Platelet count as a biomarker for monitoring treatment response and disease recurrence in recurrent epithelial ovarian cancer

Abstract

Objectives: We sought to determine the impact of pretreatment plasma platelet levels, dimerized plasmin fragment (D-dimer) and fibrinogen in recurrent epithelial ovarian cancer (EOC) and the impact of platelet levels on SKOV3 cell lines growth and responsiveness to chemotherapy.Methods: Under approval of ethical committee, we identified 104 women with recurrent EOC who underwent treatment between January 2010 and February 2015. Reviewing clinical, laboratory, and pathologic records from this retrospective cohort, we analyzed the correlation between pretreatment plasma D-dimer, fibrinogen, platelet levels and clinicopathological parameters, progression free survival (PFS)and overall survival (OS). Inco-culture experiments human ovarian cancer SKOV3 cell lines were used to test the effect of platelet levels on tumor growth and responsiveness to docetaxel.Results: Of the 104 recurrent EOC, thrombocytosis at diagnosis and the decrease of platelet count by less than 25% after primary therapy were associated with worse median progression free survival (P=0.003;P=0.021) and median overall survival (P = 0.009;P=0.009).Mean platelet levels declined at the end of primary therapy(P<0.001) and rose at recurrence(P=0.007) .In multivariate analysis, elevated platelet levels at primary therapy and the decrease of platelet count less than 25% after primary therapy were unfavorable prognostic factor for PFS( P=0.022; P=0.015) and OS(P=0.013;P=0.007)in recurrent EOC, but elevated plasma D-dimer and fibrinogen were not. In SKOV-3 ovarian cancer cell lines, suitable concentration platelet co-culture protected against apoptosis (P< 0.05).Conclusions: Platelet count during treatment could be used as a biomarker used for monitoring the disease recurrence and predicting treatment response. And platelet with suitable concentration co-culture protected against apoptosis in SKOV3 cell line, which may explain clinical observations.

Predictive value of the systemic immune-inflammation index for the efficacy of neoadjuvant chemotherapy and prognosis in patients with stage III ovarian cancer—a retrospective cohort study

“…Recently, the concept of the SII has been proposed, which comprehensively takes the influence of platelets into consideration based on the ratio of neutrophils to lymphocytes. Platelets are small pieces of cytoplasm that detach from the cytoplasm of mature megakaryocytes in bone marrow, and participate in tumor growth, tumor cell extravasation, tumor metastasis, which can inhibit tumor cell apoptosis and maintain the integrity of tumor blood vessels (21)(22)(23). Previous studies showed that the progression-free survival and overall survival of ovarian cancer patients with a high SII (>612) were shortened, and a high level of SII was an independent factor resulting in poor prognosis (11).…”

Identification of a Novel Prognostic Classifier for Platelet-related Genes Characteristics and Prognostic Significance of Aberrant Expression of PAFAH1B3 in Hepatocellular Carcinoma

“…Tumors can cause abnormalities in platelet counts and functions of activation and aggregation. Platelet counts have been shown to be a prognostic predictor for patients with a variety of tumors, including lung, ovarian, prostate, colon cancers, and melanoma [2][3][4][5]. Abnormal activation and aggregation of platelets, especially tumor-activated platelets, may lead to thrombosis, especially cancerrelated thrombosis, which may cause death in cancer patients [6,7].…”