Platelet Count, ADAMTS13 Activity, von Willebrand Factor Level and Survival in Patients with Colorectal Cancer: 5-Year Follow-up Study

Abstract

Distant metastasis is a major cause of colorectal cancer-related death, but the mechanism of tumour progression is not fully understood. There is growing evidence of an interaction between tumour cells and platelets which may influence tumour progression and metastasis formation. Quality and quantity of von Willebrand factor may regulate the interaction between tumour cells and platelets. Our aim was to measure the platelet count, von Willebrand factor antigen (VWF:Ag) levels and ADAMTS13 activity in a large ( = 232) cohort of colorectal cancer patients and to examine their relationships with the stage of the disease and 5-year survival without thrombotic complications using multivariable models. Significantly higher platelet counts ( = 0.005), VWF:Ag levels ( = 0.008) and decreased ADAMTS13 activity ( = 0.006) were observed in patients with metastatic disease. Results of the Kaplan-Meier analysis showed that lower platelet counts ( < 0.0001), lower VWF:Ag ( = 0.0008) levels and higher ADAMTS13 activity ( < 0.0001) were associated with better event-free survival. Finally, to investigate the association between overall event-free survival and the three study variables, multivariate Cox proportional hazard models were generated. All models were adjusted for age, gender and disease stage. Platelet count, ADAMTS13 activity or VWF:Ag level were incorporated and all of these variables turned out to be age-, gender- and stage-independent predictors of mortality (all hazard ratio >1.7, < 0.05). In summary, this is the first observational study reporting association between higher mortality or thrombotic complications and increased platelet count, increased VWF:Ag levels and decreased ADAMTS13 activity in colorectal cancer.

Effects of a 1-Year Physical Activity Intervention on Markers of Hemostasis among Breast Cancer Survivors: A Randomized Controlled Trial

“…line with this, a recent observational study in colorectal patients found that the lower levels of VWF were associated with improved event-free survival and less thrombotic complications. 41 Notably, the plasma concentration of VWF is increased among patients with malignant breast disease. 42 In accordance with our findings, a large British prospective study of cardiovascular disease in 3,810 elderly men found that physical activity was significantly and inversely related with VWF in a dose-response manner.…”

Prognostic Values for the mRNA Expression of the ADAMTS Family of Genes in Gastric Cancer

“…Garam et al found that ADAMTS13 is a prognostic risk factor for colon and liver cancer [ 51 ]. The single nucleotide polymorphism of ADAMTS14 is closely related to liver cancer and oral cancer [ 52 , 53 ].…”

Diagnostic Value of Albumin to Fibrinogen Ratio in Cervical Cancer

“…6,7 Research on inflammation and inflammatory mediators has revealed that inflammation markers can trigger a premetastatic niche to escape the immunological surveillance and to play decisive roles at every step of tumorigenesis and development. 8 These inflammatory molecules-such as neutrophils, 9 platelets, 10 lymphocytes, 11 fibrinogen (Fib), 12 albumin (Alb), 13 and combinations of several single markers in the forms of ratios, 14,15 which are usually derived from circulating immune cells and acute-phase reactive proteins-have been reported as valuable predictors in a variety of human tumors. Currently, many studies have applied these routine parameters for the diagnosis and prognosis of malignant tumors.…”