Elevated preoperative platelet distribution width predicts poor prognosis in Esophageal Squamous Cell Carcinoma

Song, Qian; Wu, Junzhou; Wang, Sheng; Chen, Wenhu

doi:10.1038/s41598-019-51675-y

Cited by 15 publications

(16 citation statements)

References 37 publications

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“…The PDW levels at the pretherapeutic, preoperative, and postoperative time points were 11.1 (10.2-12.4) fl, 10.2 (9.1-11.2) fl, and 9.9 (8.9-10.9) fl, respectively, while serum CRP levels at the three time points were 0.13 (0.06-0.51) mg/dl, 0.14 (0.06-0.41) mg/dl, and 0.13 (0.05-0.46) mg/dl, respectively. Interestingly, the PDW levels in our cohort tended to be lower than in earlier studies of esophageal cancer (9,10).…”

Section: Resultscontrasting

confidence: 92%

“…Consequently, the advantage of the CPC score is that it enables detection of EC patients with favorable and poor prognoses, irrespective of ypTNM Stage. Most studies of the association between PDW and malignancies have shown that high PDWs correlate significantly with poor prognoses (8)(9)(10)(11)(12). Within the tumor microenvironment, tumor cells induce platelet activation and aggregation, and enhance thrombopoiesis by releasing thrombopoietic cytokines, such as interleukin-6 (IL-6) and tumor-derived platelet factor 4 (PF4) (7).…”

Section: Discussionmentioning

confidence: 99%

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Prognostic Significance of Combined Platelet Distribution Width and C-Reactive Protein Score in Esophageal Cancer

et al. 2020

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Background/Aim: The platelet distribution width (PDW) and serum C-reactive protein (CRP) levels are known to be predictive of prognosis in various malignancies. Our aim was to determine whether combining PDW and serum CRP levels produces a prognostic indicator for esophageal cancer (EC) patients. Patients and Methods: A total of 168 EC patients who underwent neoadjuvant therapy prior to esophagectomy were included in this study. Results: We defined a combined PDW and CRP (CPC) score as follows: patients with both low pretherapeutic PDW (≤12.4 fl) and high postoperative serum CRP levels (≥0.5 mg/dl) were assigned a score of 2, while patients with one or neither of those were assigned a score of 1 or 0. A multivariable analysis showed that the CPC score was a significant risk factor for overall (p=0.006) and recurrence-free (p=0.004) survival. Conclusion: The CPC score is a strong prognostic indicator in EC patients. Esophageal cancer (EC) is highly invasive and metastatic, making it one of the most malignant of gastrointestinal tumors (1). Over the course of therapy, EC patients frequently exhibit hematological and serological abnormalities due to the burdens of adjuvant therapy, highly invasive esophagectomy, and postoperative complications (2, 3). In recent years, much effort has gone into establishing a novel prognostic marker for EC, analogous to the neutrophil-to-lymphocyte ratio (NLR) (4), by combining hematological and serological parameters obtained from routine blood tests. The platelet distribution width (PDW), a parameter determined from complete blood count data, is a marker of the heterogeneity of platelet size and reflects platelet activity more directly than the mean platelet volume (MPV) (5, 6). Activated platelets are recognized to be key players in tumorigenesis (7), and high PDW levels are reportedly related to poor outcomes in various types of cancer (8-12). On the other hand, a small number of studies have demonstrated that low PDW levels are significantly associated with poor prognoses in gastric cancer (13, 14) and lung cancer (15, 16). C-reactive protein (CRP) is one of the acute-phase proteins produced predominantly by hepatocytes in response to inflammation (17). Whether alone or combined with other routine blood data, elevated CRP levels have already been shown to be useful prognostic markers in several cancer types (18, 19). To the best of our knowledge, however, no studies have investigated whether combining PDW levels and serum CRP levels produces a stronger prognostic indicator of malignant tumors than other known prognostic markers. In the present study, therefore, we evaluated the predictive value of the combination of PDW levels and serum CRP levels for the survival of EC patients receiving neoadjuvant therapy (NAT) plus esophagectomy. In addition, we also determined at which point during the course of therapy each parameter correlated most strongly with prognosis. Patients and Methods Patients. This study was approved by the Ethics Committee of Akita University (Approval number: ...

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Section: Resultscontrasting

confidence: 92%

Section: Discussionmentioning

confidence: 99%

Prognostic Significance of Combined Platelet Distribution Width and C-Reactive Protein Score in Esophageal Cancer

et al. 2020

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“…believed that PDW < 12.5 could predict the poor prognosis of esophageal cancer, consistent with this study. However, in contrast to Song Q [17] etal., he believed that high PDW could predict the poor prognosis of esophageal cancer. In predicting the prognosis of esophageal cancer, due to inconsistent results, the role of LMR in the prognosis of esophageal cancer was very different.…”

Section: Discussionmentioning

confidence: 77%

The Value of Complete Blood Count For The Prognosis Analysis of Esophageal Squamous Cell Carcinoma

Han

et al. 2021

Preprint

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Objective To investigate the value of complete blood count in predicting the survival rate of patients with esophageal squamous cell carcinoma. Methods A total of 3587 patients with esophageal squamous cell carcinoma who were initially admitted to the Affiliated Cancer Hospital of Xinjiang Medical University from January 2010 to December 2017 were collected by retrospective study. The relevant clinical data were collected by the medical record system, and the patients were followed up by the hospital medical record follow-up system. The follow-up outcome was death. The survival time of all patients was obtained. The survival curve was established using the cut-off value of each index obtained by ROC curve. The Cox proportional hazards regression analysis model and nomogram were established to predict the survival prognosis of esophageal squamous cell carcinoma. The role of each index in the prognosis of patients with esophageal squamous cell carcinoma was studied Results The cut-off values of NLR, NMR, LMR, RDW and PDW in blood routine were 3.52, 10.22, 2.25, 13.85% and 12.05%, respectively. Survival curve analysis showed that patients aged < 60 years and NLR < 3.52 had survival. All indicators were divided into high and low groups according to ROC curve. Univariate Cox regression analysis model showed that RDW (≥ 13.85) and NLR (≥ 3.52) groups were risk factors for the prognosis of ESCC, with HR values of 1.099 (1.015–1.191; p = 0.020) and 1.340 (1.231–1.458; p < 0.001) compared with RDW (< 13.85) and NLR (< 3.52), respectively; multivariate Cox regression analysis model showed that NLR was significantly associated with the prognosis of ESCC, with HR of 1.342 (1.232–1.461; p < 0.001) for NLR (≥ 3.52) NLR (< 3.52). Conclusion NLR results in blood count can be used to predict the survival of patients with esophageal squamous cell carcinoma.

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“…1 ), we found that MPV and PDW/PCT have the highest potential to be independent prognostic factors of BTC, which was subsequently confirmed by the final multivariable Cox analysis. MPV, representing platelet size, has been demonstrated to be an independent predictor for OS in many cancers, and a high MPV has been reported as a poor indicator of OS in pancreatic cancer [ 11 ], invasive breast cancer [ 12 ], lung cancer [ 13 ] and esophageal carcinoma [ 14 ]. Our findings add to the accumulating evidence that high MPV is an independent negative predictor of OS.…”

Section: Discussionmentioning

confidence: 99%

“…The role of platelets as regulators of inflammation has been recognized, and as a result, the prognostic ability of platelet-related indices has been investigated in many cancers. Platelet count (PLT) and morphologic indices, including the mean platelet volume (MPV), plateletocrit (PCT), and platelet distribution width (PDW), have been frequently studied in a number of cancers, including pancreatic cancer [ 11 ], invasive breast cancer [ 12 ], lung cancer [ 13 ], and esophageal cell carcinoma [ 14 ]. However, the relationship between platelet-related indices and prognosis in BTC remains unknown.…”

Section: Introductionmentioning

confidence: 99%

Comparison of the Prognostic Value of Platelet-Related Indices in Biliary Tract Cancer Undergoing Surgical Resection

et al. 2021

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Platelet-related indices, including mean platelet volume (MPV) and plateletocrit (PCT), have been reported as new prognostic factors of overall survival (OS) in many cancers, but not yet in biliary tract cancer (BTC). We intended to assess these indices in predicting OS in BTC patients with the aim to build a new prognostic model for patients with BTC after surgical resection. Materials and methods Survival analysis and time receiver operating characteristic (time-ROC) analysis were applied to screen the platelet indices. Univariate and multivariate Cox analyses were used to identify independent prognostic factors and develop a new prognostic model. Harrell's C-statistics, calibration curves, and decisive curve analysis (DCA) were used to assess the model. Results MPV and platelet distribution width (PDW)/PCT showed the best prognostic accuracy among the platelet indices. In multivariable analysis, factors predictive of poor OS were presence of nodal involvement, Non-radical surgery, poor tumor differentiation, carbohydrate antigen 19-9 > 100 U/mL, MPV > 8.1 fl, and PDW/PCT > 190. The new model was found to be superior to the TNM staging system and our new staging system showed higher discriminative power. Conclusion MPV and PDW/PCT have high prognostic value in BTC patients, and the novel staging system based on these two indices showed good discrimination and accuracy compared with the American Joint Committee on Cancer 7th TNM staging system.

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Elevated preoperative platelet distribution width predicts poor prognosis in Esophageal Squamous Cell Carcinoma

Cited by 15 publications

References 37 publications

Prognostic Significance of Combined Platelet Distribution Width and C-Reactive Protein Score in Esophageal Cancer

Prognostic Significance of Combined Platelet Distribution Width and C-Reactive Protein Score in Esophageal Cancer

The Value of Complete Blood Count For The Prognosis Analysis of Esophageal Squamous Cell Carcinoma

Comparison of the Prognostic Value of Platelet-Related Indices in Biliary Tract Cancer Undergoing Surgical Resection

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