Prognostic significance of thrombocytosis in patients with primary lung cancer

Pedersen, Lars Møller; Milman, Nils

doi:10.1183/09031936.96.09091826

Cited by 190 publications

(93 citation statements)

References 41 publications

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“…Patients with lung cancer producing bone marrow-stimulating cytokines such as interleukin (IL)-6 [15, 16, 17], IL-1 [15, 17]and macrophage colony-stimulating factor (M-CSF) [18]could exhibit thrombocytosis even at an early stage. Thrombocytosis has been linked with shorter survival in patients with gynecologic cancer [8, 9, 10, 11, 12, 13, 19, 20], renal cancer [8], gastric cancer [14], and lung cancer [6, 7]. Our results confirmed a poor prognosis for lung cancer patients manifesting thrombocytosis.…”

Section: Discussionsupporting

confidence: 78%

“…Thrombocytosis usually is recognized as a complication occurring at a late or terminal stage of disease, especially in lung cancer. However, we found no correlation between the clinical stage and thrombocytosis, in disagreement with previous reports [4, 5, 6, 7]. Although the specific mechanism underlying development of thrombocytosis in lung cancer patients remains unclear, our results suggest that thrombocytosis does not depend on tumor burden, but instead may represent a biologic phenotype of individual lung tumors.…”

Section: Discussioncontrasting

confidence: 57%

“…Thrombocytosis was defined as a platelet count of at least 40 × 10 4 /mm 3 , in agreement with other studies [2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13]. Only platelet counts determined before invasive diagnostic procedures obtained at the first visit to our hospital were considered.…”

Section: Methodsmentioning

confidence: 92%

“…In addition, thrombocytosis is frequent in patients with colon cancer [2], lung cancer [2, 3, 4, 5, 6, 7], renal cancer [8], cervical cancer [9, 10, 11], and ovarian cancer [12, 13], with a reported occurrence of 15–40%. However, few reports have assessed correlations of this finding with other clinicopathologic factors, or with survival, in patients with lung cancer.…”

Section: Introductionmentioning

confidence: 99%

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Thrombocytosis as a Useful Prognostic Indicator in Patients with Lung Cancer

et al. 2004

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Background: Thrombocytosis can accompany various cancers including lung cancer. This finding has recently been suggested to indicate poor prognosis. Objectives and Methods: We retrospectively examined the clinical records of 611 patients with lung cancer to investigate whether there is a correlation between thrombocytosis, other clinicopathologic factors, and survival Results: Ninety-eight of the patients (16%) manifested thrombocytosis at the time of their first evaluation at our hospital. Thrombocytosis and age (p = 0.0006) and thrombocytosis and performance status (p = 0.0002) are significantly correlated, but thrombocytosis is not related to gender, tumor histology, clinical stage, or serum lactate dehydrogenase concentrations. Survival is significantly shorter in patients with thrombocytosis: [median survival time (MST) 7.5 months; n = 98] than without thrombocytosis (MST 10.1 months; n = 513; p = 0.0029). Multivariate analysis of prognostic factors using the Cox proportional hazards model indicated that thrombocytosis had independent prognostic significance. Conclusion: Thrombocytosis at the first patient evaluation is an independent prognostic factor in lung cancer.

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Section: Discussionsupporting

confidence: 78%

Section: Discussioncontrasting

confidence: 57%

Section: Methodsmentioning

confidence: 92%

Section: Introductionmentioning

confidence: 99%

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Thrombocytosis as a Useful Prognostic Indicator in Patients with Lung Cancer

et al. 2004

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“…Regarding the results presented here, studies addressing the prognostic value of VEGF-S in cancer patients should be interpreted with caution and be reassessed by using VEGF-S corrected for peripheral blood PC. Thrombocytosis is known to be associated with poor prognosis in many cancer types such as lung cancer, cervical cancer, ovarian cancer and lymphoma [26, 27, 28, 29]. It remains to be seen whether the determination of VEGF-S levels, corrected for the peripheral blood PC provides an independent prognostic marker.…”

Section: Discussionmentioning

confidence: 99%

Thrombocytes Are the Major Source for Soluble Vascular Endothelial Growth Factor in Peripheral Blood

Gunsilius

Petzer

Stockhammer³

et al. 2000

Oncology

150

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Serum levels of vascular endothelial growth factor (VEGF-S) have been reported to correlate with tumor stage and prognosis in various human malignancies. The source of soluble VEGF in peripheral blood remains obscure. We therefore measured the concentration of immunoreactive VEGF in 241 serum samples and 61 plasma samples (VEGF-P) from 20 subjects undergoing myeloablative chemotherapy and from 3 normal platelet donors. A significant correlation between the peripheral blood platelet count (PC) and VEGF-S (r = 0.86) but not VEGF-P was found. VEGF-S levels were 58.43 ± 42.50 pg/ml (mean ± SD) in patients with a PC < 50 × 10⁹/l, 203.29 ± 176.56 pg/ml for a PC of 50–150 × 10⁹/l, and 457.42 ± 475.41 pg/ml for a PC > 150 × 10⁹/l. Interestingly, VEGF-P levels were substantially lower than the corresponding VEGF-S values, namely below the detection limit in most cases. Supernatants from platelet-rich plasma contained no VEGF, but after in vitro lysis of the platelets very high VEGF levels were found. The VEGF content per 10⁹ platelets was calculated at 2.51 ± 2.39 pg and was dependent on the mean platelet volume. In summary, VEGF release from platelets during blood clotting was found to be the main source of VEGF in serum samples. Cancer patients in clinical remission have negligible amounts of soluble VEGF in peripheral blood, and myeloablative chemotherapy causes a significant drop in VEGF-S levels corresponding to the decrease in PC. Thus, studies addressing the diagnostic and prognostic value of VEGF-S in cancer patients must be interpreted with caution. Our data provide the basis for predicting VEGF-S in relation to PC in vivo, and for reevaluating former studies of VEGF-S in patients with malignant or nonmalignant disease.

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Analysis of Platelet Count and New Cancer Diagnosis Over a 10-Year Period

et al. 2022

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IMPORTANCE Individuals with cancer often have an elevated platelet count at the time of diagnosis.The extent to which an elevated platelet count is an indicator of cancer is unclear.OBJECTIVE To evaluate the association of an elevated platelet count with a cancer diagnosis. DESIGN, SETTING, AND PARTICIPANTSThis nested case-control study included Ontario residents enrolled in the provincial health insurance plan who had 1 or more routine complete blood count (CBC) tests performed between January 1, 2007, and December 31, 2017, with follow-up through December 31, 2018. Case patients were individuals with a new cancer diagnosis during the observation period. Eligible control individuals were cancer free before the date of diagnosis for a case patient to whom they were matched. One case patient was matched to 3 controls based on sex, age, and health care use patterns. Data were analyzed from September 24, 2020, to July 13, 2021.EXPOSURES Case patients and controls were assigned to 1 of 5 exposure groups based on age-and sex-specific platelet count distributions in the control population: very low (Յ10th percentile), low (>10th to 25th percentile), medium (>25th to <75th percentile), high (75th to <90th percentile), and very high (Ն90th percentile). MAIN OUTCOMES AND MEASURESOdds ratios (ORs) were estimated for specific cancer sites for each category of platelet count at intervals up to 10 years after a blood test. RESULTSOf the 8 917 187 eligible Ontario residents with a routine CBC record available, 4 971 578 (55.8%) were women; the median age at the first CBC was 46.4 years (IQR, 32.5-59.5 years). Among individuals with a routine CBC record available, 495 341 (5.6%) received a diagnosis of first primary cancer during the 10-year observation period. The OR for a solid tumor diagnosis associated with a very high platelet count vs a medium platelet count in the 6-month period before the diagnosis was 2.32 (95% CI, 2.28-2.35). A very high platelet count was associated with colon (OR, 4.38; 95% CI, lung (OR, 4.37; 95% CI, ovarian (OR, 4.62; 95% CI,, and stomach (OR, 4.27; 95% CI, 3.91-4.66) cancers. Odds ratios attenuated with increasing time from CBC test to cancer diagnosis. CONCLUSIONS AND RELEVANCEIn this nested case-control study, an elevated platelet count was associated with increased risk of cancer at several sites. Our findings suggest that an elevated platelet count could potentially serve as a marker for the presence of some cancer types.

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Prognostic significance of thrombocytosis in patients with primary lung cancer

Cited by 190 publications

References 41 publications

Thrombocytosis as a Useful Prognostic Indicator in Patients with Lung Cancer

Thrombocytosis as a Useful Prognostic Indicator in Patients with Lung Cancer

Thrombocytes Are the Major Source for Soluble Vascular Endothelial Growth Factor in Peripheral Blood

Analysis of Platelet Count and New Cancer Diagnosis Over a 10-Year Period

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