The clinicopathological and prognostic role of thrombocytosis in patients with cancer: A meta-analysis

Abstract

Abstract. Previous studies have linked the presence of thrombocytosis with the progression and development of cancer; however, this trend requires further investigation. The present study aimed to derive an estimation of the degree of association between thrombocytosis and the 5-year overall survival rate of patients with cancer, as well as common clinicopathological features, by performing a meta-analysis of 20 (n=12,778) published studies. The PubMed and Embase databases were searched systematically for all relevant articles published in English. Odds ratios (ORs) with 95% confidence intervals (CI) were calculated using a fixed effects or random effects model to evaluate the degree of the observed associations. The results suggested that thrombocytosis (platelet count, >400x10 9 /l) correlated with a decreased 5-year overall survival rate (OR=2.70, 95% CI=2.03-3.61) and an advanced tumor-node-metastasis stage (III + IV; OR=2.14, 95% CI=1.58-2.90). Furthermore, these associations remained robust following stratification of the data by cancer type and ethnicity. In addition, thrombocytosis (platelet count, >300x10 9 /l) correlated with a decreased 5-year overall survival rate in patients with colorectal cancer (OR=3.49, 95% CI=1. 44-8.46). Although certain biases were not able to be eliminated, the present meta-analysis suggested that thrombocytosis is a valuable indicator for the evaluation of pathological diagnosis and prognosis for patients with cancer. Further studies are required to investigate the effect of thrombocytosis on the prognosis of patients with cancer. IntroductionDespite improvements in early diagnosis, radical surgery and various novel treatments, the prognosis for patients with cancer remains poor (1). Esophageal cancer patients without detectable metastasis in the clinic at the time of diagnosis may still succumb to cancer recurrence following surgery (2). This suggests that certain metastasis of cancer may not be detected using conventional biochemistry testing, imaging or histopathological methods (2). Therefore, a novel biological marker that may enhance the ability to accurately predict patient treatment outcomes is required. In previous years, a number of studies have investigated potential prognostic factors in patients with cancer. Previous studies have demonstrated that certain preoperative alterations in hematological parameters may be associated with patient outcomes for several forms of solid tumors (3). In addition, it has been suggested that circulating platelet (PLT)-tumor cell aggregates may promote cancer metastasis (4).Previous studies have investigated the association between thrombocytosis and tumor growth and development in various forms of malignancy (5-7); however, this trend requires further investigation. Yu et al (8) demonstrated, using a meta-analysis, that thrombocytosis (PLT count >400x10 9 /l) may be associated with a poorer prognosis for patients with a gynecological malignancy. Therefore, the present meta-analysis was performed in order to assess the associati...

Neutrophil-lymphocyte ratio as a predictor of oncologic outcomes in stage IVB, persistent, or recurrent cervical cancer patients treated by chemotherapy

“…Paraneoplastic thrombocytosis was driven by IL-6 and hepatic thrombopoietin, both of which stimulated tumor cell proliferation and migration; however, the mechanism is not clearly understood [28]. Previous studies in cancer patients showed that a platelet count > 400,000/mm 3 correlated with advanced stage of disease and decreased 5-year OS (odds ratio = 2.70, 95% CI: 2.03–3.61) [29]. The impact of pretreatment platelet counts in early stage cervical cancer is still being debated [30].…”

Cancer Immune Therapy for Philadelphia Chromosome-Negative Chronic Myeloproliferative Neoplasms

“…Other potential but unproven immune escape mechanisms include platelet-T-cell interactions. Thrombocythemia confers a dismal prognosis in several types of solid malignancies [72]. The thrombocythemia commonly found in MPN patients has been speculated to give rise to increased cancer invasiveness and enhance the metastatic potential of second cancers through a "platelet-cancer loop" [73].…”

“…Fewer effector T cells in peripheral blood PMF [40] Fewer NK cells in peripheral blood All MPN [43] Elevated numbers of MDSC in peripheral blood All MPN [47,48] Higher inhibitory potential of MDSC in peripheral blood All MPN [47] Elevated TGFβ production by bone-marrow-derived monocytes PMF [57] Lower levels of naïve T-cells and higher levels of terminally differentiated effector T-cells PV [58] Lower levels HLA-I on monocytes PV [58] Lower levels of HLA-I on mutant cells CALR-mutant MPN [72] Deregulation of genes related to antigen processing and activation as well as immune cell activation and inflammation All MPN [59][60][61] Lower number of myeloid dendritic cells and lower priming potential of myeloid dendritic cells Myeloid cells such as monocytes and myeloid-derived suppressor cells secrete TGF-β and ARG1, respectively. These proteins are highly immunosuppressive to T cells and thus induce immune suppression in the tumor microenvironment (TME).…”

<p>Elevated Platelet Count Predicts Poor Prognosis in Breast Cancer Patients with Supraclavicular Lymph Node Metastasis</p>

“… 11 , 12 Previous studies have shown that increased platelet count is associated with poor disease-free survival (DFS) and overall survival of various cancers. 13 , 15 However, the prognostic value of the platelet count for locally advanced breast cancer patients with ISLN metastasis is rarely reported. The purpose of this study is to explore the prognostic value of peripheral blood platelet count in breast cancer patients with ISLN metastasis.…”