immune surveillance and physical stress during circulation. Additionally, platelet-tumor cell interactions promote tumor cell intravasation, intravascular arrest, and extravasation through a repertoire of adhesion molecules, growth factors and angiogenic factors. Particularly, the presence of circulating tumor cell (CTC) clusters in association with platelets is a negative prognostic indicator. The contribution of platelets to the metastatic process is an area of intense investigation and this review provides an overview of the advances in understanding platelet-tumor cell interactions and their contribution to disease progression. Also, we review the potential of targeting platelets to interfere with the metastatic process.
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Affiliation(s)
- Hans Raskov
- Center for Surgical Science, Zealand University Hospital, Køge, Denmark
| | - Adile Orhan
- Center for Surgical Science, Zealand University Hospital, Køge, Denmark
- University of Copenhagen, Faculty of Health and Medical Sciences, Copenhagen, Denmark
| | - Mette Ørskov Agerbæk
- Centre for Translational Medicine and Parasitology, Department of Immunology and Microbiology, University of Copenhagen, Denmark
| | - Ismail Gögenur
- Center for Surgical Science, Zealand University Hospital, Køge, Denmark
- Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
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Boutin R, Rolland J, Codet M, Bézier C, Maes N, Kolh P, Equinet L, Thys M, Moutschen M, Lamy PJ, Albert A. Use of hospital big data to optimize and personalize laboratory test interpretation with an application. Clin Chim Acta 2024; 561:119763. [PMID: 38851476 DOI: 10.1016/j.cca.2024.119763] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2023] [Revised: 04/29/2024] [Accepted: 06/03/2024] [Indexed: 06/10/2024]
Abstract
BACKGROUND AND AIMS In laboratory medicine, test results are generally interpreted with 95% reference intervals but correlations between laboratory tests are usually ignored. We aimed to use hospital big data to optimize and personalize laboratory data interpretation, focusing on platelet count. MATERIAL AND METHODS Laboratory tests were extracted from the hospital database and exploited by an algorithmic stepwise procedure. For any given laboratory test Y, an "optimized and personalized reference population" was defined by keeping only patients whose laboratory values for all Y-correlated tests fell within their own usual reference intervals, and by partitioning groups by individual-specific variables like sex and age category. The method was applied to platelet count. RESULTS Laboratory data were recorded for 28,082 individuals. At the end of the algorithmic process, seven correlated laboratory tests were chosen, resulting in a reference sample of 159 platelet counts. A new 95 % reference interval was constructed [152-334 × 109/L], notably reduced (27.2 %) compared to conventional reference values [150-400 × 109/L]. The reference interval was validated on a sample of 2,129 patients from another downtown laboratory, emphasizing the potential transference of the hospital-derived reference limits. CONCLUSION This method offers new perspectives in laboratory data interpretation, especially in patient screening and longitudinal follow-up.
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Affiliation(s)
- Ronan Boutin
- Bio Logbook, 1 rue Julien Videment, 44200 Nantes, France.
| | - Jakez Rolland
- Bio Logbook, 1 rue Julien Videment, 44200 Nantes, France; Nantes University, École Centrale Nantes, CNRS, LS2N, UMR 6004, 1 Rue de la Noë, 44321 Nantes, France.
| | - Marie Codet
- Bio Logbook, 1 rue Julien Videment, 44200 Nantes, France.
| | - Clément Bézier
- Bio Logbook, 1 rue Julien Videment, 44200 Nantes, France; University of Western Brittany, INSERM, LBAI, UMR1227, 9 Rue Félix le Dantec, 29200 Brest, France.
| | - Nathalie Maes
- Biostatistics and Medico-economic Information Department, University Hospital of Liege, Avenue de l'Hôpital 1, 4000 Liège, Belgium.
| | - Philippe Kolh
- Department of Information Systems Management, University Hospital of Liege, Avenue de l'Hôpital 1, 4000 Liège, Belgium.
| | - Leila Equinet
- Bio Logbook, 1 rue Julien Videment, 44200 Nantes, France.
| | - Marie Thys
- Use of medico-economic data, University Hospital of Liege, Avenue de l'Hôpital 1, 4000 Liège, Belgium.
| | - Michel Moutschen
- Infectious Diseases Department, University Hospital of Liege, Avenue de l'Hôpital 1, 4000 Liège, Belgium.
| | - Pierre-Jean Lamy
- Biopathology and Genetics of Cancers, Institute of Medical Analysis IMAGENOME, INOVIE, 90 rue Nicolas Chedeville, 34075 Montpellier, France; Clinical Research Department, Clinique BeauSoleil, Aesio Santé Méditerranée, 149 Rue de la Taillade, 34070 Montpellier, France.
| | - Adelin Albert
- Biostatistics and Medico-economic Information Department, University Hospital of Liege, Avenue de l'Hôpital 1, 4000 Liège, Belgium; Public Health Department, University of Liege, Avenue de l'Hôpital 1, 4000 Liège, Belgium.
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Gonzalez CA, Van Rysselberghe NL, Maschhoff C, Gardner MJ. Outcomes of Patients with Preoperative Thrombocytosis After Hip Fracture Surgery. J Am Acad Orthop Surg Glob Res Rev 2024; 8:01979360-202404000-00014. [PMID: 38595218 PMCID: PMC11003512 DOI: 10.5435/jaaosglobal-d-23-00159] [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: 08/20/2023] [Revised: 12/13/2023] [Accepted: 01/30/2024] [Indexed: 04/11/2024]
Abstract
INTRODUCTION Low platelet counts have clinically relevant effects on patient outcomes after hip fracture surgery; however, the relationship between abnormally high platelet counts and postoperative outcomes in this population is unknown. METHODS The ACS-NSQIP database was queried for patients who underwent hip fracture surgery between 2015 and 2019. Outcomes were compared between patients with normal platelet counts (150,000 to 450,000/μL) and thrombocytosis (>450,000/μL). RESULTS Eighty-six thousand three hundred eleven hip fracture patients were identified, of which 1067 (1.2%) had preoperative thrombocytosis. Compared with patients with normal platelet counts, patients with preoperative thrombocytosis had increased rates of 30-day mortality (6.4% vs 4.5%, P = 0.004; OR 1.15 [95% CI 0.88 to 1.50], P = 0.322) as well as increased rates and odds of readmission (11.4% vs 7.8%, P < 0.001; OR 1.35 [95% CI 1.10 to 1.65], P = 0.004) and venous thromboembolic events (3.2% vs 1.7%, P < 0.001; OR 1.88 [95% CI 1.31 to 2.71], P < 0.001). CONCLUSIONS Hip fracture patients with preoperative thrombocytosis had increased rates of early mortality as well as increased odds of venous thromboembolic events and readmission. A patient with thrombocytosis may benefit from close postoperative surveillance and careful follow-up. Future prospective studies are needed to verify causation and investigate how to mitigate adverse outcomes in hip fracture patients with preoperative thrombocytosis.
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Affiliation(s)
- Christian A. Gonzalez
- From the Reno School of Medicine, University of Nevada, Reno, NV (Dr. Gonzalez); the Department of Orthopaedic Surgery, Stanford University, Stanford, CA (Dr. Rysselberghe and Dr. Gardner); and the University of Illinois College of Medicine, Chicago, IL (Dr. Maschhoff)
| | - Noelle L. Van Rysselberghe
- From the Reno School of Medicine, University of Nevada, Reno, NV (Dr. Gonzalez); the Department of Orthopaedic Surgery, Stanford University, Stanford, CA (Dr. Rysselberghe and Dr. Gardner); and the University of Illinois College of Medicine, Chicago, IL (Dr. Maschhoff)
| | - Clayton Maschhoff
- From the Reno School of Medicine, University of Nevada, Reno, NV (Dr. Gonzalez); the Department of Orthopaedic Surgery, Stanford University, Stanford, CA (Dr. Rysselberghe and Dr. Gardner); and the University of Illinois College of Medicine, Chicago, IL (Dr. Maschhoff)
| | - Michael J. Gardner
- From the Reno School of Medicine, University of Nevada, Reno, NV (Dr. Gonzalez); the Department of Orthopaedic Surgery, Stanford University, Stanford, CA (Dr. Rysselberghe and Dr. Gardner); and the University of Illinois College of Medicine, Chicago, IL (Dr. Maschhoff)
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Wei L, Xie H, Wang Q, Tang S, Gan J. The prognostic value of preoperative D-dimer to albumin ratio for overall survival and progression-free survival in colorectal cancer. Front Physiol 2024; 15:1369855. [PMID: 38487266 PMCID: PMC10937459 DOI: 10.3389/fphys.2024.1369855] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2024] [Accepted: 02/15/2024] [Indexed: 03/17/2024] Open
Abstract
Introduction: This study aimed to explore the predictive value of the D-dimer-to-albumin ratio (DAR) for progression-free survival (PFS) and overall survival (OS) in patients with colorectal cancer (CRC). Methods: The Kaplan-Meier method was used to plot survival curves for PFS and OS. Receiver operating characteristic (ROC) curve analysis was used to evaluate the predictive efficacy of the DAR for PFS and OS in patients with CRC. Cox proportional hazards regression analysis was used to analyze prognostic factors influencing outcomes. A nomogram based on the DAR was constructed to predict 1-, 3-, and 5-year prognoses of patients with CRC; its predictive ability was evaluated using the concordance index (C-index) and calibration curves. Additionally, the clinical utility of the DAR-based nomogram was validated using an internal randomized validation cohort. Results: A total of 1,339 patients with CRC who underwent surgery were enrolled. The optimal cut-off value for DAR was determined to be 3.320, dividing patients into low (<3.320 [n = 470]) and high (≥3.320 [n = 869]) DAR groups. Compared with other composite immune inflammatory markers, DAR exhibited superior prognostic predictive efficacy. Patients with a high DAR had a significantly worse prognosis than those with a low DAR (PFS, 50.9% versus [vs.] 69.4%, p < 0.001; OS, 52.9% vs. 73.8%, p < 0.001). DAR also demonstrated significant prognostic stratification for most tumor subgroups, particularly in the stage III-IV subgroup and normal carcinoembryonic antigen subgroup. DAR has been identified as an independent predictive indicator of PFS/OS in patients with CRC. For every standard deviation increase in DAR, the risk for PFS/OS in patients with CRC was reduced by 9.5% (hazard ratio [HR] 1.095 [95% confidence interval (CI) 1.013-1.185]; p = 0.022) and 9.3% (HR 1.093 [95% CI 1.012-1.180]; p = 0.024), respectively. The DAR-based nomogram was confirmed to demonstrate good prognostic prediction accuracy and achieved high evaluation in the internal validation cohort. Conclusion: Preoperative DAR is a promising biomarker for predicting PFS and OS among patients with CRC. The DAR-based prognostic prediction nomogram may serve as an effective tool for the comprehensive assessment of prognosis in patients with CRC.
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Affiliation(s)
- Lishuang Wei
- Department of Colorectal and Anal Surgery, The First Affiliated Hospital, Guangxi Medical University, Nanning, Guangxi, China
| | - Hailun Xie
- Department of Colorectal and Anal Surgery, The First Affiliated Hospital, Guangxi Medical University, Nanning, Guangxi, China
- Guangxi Key Laboratory of Enhanced Recovery After Surgery for Gastrointestinal Cancer, Nanning, Guangxi, China
| | - Qiwen Wang
- Department of Colorectal and Anal Surgery, The First Affiliated Hospital, Guangxi Medical University, Nanning, Guangxi, China
- Guangxi Key Laboratory of Enhanced Recovery After Surgery for Gastrointestinal Cancer, Nanning, Guangxi, China
| | - Shuangyi Tang
- Department of Pharmacy, The First Affiliated Hospital, Guangxi Medical University, Nanning, Guangxi, China
| | - Jialiang Gan
- Department of Colorectal and Anal Surgery, The First Affiliated Hospital, Guangxi Medical University, Nanning, Guangxi, China
- Guangxi Key Laboratory of Enhanced Recovery After Surgery for Gastrointestinal Cancer, Nanning, Guangxi, China
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Lin GS, Lu J, Lin J, Zheng HL, Xu BB, Xue Z, Wu D, Shen L, Zheng CH, Li P, Xie JW, Chen QY, Huang CM. Value of the Preoperative D-Dimer to Albumin Ratio for Survival and Recurrence Patterns in Gastric Cancer. Ann Surg Oncol 2023; 30:1132-1144. [PMID: 36284056 DOI: 10.1245/s10434-022-12625-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2022] [Accepted: 09/12/2022] [Indexed: 01/06/2023]
Abstract
BACKGROUND D-dimer (DDI) and albumin are prognostic markers for numerous cancers; however, the predictive value of the preoperative DDI-to-albumin ratio (DAR) on the survival and recurrence patterns of gastric cancer (GC) remains unclear. OBJECTIVE The aim of this study was to explore the prognostic value of the DAR in GC. METHODS Our study included 1766 patients with GC, divided into training and testing cohorts at a ratio of 7:3. Patients were classified into either a high-DAR group (> 0.0145) or low-DAR group (≤ 0.0145) according to the cut-off value of receiver operating characteristic (ROC) curve analysis. The relationship between the DAR and recurrence pattern was analyzed in stage II/III patients. RESULTS Eight preoperative hematological factors were included and 17 composite inflammatory markers were constructed. ROC and random forest analyses indicated that among 17 markers, DAR was the best predictor for overall survival (OS) in GC (p < 0.01). High DAR was significantly associated with poor OS (hazard ratio [HR] 1.89, p < 0.001) and recurrence-free survival (RFS; HR 1.85, p < 0.001). Subgroup analysis showed no differences in OS and RFS between the high- and low-DAR groups in stage I or pT1/2 or pN0/1 patients; however, in stage II/III or pT3/4 or pN2/3 patients, the high-DAR group had shorter OS and RFS rates than the low-DAR group (p < 0.001). Similar results were found in the testing cohort. According to the multivariate analysis based on the training cohort, five indices, including DAR, cT stage, cN stage, age and body mass index (BMI), were incorporated to establish a nomogram model to predict the long-term prognosis of GC. The model showed comparable forecast performance in predicting OS (C-index: 0.773 vs. 0.786) and RFS (C-index: 0.788 vs. 0.795) compared with pTNM. Recurrence pattern analysis in stage II/III patients showed that the high-DAR group had a higher incidence of peritoneal implantation and early recurrence (ER) than the low-DAR group, and the post-recurrence survival in the high-DAR group was significantly shorter than that in the low-DAR group (p = 0.016). CONCLUSION The preoperative DAR is a new biomarker for the long-term survival prediction of GC. In advanced GC, a preoperative DAR > 0.0145 aids the timely detection of ER and peritoneal recurrence after surgery, thus guiding individual follow-up strategies.
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Affiliation(s)
- Guo-Sheng Lin
- Department of Gastric Surgery, Fujian Medical University Union Hospital, Fuzhou, Fujian Province, China.,Key Laboratory of Ministry of Education of Gastrointestinal Cancer, Fujian Medical University, Fuzhou, Fujian Province, China
| | - Jun Lu
- Department of Gastric Surgery, Fujian Medical University Union Hospital, Fuzhou, Fujian Province, China.,Key Laboratory of Ministry of Education of Gastrointestinal Cancer, Fujian Medical University, Fuzhou, Fujian Province, China
| | - Jia Lin
- Department of Gastric Surgery, Fujian Medical University Union Hospital, Fuzhou, Fujian Province, China.,Key Laboratory of Ministry of Education of Gastrointestinal Cancer, Fujian Medical University, Fuzhou, Fujian Province, China
| | - Hua-Long Zheng
- Department of Gastric Surgery, Fujian Medical University Union Hospital, Fuzhou, Fujian Province, China.,Key Laboratory of Ministry of Education of Gastrointestinal Cancer, Fujian Medical University, Fuzhou, Fujian Province, China
| | - Bin-Bin Xu
- Department of Gastric Surgery, Fujian Medical University Union Hospital, Fuzhou, Fujian Province, China.,Key Laboratory of Ministry of Education of Gastrointestinal Cancer, Fujian Medical University, Fuzhou, Fujian Province, China
| | - Zhen Xue
- Department of Gastric Surgery, Fujian Medical University Union Hospital, Fuzhou, Fujian Province, China.,Key Laboratory of Ministry of Education of Gastrointestinal Cancer, Fujian Medical University, Fuzhou, Fujian Province, China
| | - Dong Wu
- Department of Gastric Surgery, Fujian Medical University Union Hospital, Fuzhou, Fujian Province, China.,Key Laboratory of Ministry of Education of Gastrointestinal Cancer, Fujian Medical University, Fuzhou, Fujian Province, China
| | - Lili Shen
- Department of Gastric Surgery, Fujian Medical University Union Hospital, Fuzhou, Fujian Province, China.,Key Laboratory of Ministry of Education of Gastrointestinal Cancer, Fujian Medical University, Fuzhou, Fujian Province, China
| | - Chao-Hui Zheng
- Department of Gastric Surgery, Fujian Medical University Union Hospital, Fuzhou, Fujian Province, China.,Key Laboratory of Ministry of Education of Gastrointestinal Cancer, Fujian Medical University, Fuzhou, Fujian Province, China
| | - Ping Li
- Department of Gastric Surgery, Fujian Medical University Union Hospital, Fuzhou, Fujian Province, China.,Key Laboratory of Ministry of Education of Gastrointestinal Cancer, Fujian Medical University, Fuzhou, Fujian Province, China
| | - Jian-Wei Xie
- Department of Gastric Surgery, Fujian Medical University Union Hospital, Fuzhou, Fujian Province, China.,Key Laboratory of Ministry of Education of Gastrointestinal Cancer, Fujian Medical University, Fuzhou, Fujian Province, China
| | - Qi-Yue Chen
- Department of Gastric Surgery, Fujian Medical University Union Hospital, Fuzhou, Fujian Province, China.,Key Laboratory of Ministry of Education of Gastrointestinal Cancer, Fujian Medical University, Fuzhou, Fujian Province, China
| | - Chang-Ming Huang
- Department of Gastric Surgery, Fujian Medical University Union Hospital, Fuzhou, Fujian Province, China. .,Key Laboratory of Ministry of Education of Gastrointestinal Cancer, Fujian Medical University, Fuzhou, Fujian Province, China.
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6
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Zhang X, Wang X, Li W, Sun T, Dang C, Diao D. D-dimer, a predictor of bad outcome in gastric cancer patients undergoing radical resection. Sci Rep 2022; 12:16432. [PMID: 36180481 PMCID: PMC9525585 DOI: 10.1038/s41598-022-16582-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2022] [Accepted: 07/12/2022] [Indexed: 11/09/2022] Open
Abstract
As a marker of hypercoagulability, plasma D-dimer is associated with progression of many cancers but remains controversial in gastric cancer (GC). We aim to investigate the predictive value of D-dimer for postoperative outcomes after radical gastrectomy of GC patients. We enrolled 903 consecutive patients with GC who underwent radical gastrectomy and the clinicopathological characteristics were compared. Risk factors for overall survival (OS) and disease-free survival (DFS) were determined using multivariate cox regression analysis. We also compared the survival difference based on Kaplan-Meier method after a one-to-one propensity score matching (PSM). Patients with elevated D-dimer had older age (p < 0.001), advanced TNM stage (p < 0.001), larger tumor size (p = 0.005), lower 5-year OS rate (32.8% vs 62.6%, p < 0.001) and DFS (29% vs 59.6%, p < 0.001). In multivariate analysis, elevated D-dimer was independently associated with shorter OS [hazard ratio (HR): 1.633, 95% confidence interval (CI) 1.178-2.264, p = 0.003] and DFS (HR: 1.58, 95% CI 1.151-2.169, P = 0.005). After PSM, the 5-year OS rate of patients with elevated D-dimer was still significantly lower than matched group (32.8% vs 40.6%, p = 0.005), so was DFS (29% vs 36.6%, p = 0.008). Preoperative elevated D-dimer is an independent risk factor for GC patients undergoing curative gastrectomy.
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Affiliation(s)
- Xin Zhang
- Department of Surgical Oncology, First Affiliated Hospital Medical College Xi'an Jiaotong University, 277 West Yanta Road, Xi'an, Shaanxi, 710061, People's Republic of China
| | - Xuan Wang
- Department of Surgical Oncology, First Affiliated Hospital Medical College Xi'an Jiaotong University, 277 West Yanta Road, Xi'an, Shaanxi, 710061, People's Republic of China
| | - Wenxing Li
- Department of Surgical Oncology, First Affiliated Hospital Medical College Xi'an Jiaotong University, 277 West Yanta Road, Xi'an, Shaanxi, 710061, People's Republic of China
| | - Tuanhe Sun
- Department of Surgical Oncology, First Affiliated Hospital Medical College Xi'an Jiaotong University, 277 West Yanta Road, Xi'an, Shaanxi, 710061, People's Republic of China
| | - Chengxue Dang
- Department of Surgical Oncology, First Affiliated Hospital Medical College Xi'an Jiaotong University, 277 West Yanta Road, Xi'an, Shaanxi, 710061, People's Republic of China.
| | - Dongmei Diao
- Department of Surgical Oncology, First Affiliated Hospital Medical College Xi'an Jiaotong University, 277 West Yanta Road, Xi'an, Shaanxi, 710061, People's Republic of China.
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Guan Y, Xu F, Tian J, Wang Y, Guo N, Wan Z, He M, Gao M, Gao K, Chong T. Prognostic value of circulating tumor cells and immune-inflammatory cells in patients with renal cell carcinoma. Urol Oncol 2022; 40:167.e21-167.e32. [PMID: 35216891 DOI: 10.1016/j.urolonc.2021.12.021] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2021] [Revised: 12/13/2021] [Accepted: 12/31/2021] [Indexed: 02/07/2023]
Abstract
PURPOSE The relationships among circulating tumor cells (CTCs), inflammatory cells, and platelets in patients with renal cell carcinoma (RCC) are not transparent. We evaluated the correlations among CTCs, blood inflammatory cells, and platelets in patients with RCC and their prognostic value for metastasis-free survival. METHODS CTC and typical tumor cell chip data were collected and analyzed by the GEO database. The baseline data, survival data, CTCs data, and blood test results were statistically analyzed. RESULTS Bioinformatics analysis showed that the function of the differentially expressed genes between CTCs and normal tumor cells mainly involved platelets and immune inflammation. A total of 82 patients whose follow-up time was 3 to 68 months were included in the analysis. Clinical data of the patients confirmed that there is a correlation between platelets and mesenchymal CTCs. Simultaneously, there was a correlation between immune inflammatory cells and platelets. The univariate Cox proportional hazards model indicated that staging, mesenchymal CTCs, and the monocyte-to-neutrophil ratio (MNR) had prognostic value. The multivariate Cox proportional hazards model indicated that staging and the MNR had prognostic value and high accuracy. CONCLUSIONS Bioinformatics analysis showed that CTCs were related to platelets and immune-inflammatory cells. Furthermore, the clinical data confirmed that platelets were correlated with mesenchymal CTCs and immune-inflammatory cells in the blood. By using mesenchymal CTCs, the MNR, or staging respectively, it is possible to predict the risk of postoperative metastasis in RCC patients. As a compound prognostic factor, staging, and the MNR can provide more convenient and accurate condition monitoring.
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Affiliation(s)
- Yibing Guan
- Department of Urology, the Second Affiliated Hospital, School of Medicine, Xi'an Jiaotong University, Xi'an, Shaan Xi Province, China; School of Medicine, Xi'an Jiaotong University, Xi'an, China
| | - Fangshi Xu
- Department of Urology, the Second Affiliated Hospital, School of Medicine, Xi'an Jiaotong University, Xi'an, Shaan Xi Province, China; School of Medicine, Xi'an Jiaotong University, Xi'an, China
| | - Juanhua Tian
- Department of Urology, the Second Affiliated Hospital, School of Medicine, Xi'an Jiaotong University, Xi'an, Shaan Xi Province, China; School of Medicine, Xi'an Jiaotong University, Xi'an, China
| | - Yiyuan Wang
- Department of Stomatology, the Second Affiliated Hospital of Shaanxi University of Traditional Chinese Medicine, Xianyang, China
| | - Ni Guo
- National & Local Joint Engineering Research Center of Biodiagnosis and Biotherapy, The Second Affiliated Hospital, Xi'an Jiaotong University, Xi'an, Shaan Xi Province, China
| | - Ziyan Wan
- Department of Urology, the Second Affiliated Hospital, School of Medicine, Xi'an Jiaotong University, Xi'an, Shaan Xi Province, China; School of Medicine, Xi'an Jiaotong University, Xi'an, China
| | - Minxin He
- Department of Urology, the Second Affiliated Hospital, School of Medicine, Xi'an Jiaotong University, Xi'an, Shaan Xi Province, China; School of Medicine, Xi'an Jiaotong University, Xi'an, China
| | - Mei Gao
- Department of Urology, the Second Affiliated Hospital, School of Medicine, Xi'an Jiaotong University, Xi'an, Shaan Xi Province, China
| | - Ke Gao
- Department of Urology, the Second Affiliated Hospital, School of Medicine, Xi'an Jiaotong University, Xi'an, Shaan Xi Province, China; School of Medicine, Xi'an Jiaotong University, Xi'an, China
| | - Tie Chong
- Department of Urology, the Second Affiliated Hospital, School of Medicine, Xi'an Jiaotong University, Xi'an, Shaan Xi Province, China.
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Duan X, Chen H, Zhou X, Liu P, Zhang X, Zhu Q, Zhong L, Zhang W, Zhang S, Zhang X, Chen Y, Zhou Y, Yang C, Feng QS, Zeng YX, Xu M, Xiang T. EBV infection in epithelial malignancies induces resistance to antitumor natural killer cells via F3-mediated platelet aggregation. Cancer Res 2022; 82:1070-1083. [DOI: 10.1158/0008-5472.can-21-2292] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2021] [Revised: 12/15/2021] [Accepted: 01/18/2022] [Indexed: 11/16/2022]
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9
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Yu L, Guo Y, Chang Z, Zhang D, Zhang S, Pei H, Pang J, Zhao ZJ, Chen Y. Bidirectional Interaction Between Cancer Cells and Platelets Provides Potential Strategies for Cancer Therapies. Front Oncol 2021; 11:764119. [PMID: 34722319 PMCID: PMC8551800 DOI: 10.3389/fonc.2021.764119] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2021] [Accepted: 09/28/2021] [Indexed: 12/13/2022] Open
Abstract
Platelets are essential components in the tumor microenvironment. For decades, clinical data have demonstrated that cancer patients have a high risk of thrombosis that is associated with adverse prognosis and decreased survival, indicating the involvement of platelets in cancer progression. Increasing evidence confirms that cancer cells are able to induce production and activation of platelets. Once activated, platelets serve as allies of cancer cells in tumor growth and metastasis. They can protect circulating tumor cells (CTCs) against the immune system and detachment-induced apoptosis while facilitating angiogenesis and tumor cell adhesion and invasion. Therefore, antiplatelet agents and platelet-based therapies should be developed for cancer treatment. Here, we discuss the mechanisms underlying the bidirectional cancer-platelet crosstalk and platelet-based therapeutic approaches.
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Affiliation(s)
- Liuting Yu
- Edmond H. Fischer Translational Medical Research Laboratory, Scientific Research Center, The Seventh Affiliated Hospital, Sun Yat-Sen University, Shenzhen, China
| | - Yao Guo
- Edmond H. Fischer Translational Medical Research Laboratory, Scientific Research Center, The Seventh Affiliated Hospital, Sun Yat-Sen University, Shenzhen, China
| | - Zhiguang Chang
- Edmond H. Fischer Translational Medical Research Laboratory, Scientific Research Center, The Seventh Affiliated Hospital, Sun Yat-Sen University, Shenzhen, China
| | - Dengyang Zhang
- Edmond H. Fischer Translational Medical Research Laboratory, Scientific Research Center, The Seventh Affiliated Hospital, Sun Yat-Sen University, Shenzhen, China
| | - Shiqiang Zhang
- Department of Urology, The Seventh Affiliated Hospital, Sun Yat-sen University, Shenzhen, China
| | - Hanzhong Pei
- Edmond H. Fischer Translational Medical Research Laboratory, Scientific Research Center, The Seventh Affiliated Hospital, Sun Yat-Sen University, Shenzhen, China
| | - Jun Pang
- Department of Urology, The Seventh Affiliated Hospital, Sun Yat-sen University, Shenzhen, China
| | - Zhizhuang Joe Zhao
- Department of Pathology, University of Oklahoma Health Sciences Center, Oklahoma City, OK, United States
| | - Yun Chen
- Edmond H. Fischer Translational Medical Research Laboratory, Scientific Research Center, The Seventh Affiliated Hospital, Sun Yat-Sen University, Shenzhen, China
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Guan Y, Xu F, Tian J, Gao K, Wan Z, Wang Y, Gao M, Wang Z, Chong T. The prognostic value of circulating tumour cells (CTCs) and CTC white blood cell clusters in patients with renal cell carcinoma. BMC Cancer 2021; 21:826. [PMID: 34271857 PMCID: PMC8285812 DOI: 10.1186/s12885-021-08463-7] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2020] [Accepted: 06/08/2021] [Indexed: 01/10/2023] Open
Abstract
Purpose Circulating tumour cell (CTC) and CTC-white blood cell (CTC-WBC) clusters are related to the prognosis of tumour patients. However, the relationship between CTC-WBC clusters and prognosis in renal cell carcinoma (RCC) patients is not clear. We evaluated the prognostic value of CTC-WBC clusters using metastasis-free survival (MFS) and overall survival (OS) in patients with RCC. Materials and methods The baseline, survival, and CTC data of patients with RCC were statistically analysed by R. Results The Cox risk proportional regression model suggests that the total CTCs, pathology type, and CTC-WBC clusters can be used as prognostic indicators for the MFS of RCC patients. Total CTCs and solid tumour diameter can be used as prognostic indicators for the OS of RCC patients. Using Kaplan–Meier survival analysis, we found that patients with total CTCs, pathology, and CTC-WBC clusters greater than the cut-off value had a worse MFS, and patients with total CTCs greater than the cut-off value had a worse OS. Conclusion The analysis of the clinical sample data in patients with RCC shows that CTC-WBC clusters play an important role in monitoring the prognosis of RCC. Among them, total CTCs, pathology, and CTC-WBC clusters were combined as prognostic factors for the MFS of RCC patients. Total CTCs and solid tumour diameter can be combined as prognostic factors for the OS of RCC patients. These prognostic factors provide more convenient and accurate condition monitoring for renal cancer patients and can be used to actively improve the prognosis of patients. Supplementary Information The online version contains supplementary material available at 10.1186/s12885-021-08463-7.
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Affiliation(s)
- Yibing Guan
- Department of Urology, the Second Affiliated Hospital, School of Medicine, Xi'an Jiaotong University, No 157 Xiwu Road, Xi'an, 710004, Shaan Xi Province, China.,School of Medicine, Xi'an Jiaotong University, Xi'an, China
| | - Fangshi Xu
- Department of Urology, the Second Affiliated Hospital, School of Medicine, Xi'an Jiaotong University, No 157 Xiwu Road, Xi'an, 710004, Shaan Xi Province, China.,School of Medicine, Xi'an Jiaotong University, Xi'an, China
| | - Juanhua Tian
- Department of Urology, the Second Affiliated Hospital, School of Medicine, Xi'an Jiaotong University, No 157 Xiwu Road, Xi'an, 710004, Shaan Xi Province, China.,School of Medicine, Xi'an Jiaotong University, Xi'an, China
| | - Ke Gao
- Department of Urology, the Second Affiliated Hospital, School of Medicine, Xi'an Jiaotong University, No 157 Xiwu Road, Xi'an, 710004, Shaan Xi Province, China.,School of Medicine, Xi'an Jiaotong University, Xi'an, China
| | - Ziyan Wan
- Department of Urology, the Second Affiliated Hospital, School of Medicine, Xi'an Jiaotong University, No 157 Xiwu Road, Xi'an, 710004, Shaan Xi Province, China.,School of Medicine, Xi'an Jiaotong University, Xi'an, China
| | - Yiyuan Wang
- Department of Stomatology, the Second Affiliated Hospital of Shaanxi University of Traditional Chinese Medicine, Xianyang, China
| | - Mei Gao
- Department of Urology, the Second Affiliated Hospital, School of Medicine, Xi'an Jiaotong University, No 157 Xiwu Road, Xi'an, 710004, Shaan Xi Province, China
| | - Zhenlong Wang
- Department of Urology, the Second Affiliated Hospital, School of Medicine, Xi'an Jiaotong University, No 157 Xiwu Road, Xi'an, 710004, Shaan Xi Province, China
| | - Tie Chong
- Department of Urology, the Second Affiliated Hospital, School of Medicine, Xi'an Jiaotong University, No 157 Xiwu Road, Xi'an, 710004, Shaan Xi Province, China.
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11
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Chen Y, Yang W, Ye L, Lin S, Shu K, Yang X, Ai X, Yao Y, Jiang M. Economical and easily detectable markers of digestive tumors: platelet parameters. Biomark Med 2021; 15:157-166. [PMID: 33474972 PMCID: PMC7857339 DOI: 10.2217/bmm-2020-0203] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2020] [Accepted: 12/11/2020] [Indexed: 01/13/2023] Open
Abstract
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.
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Affiliation(s)
- Yingying Chen
- Department of Ear, Nose & Throat, The Second Affiliated Hospital & Yuying Children’s Hospital of Wenzhou Medical University, 325027, Wenzhou, Zhejiang, 325027, China
| | - Wei Yang
- Clinical Laboratory Center, The Second Affiliated Hospital & Yuying Children’s Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, 325027, China
| | - Lifang Ye
- Clinical Laboratory Center, The Second Affiliated Hospital & Yuying Children’s Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, 325027, China
| | - Suzhen Lin
- Clinical Laboratory Center, The Second Affiliated Hospital & Yuying Children’s Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, 325027, China
| | - Kuangyi Shu
- Clinical Laboratory Center, The Second Affiliated Hospital & Yuying Children’s Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, 325027, China
| | - Xiao Yang
- Clinical Laboratory Center, The Second Affiliated Hospital & Yuying Children’s Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, 325027, China
| | - Xinyi Ai
- Clinical Laboratory Center, The Second Affiliated Hospital & Yuying Children’s Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, 325027, China
| | - Yating Yao
- Clinical Laboratory Center, The Second Affiliated Hospital & Yuying Children’s Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, 325027, China
| | - Minghua Jiang
- Clinical Laboratory Center, The Second Affiliated Hospital & Yuying Children’s Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, 325027, China
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12
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Hufnagel DH, Cozzi GD, Crispens MA, Beeghly-Fadiel A. Platelets, Thrombocytosis, and Ovarian Cancer Prognosis: Surveying the Landscape of the Literature. Int J Mol Sci 2020; 21:ijms21218169. [PMID: 33142915 PMCID: PMC7663176 DOI: 10.3390/ijms21218169] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2020] [Revised: 10/26/2020] [Accepted: 10/27/2020] [Indexed: 12/16/2022] Open
Abstract
Platelets are critical components of a number of physiologic processes, including tissue remodeling after injury, wound healing, and maintenance of vascular integrity. Increasing evidence suggests that platelets may also play important roles in cancer. In ovarian cancer, thrombocytosis, both at the time of initial diagnosis and at recurrence, has been associated with poorer prognosis. This review describes current evidence for associations between thrombocytosis and ovarian cancer prognosis and discusses the clinical relevance of platelet count thresholds and timing of assessment. In addition, we discuss several mechanisms from in vitro, in vivo, and clinical studies that may underlie these associations and recommend potential approaches for novel therapeutic targets for this lethal disease.
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Affiliation(s)
- Demetra H. Hufnagel
- Vanderbilt University School of Medicine, 2209 Garland Avenue, Nashville, TN 37240, USA; (D.H.H.); (G.D.C.)
| | - Gabriella D. Cozzi
- Vanderbilt University School of Medicine, 2209 Garland Avenue, Nashville, TN 37240, USA; (D.H.H.); (G.D.C.)
| | - Marta A. Crispens
- Department of Obstetrics and Gynecology, Division of Gynecologic Oncology, Vanderbilt University Medical Center, 1161 21st Avenue South, Nashville, TN 37232, USA;
- Vanderbilt-Ingram Cancer Center, 1301 Medical Center Drive, Nashville, TN 37232, USA
| | - Alicia Beeghly-Fadiel
- Vanderbilt-Ingram Cancer Center, 1301 Medical Center Drive, Nashville, TN 37232, USA
- Department of Medicine, Division of Epidemiology, Vanderbilt University Medical Center, 2525 West End Avenue, Nashville, TN 37203, USA
- Correspondence:
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13
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Yang W, Chen Y, Bi C, Shu K, Ye M, Li F, Chen J, Wang X, Chen X, Jiang M. Predictive and prognostic values of preoperative platelet parameters in patients with gynecological tumors. J Clin Lab Anal 2020; 34:e23295. [PMID: 32170805 PMCID: PMC7370708 DOI: 10.1002/jcla.23295] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2019] [Revised: 01/17/2020] [Accepted: 02/02/2020] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Platelets play a role in tumor cell growth, metastasis, and angiogenesis, and the present study aimed to evaluate diagnostic and prognostic values of platelet parameters in patients with gynecological tumors. METHODS A total of 1062 women were included. Differences of platelet parameters (platelet count [PLT], plateletcrit [PCT], mean platelet volume [MPV], platelet-large cell rate [P-LCR], and platelet distribution width [PDW]) between different categories were analyzed by nonparametric test. The optimal cutoff value was calculated with receiver operating characteristic analysis. Overall survivals were analyzed with Kaplan-Meier method and log-rank tests for univariate analysis. RESULTS Platelet count and PCT were significantly increased, and MPV and P-LCR were significantly reduced in malign and benign gynecological tumor groups compared with the controls (P < .001); PDW had no significant differences. There were no significant differences in PLT, PCT, MPV, P-LCR, and PDW between different tumor locations and pathologic types. The optimal cutoff values of PLT, PCT, MPV and P-LCR were 274, 0.26, 10.08, and 24.8 (AUC: 0.661, 0.643, 0.593, 0.562), and PCT had preferable sensibility and specificity (50.84% and 70.42%) in predicting the presence of gynecological tumors. According to survival analysis, increased PLT (≥274 × 109 /L) and PCT (≥0.26), and induced MPV (<10.08 fL) and P-LCR (<24.8%) were associated with shorter overall survival. CONCLUSIONS Platelet count, PCT, MPV, and P-LCR can be used as preferable auxiliary parameters for predicting the presence of gynecological tumors. Increased PLT and PCT, or decreased MPV and P-LCR indicated a heavier tumor burden and shorter overall survival.
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Affiliation(s)
- Wei Yang
- The Center of Laboratory MedicineThe Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical UniversityWenzhouChina
| | - Ying‐ying Chen
- The Center of Laboratory MedicineThe Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical UniversityWenzhouChina
| | - Chen Bi
- The Center of Laboratory MedicineThe Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical UniversityWenzhouChina
| | - Kuang‐yi Shu
- The Center of Laboratory MedicineThe Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical UniversityWenzhouChina
| | - Man‐li Ye
- The Center of Laboratory MedicineThe Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical UniversityWenzhouChina
| | - Fan‐fan Li
- The Center of Laboratory MedicineThe Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical UniversityWenzhouChina
| | - Jie Chen
- The Center of Laboratory MedicineThe Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical UniversityWenzhouChina
| | - Xiao‐ou Wang
- The Center of Laboratory MedicineThe Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical UniversityWenzhouChina
| | - Xiao‐jian Chen
- The Center of Laboratory MedicineThe Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical UniversityWenzhouChina
| | - Ming‐hua Jiang
- The Center of Laboratory MedicineThe Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical UniversityWenzhouChina
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14
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Li R, Zou X, Zhu T, Xu H, Li X, Zhu L. Destruction of Neutrophil Extracellular Traps Promotes the Apoptosis and Inhibits the Invasion of Gastric Cancer Cells by Regulating the Expression of Bcl-2, Bax and NF-κB. Onco Targets Ther 2020; 13:5271-5281. [PMID: 32606746 PMCID: PMC7293391 DOI: 10.2147/ott.s227331] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2019] [Accepted: 12/18/2019] [Indexed: 12/11/2022] Open
Abstract
Introduction This study aimed to investigate the effects of Neutrophil extracellular traps (NETs) destruction on the apoptosis and invasion of gastric cancer cells and the involved mechanisms. Methods Primary human neutrophils were isolated and co-cultured with three gastric cancer cells (BGC-823, SGC7901 and MKN28), and phorbol-12-myristate-13-acetate was added to generate NETs. Expression of NETs (SPINK5/LEKTI) and Cit Histone H3 were examined by immunofluorescent analysis and Western blot. Cancer cells were then divided into five groups: Control, NETs, Neutrophil, Amidine and DNase I. Cell apoptosis and invasion were examined by Transwell assay and flow cytometry, respectively. Expression of NF-κB p65, Bcl-2 and Bax was determined by RT-PCR, immunofluorescent analysis and Western blot. Results The expression of NETs (SPINK5/LEKTI) and Cit Histone H3 after co-culture increased significantly (P < 0.05), suggesting that gastric cancer cells could promote NETs generation. The Control, NETs and Neutrophil groups exhibited similar apoptosis and invasion of gastric cancer cells and similar mRNA and protein levels of NF-κB p65, Bcl-2 and Bax. However, compared with the Control group, the apoptosis and invasion of gastric cancer cells in both Amidine and DNase I groups were enhanced and weakened, respectively (P < 0.05). Moreover, both Amidine and DNase I groups showed much higher mRNA and protein levels of NF-κB p65 and Bax and lower mRNA and protein levels of Bcl-2 than the Control group (P < 0.05). Conclusion NETs destruction promoted the apoptosis and inhibited the invasion of gastric cancer cells by regulating the expression of Bcl-2, Bax and NF-κB.
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Affiliation(s)
- Rong Li
- Department of General Surgery, The Second Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang 150000, People's Republic of China
| | - Xiaoming Zou
- Department of General Surgery, The Second Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang 150000, People's Republic of China
| | - Tong Zhu
- Department of General Surgery, The Second Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang 150000, People's Republic of China
| | - Haiyan Xu
- Department of Medicine, Central Hospital of Prison Administration Bureau of Heilongjiang Province, Harbin, Heilongjiang 150000, People's Republic of China
| | - Xiaolin Li
- Department of General Surgery, The Second Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang 150000, People's Republic of China
| | - Lei Zhu
- Department of General Surgery, The Second Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang 150000, People's Republic of China
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15
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Fares J, Fares MY, Khachfe HH, Salhab HA, Fares Y. Molecular principles of metastasis: a hallmark of cancer revisited. Signal Transduct Target Ther 2020; 5:28. [PMID: 32296047 PMCID: PMC7067809 DOI: 10.1038/s41392-020-0134-x] [Citation(s) in RCA: 991] [Impact Index Per Article: 247.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2019] [Revised: 02/05/2020] [Accepted: 02/11/2020] [Indexed: 02/07/2023] Open
Abstract
Metastasis is the hallmark of cancer that is responsible for the greatest number of cancer-related deaths. Yet, it remains poorly understood. The continuous evolution of cancer biology research and the emergence of new paradigms in the study of metastasis have revealed some of the molecular underpinnings of this dissemination process. The invading tumor cell, on its way to the target site, interacts with other proteins and cells. Recognition of these interactions improved the understanding of some of the biological principles of the metastatic cell that govern its mobility and plasticity. Communication with the tumor microenvironment allows invading cancer cells to overcome stromal challenges, settle, and colonize. These characteristics of cancer cells are driven by genetic and epigenetic modifications within the tumor cell itself and its microenvironment. Establishing the biological mechanisms of the metastatic process is crucial in finding open therapeutic windows for successful interventions. In this review, the authors explore the recent advancements in the field of metastasis and highlight the latest insights that contribute to shaping this hallmark of cancer.
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Affiliation(s)
- Jawad Fares
- Department of Neurological Surgery, Feinberg School of Medicine, Northwestern University, Chicago, IL, 60611, USA.
- High-Impact Cancer Research Program, Harvard Medical School, Boston, MA, 02115, USA.
| | - Mohamad Y Fares
- Faculty of Medicine, American University of Beirut, Beirut, Lebanon
- Neuroscience Research Center, Faculty of Medical Sciences, Lebanese University, Beirut, Lebanon
| | - Hussein H Khachfe
- Faculty of Medicine, American University of Beirut, Beirut, Lebanon
- Neuroscience Research Center, Faculty of Medical Sciences, Lebanese University, Beirut, Lebanon
| | - Hamza A Salhab
- Faculty of Medicine, American University of Beirut, Beirut, Lebanon
- Neuroscience Research Center, Faculty of Medical Sciences, Lebanese University, Beirut, Lebanon
| | - Youssef Fares
- Neuroscience Research Center, Faculty of Medical Sciences, Lebanese University, Beirut, Lebanon
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16
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Raskov H, Orhan A, Salanti A, Gögenur I. Premetastatic niches, exosomes and circulating tumor cells: Early mechanisms of tumor dissemination and the relation to surgery. Int J Cancer 2020; 146:3244-3255. [PMID: 31808150 DOI: 10.1002/ijc.32820] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2019] [Revised: 11/15/2019] [Accepted: 11/29/2019] [Indexed: 12/12/2022]
Abstract
The physiological stress response to surgery promotes wound healing and functional recovery and includes the activation of neural, inflammatory and proangiogenic signaling pathways. Paradoxically, the same pathways also promote metastatic spread and growth of residual cancer. Human and animal studies show that cancer surgery can increase survival, migration and proliferation of residual tumor cells. To secure the survival and growth of disseminated tumor cells, the formation of premetastatic niches in target organs involves a complex interplay between microenvironment, immune system, circulating tumor cells, as well as chemical mediators and exosomes secreted by the primary tumor. This review describes the current understanding of the early mechanisms of dissemination, as well as how surgery may facilitate disease progression.
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Affiliation(s)
- Hans Raskov
- Center for Surgical Science, Zealand University Hospital, Køge, Denmark
| | - Adile Orhan
- Center for Surgical Science, Zealand University Hospital, Køge, Denmark.,Department of Biomedical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Ali Salanti
- Centre for Medical Parasitology at Department of Immunology and Microbiology, University of Copenhagen and Department of Infectious Diseases, Copenhagen University Hospital, Copenhagen, Denmark
| | - Ismail Gögenur
- Center for Surgical Science, Zealand University Hospital, Køge, Denmark.,Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
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17
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Oh SE, Seo JE, An JY, Lee JH, Sohn TS, Bae JM, Kim S, Choi MG. Prognostic Impact of Increased Perioperative Platelet Count in Gastric Cancer Patients. J Surg Res 2019; 242:296-303. [PMID: 31125843 DOI: 10.1016/j.jss.2019.04.052] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2018] [Revised: 03/15/2019] [Accepted: 04/16/2019] [Indexed: 01/24/2023]
Abstract
BACKGROUND Solid tumors are a common cause of secondary (reactive) thrombocytosis, a paraneoplastic syndrome that is also a prognostic factor for various cancers. However, cutoff values for platelet count specific to gastric cancer and their prognostic roles are unknown. METHODS We retrospectively analyzed records of 4643 patients with gastric cancer who underwent radical surgery from 2007 to 2010. The minimum P-value approach was used with the log-rank test to determine the optimal prognosis predicting threshold for preoperative platelet count. Change in perioperative platelet count over time was evaluated with a generalized estimating equation. Clinicopathologic features and prognostic significance were analyzed according to platelet count. RESULTS Thrombocytosis prevalence (platelet count ≥40 × 104/μL) was 1.6% (75 of 4643 patients). The platelet count cutoff value with the lowest P-value was ≥25.5 × 104/μL, and patients with higher platelet count had more advanced disease. Multivariate analysis showed that cutoff value was an independent prognostic factor of overall survival (hazard ratio 1.19, 95% confidence interval 1.03-1.37, P = 0.017). Patients who underwent adjuvant chemotherapy (n = 1300) and had a greater than 10% increase in platelet count at postoperative 1 y compared to before surgery had significantly poorer overall survival (hazard ratio 1.65, 95% confidence interval 1.11-2.45, P = 0.013). CONCLUSIONS Elevated preoperative platelet count (≥25.5 × 104/μL) and increased platelet count (≥10%) at postoperative 1 y in an adjuvant chemotherapy group were unfavorable prognostic factors. Platelet count could be a cost-effective biomarker for screening and monitoring patients with unfavorable survival outcomes.
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Affiliation(s)
- Sung Eun Oh
- Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Jeong Eun Seo
- Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Ji Yeong An
- Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Jun Ho Lee
- Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Tae Sung Sohn
- Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Jae Moon Bae
- Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Sung Kim
- Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Min-Gew Choi
- Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea.
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18
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Emodin regulates neutrophil phenotypes to prevent hypercoagulation and lung carcinogenesis. J Transl Med 2019; 17:90. [PMID: 30885207 PMCID: PMC6423780 DOI: 10.1186/s12967-019-1838-y] [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: 12/07/2018] [Accepted: 03/08/2019] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Hypercoagulation and neutrophilia are described in several cancers, however, whether they are involved in lung carcinogenesis is currently unknown. Emodin is the main bioactive component from Rheum palmatum and has many medicinal values, such as anti-inflammation and anticancer. This study is to investigate the contributions of neutrophils to the effects of emodin on hypercoagulation and carcinogenesis. METHODS The effects of emodin on neutrophil phenotypes were assessed by cell proliferation, morphological changes, phagocytosis and autophagy in vitro. The anti-coagulation and cancer-preventing actions of emodin were evaluated in the urethane-induced lung carcinogenic model. The expressions of Cit-H3 and PAD4 in lung sections were assessed by immunohistochemistry, CD66b+ neutrophils were distinguished by immunofluorescence, and cytokines and ROS were examined with ELISA. The neutrophils-regulating and hypercoagulation-improving efficacies of emodin were confirmed in a Lewis lung cancer allograft model. The related targets and pathways of emodin were predicted by network pharmacology. RESULTS In vitro, emodin at the dose of 20 µM had no effect on cell viability in HL-60N1 but increased ROS and decreased autophagy and thus induced apoptosis in HL-60N2 with the morphological changes. In the urethane-induced lung carcinogenic model, before lung carcinogenesis, urethane induced obvious hypercoagulation which was positively correlated with lung N2 neutrophils. There were the aggravated hypercoagulation and lung N2 neutrophils after lung carcinoma lesions. Emodin treatment resulted in the ameliorated hypercoagulation and lung carcinogenesis accompanied by the decreased N2 neutrophils (CD66b+) in the alveolar cavity. ELISA showed that there were more IFN-γ, IL-12 and ROS and less IL-6, TNF-α and TGF-β1 in the alveolar cavity in the emodin group than those in the control group. Immunohistochemical analysis showed that emodin treatment decreased Cit-H3 and PAD4 in lung sections. In the Lewis lung cancer allograft model, emodin inhibits tumor growth accompanied by the attenuated coagulation and intratumor N2 neutrophils. Network pharmacology indicated the multi-target roles of emodin in N2 neutrophil activation. CONCLUSIONS This study suggests a novel function of emodin, whereby it selectively suppresses N2 neutrophils to prevent hypercoagulation and lung carcinogenesis.
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Yang C, Jiang H, Huang S, Hong H, Huang X, Wang X, Liao W, Wang X, Chen X, Jiang L. The prognostic role of pretreatment thrombocytosis in gastric cancer: A systematic review and meta-analysis. Medicine (Baltimore) 2018; 97:e11763. [PMID: 30075601 PMCID: PMC6081180 DOI: 10.1097/md.0000000000011763] [Citation(s) in RCA: 6] [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: 01/01/2023] Open
Abstract
BACKGROUND The association between platelet count and the prognosis of patients with gastric cancer has already been reported by numerous studies. As the reports are inconsistent, we conducted this meta-analysis to evaluate the prognostic significance of platelet count in patients with gastric cancer. METHODS A comprehensive search was performed in PubMed, Embase, and the Cochrane Library to identify relevant studies, which evaluated the prognostic impact of pretreatment platelet count in patients with gastric cancer. Data was pooled using a random effect model to calculate hazard ratios (HRs) and odds ratios (ORs) with 95% confidence intervals (CIs). RESULTS Around 10 studies were included, comprising 8166 patients in total. The result showed that patients with thrombocytosis had significant worse overall survival (HR 1.57, 95% CI 1.36-1.81, P < .001) than those with normal platelet count, and were associated with advanced clinical stage (OR, 1.57; 95% CI, 1.15-2.13; P = .004), deeper tumor invasion (OR,3.49; 95% CI, 2.48-4.91; P < .001), and higher risk of recurrence (OR, 2.28; 95% CI, 1.55-3.35; P < .001). CONCLUSION Pretreatment thrombocytosis is a potential effective predictor of overall survival (OS) for patients with gastric cancer and is correlated with higher risks of recurrence, serosal invasion, and advanced stage.
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Affiliation(s)
- Chen Yang
- The First School of Clinical Medicine
| | - Hui Jiang
- The First School of Clinical Medicine
| | | | - Hui Hong
- The First School of Clinical Medicine
| | | | | | | | - Xueyi Wang
- School of Traditional Chinese Medicine, Southern Medical University, Guangzhou, Guangdong
| | | | - Liming Jiang
- Department of Medical Radiology, Zhejiang Cancer Hospital, Hangzhou, Zhejiang, China
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20
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Xie Y, Wen JB, Li X. Value of routine blood test in early diagnosis of gastric cancer and its relationship with Helicobacter pylori infection. Shijie Huaren Xiaohua Zazhi 2018; 26:904-911. [DOI: 10.11569/wcjd.v26.i15.904] [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: 02/06/2023] Open
Abstract
AIM To assess the value of each index of routine blood test in the early diagnosis of gastric cancer (GC), and investigate the effect of Helicobacter pylori (H. pylori) infection on routine blood indexes.
METHODS A total of 223 inpatients or hospitalized patients who underwent gastroscopy from September 2016 to September 2017 were selected and divided into four groups according to gastroscopic and pathological results, including 58 patients with chronic superficial gastritis (CSG), 59 patients with chronic atrophic gastritis (CAG), 52 patients with high-grade intraepithelial neoplasia (HIN), and 57 patients with GC. Red blood cell distribution width (RDW), platelet count (PLT), mean platelet volume (MPV), platelet distribution width (PDW), white blood cell count (WBC), lymphocyte count (LYMP), neutrophil count (NR), neutrophil count to lymphocyte ratio (NLR), and platelet count to lymphocyte ratio (PLR) were compared in different groups, and the sensitivity and specificity of each index for diagnosis of GC were calculated. The effect of H. pylori infection on routine blood indexes was also analyzed.
RESULTS LYMP and MPV gradually decreased and RDW, NLR, and PLR gradually increased from CSG to CAG, HIN, and GC. RDW, MPV, LYMP, NLR, and PLR were all significantly different between the CSG group and GC group (P < 0.05). In detecting GC, the sensitivities of RDW, MPV, LYMP, NLR, PLR, and NC were 82.5%, 80.7%, 84.2%, 84.2%, 71.9%, and 45.6%, respectively, and the specificities were 72.4%, 55.2%, 82.8%, 91.0%, 89.7%, and 89.7%, respectively. The positive rates of H. pylori in the CSG group, CAG group, HIN group, and GC group were 63.7%, 62.5%, 63.5%, and 66.7%, respectively. In the CSG group, PLT, WBC, and NR were significantly higher in H. pylori positive patients than in H. pylori negative patients (P < 0.05). There were no significant differences in blood routine indexes between H. pylori positive and H. pylori negative patients in the CAG, HIN, and GC groups (P > 0.05).
CONCLUSION RDW, PLT, MPV, LYMP, NLR, and PLR can be used in the early diagnosis of GC. H. pylori infection can lead to systemic inflammatory reactions. Early eradication of H. pylori is beneficial to the prevention of GC.
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Affiliation(s)
- Yan Xie
- Department of Gastroenterology, Affiliated Pingxiang Hospital of Southern Medical University, Pingxiang 337000, Jiangxi Province, China
| | - Jian-Bo Wen
- Department of Gastroenterology, Affiliated Pingxiang Hospital of Southern Medical University, Pingxiang 337000, Jiangxi Province, China
| | - Xing Li
- Department of Gastroenterology, Affiliated Pingxiang Hospital of Southern Medical University, Pingxiang 337000, Jiangxi Province, China
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Wang YH, Kang JK, Zhi YF, Zhang Y, Wang ZQ, Zhou Q, Niu WY, Ma MJ. The pretreatment thrombocytosis as one of prognostic factors for gastric cancer: A systematic review and meta-analysis. Int J Surg 2018; 53:304-311. [PMID: 29654963 DOI: 10.1016/j.ijsu.2018.03.084] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2018] [Accepted: 03/31/2018] [Indexed: 02/07/2023]
Abstract
BACKGROUND & AIMS At present, increasing reports have shown that pretreatment platelet count was associated with the prognosis of many types of cancer. We performed rounded analysis to comprehensively analyze and evaluate the prognostic significance of pretreatment thrombocytosis for patients with gastric cancer. METHODS We identified relevant studies by searching database including PubMed, Embase, Cochrane Library and Web of Science. The relative risk (RR) with its 95% confidence interval (CI) was used to assess the correlation between thrombocytosis and overall survival (OS) of gastric cancer patients. We also conducted subgroup analysis and sensitivity analysis for the prognostic effect of thrombocytosis on OS. The analysis was performed and assessed using Review Manager 5.2. RESULTS A total of nine studies including 7158 participants were included in this systematic review. Analysis results showed that pretreatment thrombocytosis had a close relationship with 1, 3 and 5 years survival of gastric cancer, with the pooled RRs being 0.80 (95% CI 0.71-0.90; P = 0.0004), 0.65 (95% CI 0.45-0.92; P = 0.02) and 0.64 (95% CI 0.47-0.87; P = 0.004) respectively. CONCLUSIONS The present rounded analysis suggests that pretreatment thrombocytosis may have significant association with poor survival of patients with gastric cancer.
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Affiliation(s)
- Yong-Hong Wang
- Department of Gastrointestinal Surgery, Qinghai Red Cross Hospital, Xi'ning 810000, China; The First Clinical Medical College of Lanzhou University, Lanzhou 730000, China
| | - Jin-Ke Kang
- Department of Gastrointestinal Surgery, Qinghai Red Cross Hospital, Xi'ning 810000, China.
| | - Yong-Fa Zhi
- Department of Gastrointestinal Surgery, Qinghai Red Cross Hospital, Xi'ning 810000, China
| | - Yi Zhang
- Department of Gastrointestinal Surgery, Qinghai Red Cross Hospital, Xi'ning 810000, China
| | - Zhi-Qiang Wang
- Department of Gastrointestinal Surgery, Qinghai Red Cross Hospital, Xi'ning 810000, China
| | - Qing Zhou
- Department of Gastrointestinal Surgery, Qinghai Red Cross Hospital, Xi'ning 810000, China
| | - Wen-Yu Niu
- Department of Gastrointestinal Surgery, Qinghai Red Cross Hospital, Xi'ning 810000, China
| | - Ming-Jie Ma
- Department of Gastrointestinal Surgery, Qinghai Red Cross Hospital, Xi'ning 810000, China
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Gu L, Wen W, Wu Z, Bai K, Liu W, Lai G, Li D. Abnormal platelet count correlates with poor survival in hepatocellular carcinoma. INFECTION INTERNATIONAL 2018. [DOI: 10.1515/ii-2017-0160] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
AbstractBackgroundNormal platelet (PLT) plays a vital role in thrombosis, the inflammatory response, and liver regeneration. The effect of abnormal PLT counts has been seldom explored in hepatocellular carcinoma (HCC); hence, this investigation was conducted to evaluate the prognostic importance of preoperative abnormal PLT count in HCC patients after liver resection retrospectively.MethodologyThe PLT counts were determined using Sysmex XT-1800i automated hematology analyzer and its matching reagents. Patients were divided into two groups: a normal PLT group and an abnormal PLT group. Chi-square test, Kaplan–Meier method, and Cox univariable and multivariable regressions were utilized to analyze the data.ResultsA total of 391 HCC patients who underwent liver resection were included in this study. The overall survival (OS) rates were 59% and 31%, and the median survival time was 69 months and 31 months in the normal and abnormal PLT groups, respectively. The PLT level was associated with OS in univariate and multivariate analyses (hazard ratio [HR], 1.991 [95% confidence interval {CI}, 1.412–2.808] and HR, 2.217 [95% CI, 1.556–3.159], respectively).ConclusionsPatients with normal PLT had a better outcome in terms of OS. The results suggested that abnormal PLT count is an independent prognostic factor for HCC patients after liver resection.
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Tsuru M, Sata M, Tanaka M, Umeyama H, Kodera Y, Shiwa M, Aoyagi N, Yasuda K, Matsuoka K, Fukuda T, Yamana H, Nagata K. Retrospective Proteomic Analysis of a Novel, Cancer Metastasis-Promoting RGD-Containing Peptide. Transl Oncol 2017; 10:998-1007. [PMID: 29096248 PMCID: PMC5671418 DOI: 10.1016/j.tranon.2017.10.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2017] [Revised: 10/02/2017] [Accepted: 10/05/2017] [Indexed: 12/28/2022] Open
Abstract
Patients who undergo surgical extirpation of a primary liver carcinoma followed by radiotherapy and chemotherapy leading to complete remission are nevertheless known to develop cancerous metastases 3-10 years later. We retrospectively examined the blood sera collected over 8 years from 30 patients who developed bone metastases after the complete remission of liver cancer to identify serum proteins showing differential expression compared to patients without remission. We detected a novel RGD (Arg-Gly-Asp)-containing peptide derived from the C-terminal portion of fibrinogen in the sera of metastatic patients that appeared to control the EMT (epithelial-mesenchymal transition) of cancer cells, in a process associated with miR-199a-3p. The RGD peptide enhanced new blood vessel growth and increased vascular endothelial growth factor levels when introduced into fertilized chicken eggs. The purpose of this study was to enable early detection of metastatic cancer cells using the novel RGD peptide as a biomarker, and thereby develop new drugs for the treatment of metastatic cancer.
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Affiliation(s)
- Michiyo Tsuru
- Clinical Proteomics and Gene Therapy Laboratory, Kurume University, Kurume, Japan; Research Center for Innovative Cancer Therapy, Kurume University, Kurume, Japan; Department of Orthopedic Surgery, Kurume University School of Medicine, Kurume, Japan.
| | - Michio Sata
- Research Center for Innovative Cancer Therapy, Kurume University, Kurume, Japan; Division of Gastroenterology, Department of Medicine, Kurume University School of Medicine, Kurume, Japan
| | - Maki Tanaka
- Department of Surgery, Kurume General Hospital, Kurume, Japan
| | - Hideaki Umeyama
- Department of Biological Science, Chuo University, Tokyo, Japan
| | - Yoshio Kodera
- Department of Physics, School of Science, Kitasato University, Kanagawa, Japan
| | - Mieko Shiwa
- Life Science Division, Bio-Rad Laboratories K.K., Tokyo, Japan
| | - Norikazu Aoyagi
- Life Science Division, Bio-Rad Laboratories K.K., Tokyo, Japan
| | | | - Kei Matsuoka
- Research Center for Innovative Cancer Therapy, Kurume University, Kurume, Japan; Department of Urology, Kurume University, Kurume, Japan
| | - Takaaki Fukuda
- Center for Rheumatology, Kurume University School of Medicine, Kurume, Japan
| | - Hideaki Yamana
- Research Center for Innovative Cancer Therapy, Kurume University, Kurume, Japan; Center for Multidisciplinary Treatment of Cancer, Kurume University School of Medicine, Kurume, Japan
| | - Kensei Nagata
- Clinical Proteomics and Gene Therapy Laboratory, Kurume University, Kurume, Japan; Research Center for Innovative Cancer Therapy, Kurume University, Kurume, Japan; Department of Orthopedic Surgery, Kurume University School of Medicine, Kurume, Japan
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Strumfa I, Bogdanova T, Kalva A, Strumfs B, Rumba R, Vanags A, Drike I, Mezale D, Abolins A, Jakovlevs A, Balodis D, Gardovskis J. Systemic Inflammatory Reaction in Gastric Cancer: Biology and Practical Implications of Neutrophil to Lymphocyte Ratio, Glasgow Prognostic Score and Related Parameters. Gastric Cancer 2017. [DOI: 10.5772/intechopen.69723] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
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25
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Repetto O, De Re V. Coagulation and fibrinolysis in gastric cancer. Ann N Y Acad Sci 2017; 1404:27-48. [PMID: 28833193 DOI: 10.1111/nyas.13454] [Citation(s) in RCA: 72] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2017] [Revised: 07/12/2017] [Accepted: 07/25/2017] [Indexed: 12/12/2022]
Abstract
Coagulation is a highly conserved process occurring after an injury to a blood vessel and resulting in hemostasis. In the thrombus microenvironment, finely orchestrated events restore vessel integrity through platelet activation, adhesion, and aggregation (primary hemostasis), followed by the coagulation cascades, thrombin generation, and fibrin clot deposition (secondary hemostasis). Several studies on cancer have provided insight into dramatic changes to coagulation-related events (i.e., fibrin clot deposition, fibrinolysis) during tumor pathogenesis, progression, and metastasis, in addition to a tumor-driven systemic activation of hemostasis and thrombosis (Trousseau's syndrome). Diverse molecular and cellular effectors participate in the cross talk between hemostasis and tumors. Here, we focus on some aspects of the interconnection between cancer biology and hemostatic components, with particular attention to some key coagulation-related proteins (e.g., tissue factor, thrombin, fibrinogen, and D-dimers) in the particular case of gastric cancer (GC). Recent advances in deciphering the complex molecular link between GC and the coagulation system are described, showing their important roles in better management of patients affected by GC.
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Affiliation(s)
- Ombretta Repetto
- Facility of Bio-Proteomics, Immunopathology and Cancer Biomarkers, CRO Aviano National Cancer Institute, Aviano (PN), Italy
| | - Valli De Re
- Facility of Bio-Proteomics, Immunopathology and Cancer Biomarkers, CRO Aviano National Cancer Institute, Aviano (PN), Italy
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Kozasa K, Mabuchi S, Komura N, Yokoi E, Hiromasa K, Sasano T, Kawano M, Matsumoto Y, Kobayashi E, Kimura T. Comparison of clinical utilities of the platelet count and platelet-lymphocyte ratio for predicting survival in patients with cervical cancer: a single institutional study and literature review. Oncotarget 2017; 8:55394-55404. [PMID: 28903428 PMCID: PMC5589667 DOI: 10.18632/oncotarget.19560] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2017] [Accepted: 07/12/2017] [Indexed: 01/16/2023] Open
Abstract
Objective To compare the clinical utilities of the platelet count and platelet-lymphocyte ratio (PLR) for predicting survival in patients with cervical cancer. Results Multivariate analyses demonstrated that thrombocytosis and elevated PLR were found to be independent prognostic factors for progression-free survival (PFS, P = 0.0077, P = 0.044) and overall survival (OS, P = 0.025, P = 0.019) in separate Multivariate analyses. In the ROC analysis, the platelet count showed a significantly greater area under the ROC curve (AUC) value than that of PLR for predicting patient recurrence (0.5941 versus 0.5331, p = 0.018) and survival (0.6139 versus 0.5468, p = 0.029). In patients without thrombocytosis, elevated PLR correlated with shorter survival (PFS, P = 0.041; OS, P = 0.017). In contrast, PLR in patients with thrombocytosis did not provide prognostic information. We divided patients into 3 prognostic groups using platelet counts and PLR: high-risk (thrombocytosis with any PLR); intermediate-risk (elevated PLR without thrombocytosis); low-risk (none of the above), which allowed for individualized and accurate survival estimates. Materials and Methods The baseline characteristics and clinical outcomes of cervical cancer patients were identified. Patients were grouped according to their pretreatment platelet counts or PLR, and clinicopathological characteristics and patient survival were then compared between these groups. The clinical utilities of the platelet count and PLR were compared using a time-dependent receiver operating characteristic (ROC) analysis. Conclusions Pretreatment thrombocytosis and elevated PLR were identified as independent predictors in cervical cancer patients. Platelet counts were superior to PLR for predicting the prognosis of uterine cervical cancer patients. Our prognostic model consisting of platelet counts and PLR offers individualized survival estimates.
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Affiliation(s)
- Katsumi Kozasa
- Departments of Obstetrics and Gynecology, Osaka University Graduate School of Medicine, Suita, Osaka, Japan
| | - Seiji Mabuchi
- Departments of Obstetrics and Gynecology, Osaka University Graduate School of Medicine, Suita, Osaka, Japan
| | - Naoko Komura
- Departments of Obstetrics and Gynecology, Osaka University Graduate School of Medicine, Suita, Osaka, Japan
| | - Eriko Yokoi
- Departments of Obstetrics and Gynecology, Osaka University Graduate School of Medicine, Suita, Osaka, Japan
| | - Kuroda Hiromasa
- Departments of Obstetrics and Gynecology, Osaka University Graduate School of Medicine, Suita, Osaka, Japan
| | - Tomoyuki Sasano
- Departments of Obstetrics and Gynecology, Osaka University Graduate School of Medicine, Suita, Osaka, Japan
| | - Mahiru Kawano
- Departments of Obstetrics and Gynecology, Osaka University Graduate School of Medicine, Suita, Osaka, Japan
| | - Yuri Matsumoto
- Departments of Obstetrics and Gynecology, Osaka University Graduate School of Medicine, Suita, Osaka, Japan
| | - Eiji Kobayashi
- Departments of Obstetrics and Gynecology, Osaka University Graduate School of Medicine, Suita, Osaka, Japan
| | - Tadashi Kimura
- Departments of Obstetrics and Gynecology, Osaka University Graduate School of Medicine, Suita, Osaka, Japan
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The clinicopathological and prognostic role of thrombocytosis in patients with cancer: A meta-analysis. Oncol Lett 2017; 13:5002-5008. [PMID: 28588739 DOI: 10.3892/ol.2017.6054] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2015] [Accepted: 01/26/2017] [Indexed: 01/22/2023] Open
Abstract
Previous studies have linked the presence of thrombocytosis with the progression and development of cancer; however, this trend requires further investigation. The present study aimed to derive an estimation of the degree of association between thrombocytosis and the 5-year overall survival rate of patients with cancer, as well as common clinicopathological features, by performing a meta-analysis of 20 (n=12,778) published studies. The PubMed and Embase databases were searched systematically for all relevant articles published in English. Odds ratios (ORs) with 95% confidence intervals (CI) were calculated using a fixed effects or random effects model to evaluate the degree of the observed associations. The results suggested that thrombocytosis (platelet count, >400×109/l) correlated with a decreased 5-year overall survival rate (OR=2.70, 95% CI=2.03-3.61) and an advanced tumor-node-metastasis stage (III + IV; OR=2.14, 95% CI=1.58-2.90). Furthermore, these associations remained robust following stratification of the data by cancer type and ethnicity. In addition, thrombocytosis (platelet count, >300×109/l) correlated with a decreased 5-year overall survival rate in patients with colorectal cancer (OR=3.49, 95% CI=1.44-8.46). Although certain biases were not able to be eliminated, the present meta-analysis suggested that thrombocytosis is a valuable indicator for the evaluation of pathological diagnosis and prognosis for patients with cancer. Further studies are required to investigate the effect of thrombocytosis on the prognosis of patients with cancer.
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28
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Prognostic significance of hyperfibrinogenemia in patients with esophageal squamous cell carcinoma. Int J Clin Oncol 2017; 22:461-468. [DOI: 10.1007/s10147-016-1087-5] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2016] [Accepted: 12/29/2016] [Indexed: 12/27/2022]
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Subeikshanan V, Dutt A, Basu D, Tejus MN, Maurya VP, Madhugiri VS. A prospective comparative clinical study of peripheral blood counts and indices in patients with primary brain tumors. J Postgrad Med 2017; 62:86-90. [PMID: 27089106 PMCID: PMC4944356 DOI: 10.4103/0022-3859.180551] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Elevation of the neutrophil to lymphocyte ratio (NLR) has been shown to be an indicator of poor prognosis in many malignancies including recurrent glioblastoma multiforme. OBJECTIVES This study was aimed at assessing if the NLR and other leukocyte counts and indices were deranged in treatment-naïve patients with primary brain tumors when compared with an age-matched healthy control group. MATERIALS AND METHODS This was a prospective comparative clinical observational study by design. A healthy control population was compared with treatment-naïve patients diagnosed with intra- and extraaxial brain tumors. Leukocyte counts (neutrophil, lymphocyte, monocyte, eosinophil, and basophil counts) as well as leukocyte ratios such as the NLR and the monocyte to lymphocyte ratio (MLR) were calculated. We also evaluated if the counts and indices were related to the tumor volume. RESULTS In all patients with tumors, the platelet and neutrophil counts were elevated when compared to the controls. In contrast, monocyte counts and the MLR were found to be decreased in patients with tumors when compared to the controls. The subset of patients with glioblastoma showed a significant increase in NLR when compared to the controls. CONCLUSIONS Significant changes in the neutrophil, monocyte, and platelet counts as well as NLR and MLR were observed. Prospective longitudinal studies are required to determine the prognostic and therapeutic implications of these findings.
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Affiliation(s)
| | | | | | | | | | - V S Madhugiri
- Department of Neurosurgery, Jawaharlal Institute of Post-graduate Medical Education and Research, Pondicherry, India
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30
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Li X, Chang H, Tao Y, Wang X, Gao J, Zhang W, Chen C, Xia Y. Revalidation of a prognostic score model based on complete blood count for nasopharyngeal carcinoma through a prospective study. Chin J Cancer Res 2016; 28:467-477. [PMID: 27877005 PMCID: PMC5101220 DOI: 10.21147/j.issn.1000-9604.2016.05.01] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
OBJECTIVE In our previous work, we incorporated complete blood count (CBC) into TNM stage to develop a new prognostic score model, which was validated to improve prediction efficiency of TNM stage for nasopharyngeal carcinoma (NPC). The purpose of this study was to revalidate the accuracy of the model, and its superiority to TNM stage, through data from a prospective study. METHODS CBC of 249 eligible patients from the 863 Program No. 2006AA02Z4B4 was evaluated. Prognostic index (PI) of each patient was calculated according to the score model. Then they were divided by the PI into three categories: the low-, intermediate-and high-risk patients. The 5-year disease-specific survival (DSS) of the three categories was compared by a log-rank test. The model and TNM stage (7th edition) were compared on efficiency for predicting the 5-year DSS, through comparison of the area under curve (AUC) of their receiver-operating characteristic curves. RESULTS The 5-year DSS of the low-, intermediate-and high-risk patients were 96.0%, 79.1% and 62.2%, respectively. The low-and intermediate-risk patients had better DSS than the high-risk patients (P<0.001 and P<0.005, respectively). And there was a trend of better DSS in the low-risk patients, compared with the intermediate-risk patients (P=0.049). The AUC of the model was larger than that of TNM stage (0.726 vs. 0.661, P=0.023). CONCLUSIONS A CBC-based prognostic score model was revalidated to be accurate and superior to TNM stage on predicting 5-year DSS of NPC.
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Affiliation(s)
- Xiaohui Li
- Department of Radiation Oncology, Sun Yat-sen University Cancer Center; State Key Laboratory of Oncology in South China; Collaborative Innovation Center of Cancer Medicine, Guangzhou 510060, China; Department of Oncology, the 421 Hospital of Chinese People's Liberation Army, Guangzhou 510318, China
| | - Hui Chang
- Department of Radiation Oncology, Sun Yat-sen University Cancer Center; State Key Laboratory of Oncology in South China; Collaborative Innovation Center of Cancer Medicine, Guangzhou 510060, China
| | - Yalan Tao
- Department of Radiation Oncology, Sun Yat-sen University Cancer Center; State Key Laboratory of Oncology in South China; Collaborative Innovation Center of Cancer Medicine, Guangzhou 510060, China
| | - Xiaohui Wang
- Department of Radiation Oncology, Sun Yat-sen University Cancer Center; State Key Laboratory of Oncology in South China; Collaborative Innovation Center of Cancer Medicine, Guangzhou 510060, China
| | - Jin Gao
- Department of Radiation Oncology, Anhui Provincial Hospital Affiliated to Anhui Medical University, Hefei 230001, China
| | - Wenwen Zhang
- Department of Radiation Oncology, Sun Yat-sen University Cancer Center; State Key Laboratory of Oncology in South China; Collaborative Innovation Center of Cancer Medicine, Guangzhou 510060, China
| | - Chen Chen
- Department of Radiation Oncology, Sun Yat-sen University Cancer Center; State Key Laboratory of Oncology in South China; Collaborative Innovation Center of Cancer Medicine, Guangzhou 510060, China
| | - Yunfei Xia
- Department of Radiation Oncology, Sun Yat-sen University Cancer Center; State Key Laboratory of Oncology in South China; Collaborative Innovation Center of Cancer Medicine, Guangzhou 510060, China
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Gerotziafas GT, Elalamy I. [Risk of venous thromboembolism in cancer patients: Reality, actuality and perspectives]. Bull Cancer 2016; 103:764-75. [PMID: 27481723 DOI: 10.1016/j.bulcan.2016.07.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2015] [Revised: 06/30/2016] [Accepted: 07/03/2016] [Indexed: 02/07/2023]
Abstract
Cancer is a leading cause of venous thromboembolism (VTE) and vice versa. Pulmonary embolism is the second cause of death in cancer patients. Tumor progression is associated with coagulation activation. The pathogenesis of thrombosis during cancer is particularly complex stemming from multiple connections of this disease with both systems of inflammation and hemostasis. The risk of VTE depends on cancer type and the stage of the disease, the anticancer treatments and the time since cancer diagnosis as well as on the presence of patient-related risk factors (i.e. age, obesity, previous history of VTE, underlying diseases…). The presence of other precipitating factors and the duration of the exposure to them are also key elements in the assessment of such a thrombotic risk. It is therefore important to identify all the VTE risk factors to identify patients at high vascular risk and to determine the period during which this risk is significantly increased. The integration of biomarkers of hypercoagulability in proposed risk assessment models for VTE will improve their capacity to identify patients eligible for pharmacological thromboprophylaxis. In this review, we report the current status of knowledge on the connection between cancer and hypercoagulability, the numerous risk factors for VTE must be identified in cancer patients and the best methodology to build a more accurate assessment of this vascular risk in such a complex medical context.
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Affiliation(s)
- Grigoris T Gerotziafas
- Université Paris VI, faculté de médecine Pierre-et-Marie-Curie, institut universitaire de cancérologie, Inserm U938, 75012 Paris, France; Assistance publique-Hôpitaux de Paris, hôpitaux universitaires Est Parisien, hôpital Tenon, service d'hématologie biologique, 75020 Paris, France.
| | - Ismail Elalamy
- Université Paris VI, faculté de médecine Pierre-et-Marie-Curie, institut universitaire de cancérologie, Inserm U938, 75012 Paris, France; Assistance publique-Hôpitaux de Paris, hôpitaux universitaires Est Parisien, hôpital Tenon, service d'hématologie biologique, 75020 Paris, France
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Suzuki T, Shimada H, Nanami T, Oshima Y, Yajima S, Ito M, Washizawa N, Kaneko H. Hyperfibrinogenemia is associated with inflammatory mediators and poor prognosis in patients with gastric cancer. Surg Today 2016; 46:1394-1401. [PMID: 27160890 DOI: 10.1007/s00595-016-1339-z] [Citation(s) in RCA: 43] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2015] [Accepted: 02/12/2016] [Indexed: 12/11/2022]
Abstract
PURPOSE Hyperfibrinogenemia is associated with poor prognosis in various cancers; however, its clinical relevance in gastric cancer has not been well analyzed. We conducted this study to assess the clinicopathological significance and prognostic value of hyperfibrinogenemia in patients with gastric cancer. METHODS Plasma fibrinogen levels were measured preoperatively in 315 patients undergoing surgery for gastric cancer. We then evaluated the clinicopathological significance of hyperfibrinogenemia and its relationship with several biomarkers, including white blood cell (WBC), C-reactive protein (CRP), platelet count, prothrombin time (PT) and activated partial thromboplastin time (APTT). Postoperative plasma levels were compared with preoperative levels. The multivariate prognostic value of hyperfibrinogenemia was calculated using the Cox proportional hazards model. RESULTS Tumor progression was significantly associated with hyperfibrinogenemia, as were the CRP level and platelet counts. Plasma fibrinogen levels decreased significantly after radical surgery. Adjusting for TNM factors, multivariate analysis indicated that hyperfibrinogenemia was an independent prognostic factor for poor survival (hazard ratio = 2.607, 95 % confidence interval = 1.180-5.761, P = 0.018). CONCLUSION Preoperative hyperfibrinogenemia was associated with tumor progression, inflammatory mediators, and poor overall survival in patients with gastric cancer.
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Affiliation(s)
- Takashi Suzuki
- Department of Surgery, School of Medicine, Toho University, 6-11-1 Omori-nishi, Ota-ku, Tokyo, 142-8541, Japan
| | - Hideaki Shimada
- Department of Surgery, School of Medicine, Toho University, 6-11-1 Omori-nishi, Ota-ku, Tokyo, 142-8541, Japan.
| | - Tatsuki Nanami
- Department of Surgery, School of Medicine, Toho University, 6-11-1 Omori-nishi, Ota-ku, Tokyo, 142-8541, Japan
| | - Yoko Oshima
- Department of Surgery, School of Medicine, Toho University, 6-11-1 Omori-nishi, Ota-ku, Tokyo, 142-8541, Japan
| | - Satoshi Yajima
- Department of Surgery, School of Medicine, Toho University, 6-11-1 Omori-nishi, Ota-ku, Tokyo, 142-8541, Japan
| | - Masaaki Ito
- Department of Surgery, School of Medicine, Toho University, 6-11-1 Omori-nishi, Ota-ku, Tokyo, 142-8541, Japan
| | - Naohiro Washizawa
- Department of Surgery, School of Medicine, Toho University, 6-11-1 Omori-nishi, Ota-ku, Tokyo, 142-8541, Japan
| | - Hironori Kaneko
- Department of Surgery, School of Medicine, Toho University, 6-11-1 Omori-nishi, Ota-ku, Tokyo, 142-8541, Japan
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Baranyai Z, Jósa V, Tóth A, Szilasi Z, Tihanyi B, Zaránd A, Harsanyi L, Szállási Z. Paraneoplastic thrombocytosis in gastrointestinal cancer. Platelets 2016; 27:269-75. [PMID: 27136385 DOI: 10.3109/09537104.2016.1170112] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
It has been demonstrated recently in several solid tumors that thrombocytosis at diagnosis may correlate with tumor invasion, metastatic progression and worse outcome. Several details of the pathomechanism of the relationship of thrombocytosis and cancer have been elucidated; however, the complete process is not clearly understood. Several hypotheses have been proposed. Recently, it was suggested that in ovarian cancer elevated IL-6 production by the tumor may induce increased megakaryopoiesis via hepatic thrombopoietin production leading to thrombocytosis. The importance of the prognostic power of elevated platelet count is still debated in gastrointestinal cancer. The aims of this review were to evaluate the prognostic significance of thrombocytosis in gastrointestinal tumors, to see whether clinical practice confirmed the hypotheses and to reveal the causes of the inconsistent findings.
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Affiliation(s)
- Zsolt Baranyai
- a Department of Surgery , Semmelweis University Budapest , Hungary
| | - Valéria Jósa
- b Department of Otorhinolaryngology and Head and Neck Surgery, Flór Ferenc Hospital , Kistarcsa , Hungary
| | - Ambrus Tóth
- c Semmelweis University , Budapest , Hungary
| | - Zsuzsanna Szilasi
- d Department of Otorhinolaryngology and Head and Neck Surgery , HDF Medical Centre , Budapest , Hungary
| | - Balazs Tihanyi
- a Department of Surgery , Semmelweis University Budapest , Hungary
| | - Attila Zaránd
- a Department of Surgery , Semmelweis University Budapest , Hungary
| | - Laszlo Harsanyi
- a Department of Surgery , Semmelweis University Budapest , Hungary
| | - Zoltán Szállási
- e Informatics Program, Children's Hospital , Harvard Medical School , Boston , MA , USA.,f Department of Systems Biology , Technical University of Denmark , Kgs Lyngby , Denmark
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Xin-Ji Z, Yong-Gang L, Xiao-Jun S, Xiao-Wu C, Dong Z, Da-Jian Z. The prognostic role of neutrophils to lymphocytes ratio and platelet count in gastric cancer: A meta-analysis. Int J Surg 2015. [PMID: 26225826 DOI: 10.1016/j.ijsu.2015.07.681] [Citation(s) in RCA: 69] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
BACKGROUND Systemic inflammatory response was reported to be associate with a poor survival in gastric cancer. However, these results remain inconsistent. The purpose of this meta-analysis was to evaluate the prognostic role of neutrophils to lymphocytes ratio (NLR) and platelet count in gastric cancer. METHODS Relevant studies were identified by searching PubMed, Embase and Cochrane Library. Data was pooled using a fixed-effects models or random-effects models. RESULTS A total of 29 studies were included for meta-analysis (19 for NLR, 10 for platelet count). Elevated NLR and platelet count were associated with an increased lymph node metastasis and serosal invasion (T3+T4) risk with individual ORs being 1.70 (95% CI: 1.05-2.75) and 2.93 (95% CI: 2.27-3.78), 1.62 (95% CI: 1.08-2.42) and 2.09 (95% CI: 1.57-2.77), respectively. The incidence of stage (III + IV) in elevated NLR group was higher than in normal NLR group (OR = 1.87, 95% CI: 1.48-2.35). The disease-free survival in patients with elevated NLR was markedly shorter (HR = 1.61; 95% CI: 1.28-1.94). For the overall survival, both indicators were strong predictors with individual HRs being 1.65 (95% CI: 1.47-1.83), 1.61 (95% CI: 1.35-1.86), respectively. CONCLUSIONS This meta-analysis suggests that elevated NLR and platelet count predict poor survival in patients with gastric cancer, and may provides some useful evidence for the clinical application of the two prognostic indicators in gastric cancer.
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Affiliation(s)
- Zhang Xin-Ji
- Department of Urology, Shunde First People's Hospital Affiliated to Southern Medical University, Guangdong, China
| | - Liu Yong-Gang
- Department of Medical Oncology, Shunde First People's Hospital Affiliated to Southern Medical University, Guangdong, China
| | - Shi Xiao-Jun
- Department of Urology, People's Hosptial of Xuancheng City, Xuancheng, Anhui, China
| | - Chen Xiao-Wu
- Department of General Surgery, Shunde First People's Hospital Affiliated to Southern Medical University, Guangdong, China
| | - Zhou Dong
- Department of General Surgery, Baoshan Branch of Huashan Hospital, Fudan University, 1999 West Changjiang Road, Shanghai, 200431, China
| | - Zhu Da-Jian
- Department of General Surgery, Shunde First People's Hospital Affiliated to Southern Medical University, Guangdong, China.
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Pang Q, Qu K, Bi JB, Liu SS, Zhang JY, Song SD, Lin T, Xu XS, Wan Y, Tai MH, Liu HC, Dong YF, Liu C. Thrombocytopenia for prediction of hepatocellular carcinoma recurrence: Systematic review and meta-analysis. World J Gastroenterol 2015; 21:7895-7906. [PMID: 26167090 PMCID: PMC4491977 DOI: 10.3748/wjg.v21.i25.7895] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/05/2015] [Revised: 03/01/2015] [Accepted: 04/03/2015] [Indexed: 02/06/2023] Open
Abstract
AIM: To investigate the association between thrombocytopenia and relapse after treatment for hepatocellular carcinoma (HCC).
METHODS: We searched the PubMed, EMBASE, and Web of Science databases to obtain eligible studies. The hazard ratios (HRs) values and 95% confidence intervals (CIs) were pooled by random effects model. Subsequently, we estimated the heterogeneity, performed a sensitivity analysis, determined the publication bias, and performed subgroup and meta-regression analyses. Study quality was assessed by using the Oxford Center for Evidence Based Medicine tool.
RESULTS: We identified 18 eligible studies by retrieval (published during 2000-2014). Out of the 4163 patients with HCC who were recruited, 2746 (66.0%) experienced recurrence. In general, our meta-analysis suggested that low platelet count (PLT) before therapy significantly increased the probability of postoperative recurrence (HR = 1.53, 95%CI: 1.29-1.81). PLT was also valuable in the prediction of intrahepatic distant recurrence (HR = 1.49, 95%CI: 1.25-1.77). Subgroup and meta-regression analyses identified various therapeutic modalities as the source of a high degree of heterogeneity. The pooled HR values showed no obvious change when a single study was removed, but otherwise, an opposite-effects model was used. In addition, no significant publication bias was detected.
CONCLUSION: Thrombocytopenia before treatment might be an inexpensive and useful predictor of postoperative recurrence in patients with HCC.
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