Enhancing the Accuracy of Platelet to Lymphocyte Ratio after Adjustment for Large Platelet Count: A Pilot Study in Breast Cancer Patients

Abstract

Background. The objective of our study is to investigate the potential effect of adjusting preoperative platelet to lymphocyte ratio, an emerging biomarker of survival in cancer patients, for the fraction of large platelets. Methods. A total of 79 patients with breast neoplasias, 44 with fibroadenomas, and 35 with invasive ductal carcinoma were included in the study. Both conventional platelet to lymphocyte ratio (PLR) and the adjusted marker, large platelet to lymphocyte ratio (LPLR), were correlated with laboratory and histopathological parameters of the study sample. Results. LPLR elevation was significantly correlated with the presence of malignancy, advanced tumor stage, metastatic spread in the axillary nodes and HER2/neu overexpression, while PLR was only correlated with the number of infiltrated lymph nodes. Conclusions. This is the first study evaluating the effect of adjustment for large platelet count on improving PLR accuracy, when correlated with the basic independent markers of survival in a sample of breast cancer patients. Further studies are needed in order to assess the possibility of applying our adjustment as standard in terms of predicting survival rates in cancer.

White blood cell and platelet indices as prognostic markers in patients with invasive ductal breast carcinoma

“…Patients with a higher platelet-to-lymphocyte ratio experienced poorer survival times (15,16,21) and a larger number of infiltrated lymph nodes (22) compared with patients with a lower platelet-to-lymphocyte ratio. By contrast, Ulas et al (20) and Yao et al (18) reported that platelet-to-lymphocyte ratio does not significantly affect survival times in patients with breast cancer.…”

Platelet to Lymphocyte Ratio and Acute Appendicitis

“…There are some studies about PLR and periampullary cancer in the literature but reports are not satisfactory 18,19 . There are valuable results in the studies about the role of PLR in terms of prognosis of the patients with breast and gynaecological malignancies 12,13,20,21 . The predictive values of PLR in patients with myocardial infarction, peripheral arterial occlusive disease, and end-stage renal diseases were also studied [22][23][24] .…”

“…In many types of cancer and inflammatory processes, the release of proinflammatory cytokines promotes magakaryocytes' proliferation. The activation of platelets is a hallmark in the natural course of cancer, by promoting neoangiogenesis, degradation of extracellular matrix, release of adhesion molecules, and growth factors 12,13 . Lee et al demonstrated that NLR or PLR were independent prognostic factors for overall survival with …”

Hypercoagulation in colorectal cancer: What can platelet indices tell us?

“…To be more specific, this reactive thrombocytosis is an qualitative turning point, as it does not only have a quantitative substance (maintenance of the total platelet count within the normal range), since the newly formed, immature platelets are enzymatically more active than the mature ones; the reason is that the immature platelets contain more granules in their cytoplasm and have a rounder shape, fact which facilitates the exposure of their surface receptors [43,44]. Therefore, even in the absence of an abnormal total platelet count, cancer progression results in the presence of an increasing percentage of activated platelets, triggering a vicious circle of hypercoagulation-induced cancer spread and cancer-induced hypercoagulation.…”