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Published in: BMC Cancer 1/2023

Open Access 01-12-2023 | Metastasis | Research

Mean platelet volume/platelet count ratio in combination with tumor markers in colorectal cancer: a retrospective clinical study

Authors: Huan Zhang, Fan Lin, Zhuocai Wang

Published in: BMC Cancer | Issue 1/2023

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Abstract

Background

Mean platelet volume (MPV) is a marker of platelet activation, which is usually negatively correlated with platelet count (PC). The ratio of MPV to PC (MPV/PC) has an essential role in the diagnosis of multiple malignancies. However, only a few studies investigated the value of MPV/PC in colorectal cancer (CRC) and the combination of MPV/PC with tumor markers in CRC. This retrospective clinical study aimed to evaluate the diagnostic value of MPV/PC and tumor markers (CA72-4, CA125, CA199) used alone or in combination in CRC.

Methods

200 patients with CRC and 317 patients with colorectal benign polypus pathologically diagnosed during 2019/01/04 to 2022/06/30 were included. Hematological and pathological parameters of the above patients were collected, data were analyzed with Student’s t-test, one-way ANOVA or Kruskal-Wallis H test and receiver operating characteristic (ROC) curve, and ROC curve was used to evaluate the diagnostic value of tumor markers and MPV/PC used alone or in combination in CRC.

Results

The MPV/PC in CRC group was significantly lower than the control group (P < 0.0001). Among the three tumor markers, higher CA125 was correlated with distant metastasis and lower differentiation (P < 0.05), increased CA72-4 indicated positive nerve invasion (P = 0.0174), and elevated CA199 was associated with lymphatic metastasis and positive vascular invasion (P < 0.05). For subgroups regarding tumor anatomical location, both CA125 and CA199 were higher in colon cancer group than rectum cancer group (P = 0.0322, P = 0.0094). MPV/PC was associated with tumor infiltration, regional lymph node metastasis, differentiation and nerve invasion (P < 0.05) and the combination of MPV/PC with the three tumor markers produced a larger AUC with higher sensitivity, specificity and Yuden index than MPV/PC or the three tumor markers used alone to distinguish between CRC and colorectal polyps.

Conclusion

Preoperative MPV/PC in peripheral blood of patients with CRC was lower than the control group. Meanwhile, the combined detection of tumor markers with MPV/PC can improve the diagnostic value of CRC, revealing the potential of MPV/PC as a promising screening tool in CRC early diagnosis.
Literature
1.
go back to reference Sung H, Ferlay J, Siegel RL, Laversanne M, Soerjomataram I, Jemal A, Bray F, Global Cancer Statistics 2020. : GLOBOCAN Estimates of Incidence and Mortality Worldwide for 36 Cancers in 185 Countries, CA: a cancer journal for clinicians, 71 (2021)209–249. Sung H, Ferlay J, Siegel RL, Laversanne M, Soerjomataram I, Jemal A, Bray F, Global Cancer Statistics 2020. : GLOBOCAN Estimates of Incidence and Mortality Worldwide for 36 Cancers in 185 Countries, CA: a cancer journal for clinicians, 71 (2021)209–249.
2.
go back to reference Aleksandrova K, Pischon T, Jenab M, Bueno-de-Mesquita HB, Fedirko V, Norat T, et al. Combined impact of healthy lifestyle factors on colorectal cancer: a large european cohort study. BMC Med. 2014;12:168.CrossRef Aleksandrova K, Pischon T, Jenab M, Bueno-de-Mesquita HB, Fedirko V, Norat T, et al. Combined impact of healthy lifestyle factors on colorectal cancer: a large european cohort study. BMC Med. 2014;12:168.CrossRef
3.
go back to reference Ribeiro MS, Wallace MB. Endoscopic treatment of Early Cancer of the Colon. Gastroenterol Hepatol. 2015;11:445–52. Ribeiro MS, Wallace MB. Endoscopic treatment of Early Cancer of the Colon. Gastroenterol Hepatol. 2015;11:445–52.
4.
go back to reference Li JN, Yuan SY. Fecal occult blood test in colorectal cancer screening. J Dig Dis. 2019;20:62–4.CrossRef Li JN, Yuan SY. Fecal occult blood test in colorectal cancer screening. J Dig Dis. 2019;20:62–4.CrossRef
5.
go back to reference Balkwill F, Mantovani A. Inflammation and cancer: back to Virchow? Lancet (London England). 2001;357:539–45.CrossRef Balkwill F, Mantovani A. Inflammation and cancer: back to Virchow? Lancet (London England). 2001;357:539–45.CrossRef
6.
go back to reference Lech G, Słotwiński R, Słodkowski M, Krasnodębski IW. Colorectal cancer tumour markers and biomarkers: recent therapeutic advances. World J Gastroenterol. 2016;22:1745–55.CrossRef Lech G, Słotwiński R, Słodkowski M, Krasnodębski IW. Colorectal cancer tumour markers and biomarkers: recent therapeutic advances. World J Gastroenterol. 2016;22:1745–55.CrossRef
7.
go back to reference de Waal GM, de Villiers WJS, Forgan T, Roberts T, Pretorius E. Colorectal cancer is associated with increased circulating lipopolysaccharide, inflammation and hypercoagulability. Sci Rep. 2020;10:8777.CrossRef de Waal GM, de Villiers WJS, Forgan T, Roberts T, Pretorius E. Colorectal cancer is associated with increased circulating lipopolysaccharide, inflammation and hypercoagulability. Sci Rep. 2020;10:8777.CrossRef
8.
go back to reference Toyokawa T, Muguruma K, Yoshii M, Tamura T, Sakurai K, Kubo N, et al. Clinical significance of prognostic inflammation-based and/or nutritional markers in patients with stage III gastric cancer. BMC Cancer. 2020;20:517.CrossRef Toyokawa T, Muguruma K, Yoshii M, Tamura T, Sakurai K, Kubo N, et al. Clinical significance of prognostic inflammation-based and/or nutritional markers in patients with stage III gastric cancer. BMC Cancer. 2020;20:517.CrossRef
9.
go back to reference Korniluk A, Koper-Lenkiewicz OM, Kamińska J, Kemona H, Dymicka-Piekarska V. Mean Platelet Volume (MPV): New Perspectives for an Old Marker in the Course and Prognosis of Inflammatory Conditions, Mediators of inflammation, 2019 (2019) 9213074. Korniluk A, Koper-Lenkiewicz OM, Kamińska J, Kemona H, Dymicka-Piekarska V. Mean Platelet Volume (MPV): New Perspectives for an Old Marker in the Course and Prognosis of Inflammatory Conditions, Mediators of inflammation, 2019 (2019) 9213074.
10.
go back to reference Elinav E, Nowarski R, Thaiss CA, Hu B, Jin C, Flavell RA. Inflammation-induced cancer: crosstalk between tumours, immune cells and microorganisms, Nature reviews. Cancer. 2013;13:759–71. Elinav E, Nowarski R, Thaiss CA, Hu B, Jin C, Flavell RA. Inflammation-induced cancer: crosstalk between tumours, immune cells and microorganisms, Nature reviews. Cancer. 2013;13:759–71.
11.
go back to reference Stojkovic Lalosevic M, Pavlovic Markovic A, Stankovic S, Stojkovic M, Dimitrijevic I, Radoman Vujacic I et al. Combined Diagnostic Efficacy of Neutrophil-to-Lymphocyte Ratio (NLR), Platelet-to-Lymphocyte Ratio (PLR), and Mean Platelet Volume (MPV) as Biomarkers of Systemic Inflammation in the Diagnosis of Colorectal Cancer, Disease markers, 2019 (2019) 6036979. Stojkovic Lalosevic M, Pavlovic Markovic A, Stankovic S, Stojkovic M, Dimitrijevic I, Radoman Vujacic I et al. Combined Diagnostic Efficacy of Neutrophil-to-Lymphocyte Ratio (NLR), Platelet-to-Lymphocyte Ratio (PLR), and Mean Platelet Volume (MPV) as Biomarkers of Systemic Inflammation in the Diagnosis of Colorectal Cancer, Disease markers, 2019 (2019) 6036979.
12.
go back to reference Sun X, Feng Y, Zhang B, Huang W, Zhao X, Zhang H, Yue D, Wang C. The role of Neutrophil-to-lymphocyte ratio in Predicting Pathological Response for Resectable Non-Small Cell Lung Cancer treated with neoadjuvant chemotherapy combined with PD-1 checkpoint inhibitors. Cancer Res Treat. 2022;54:1017–29.CrossRef Sun X, Feng Y, Zhang B, Huang W, Zhao X, Zhang H, Yue D, Wang C. The role of Neutrophil-to-lymphocyte ratio in Predicting Pathological Response for Resectable Non-Small Cell Lung Cancer treated with neoadjuvant chemotherapy combined with PD-1 checkpoint inhibitors. Cancer Res Treat. 2022;54:1017–29.CrossRef
13.
go back to reference Erpenbeck L, MP Schön. Deadly allies: the fatal interplay between platelets and metastasizing cancer cells. Blood. 2010;115:3427–36.CrossRef Erpenbeck L, MP Schön. Deadly allies: the fatal interplay between platelets and metastasizing cancer cells. Blood. 2010;115:3427–36.CrossRef
14.
go back to reference Li JY, Li Y, Jiang Z, Wang RT, Wang XS. Elevated mean platelet volume is associated with presence of colon cancer. Asian Pac J cancer prevention: APJCP. 2014;15:10501–4.CrossRef Li JY, Li Y, Jiang Z, Wang RT, Wang XS. Elevated mean platelet volume is associated with presence of colon cancer. Asian Pac J cancer prevention: APJCP. 2014;15:10501–4.CrossRef
15.
go back to reference Sun L, Wei Y, Chen Y, Hu W, Ji X, Xu H, et al. Comparison of the Prognostic Value of platelet-related indices in biliary Tract Cancer Undergoing Surgical Resection. Cancer Res Treat. 2021;53:528–40.CrossRef Sun L, Wei Y, Chen Y, Hu W, Ji X, Xu H, et al. Comparison of the Prognostic Value of platelet-related indices in biliary Tract Cancer Undergoing Surgical Resection. Cancer Res Treat. 2021;53:528–40.CrossRef
16.
go back to reference Wu YY, Zhang X, Qin YY, Qin JQ, Lin FQ. Mean platelet volume/platelet count ratio in colorectal cancer: a retrospective clinical study. BMC Cancer. 2019;19:314.CrossRef Wu YY, Zhang X, Qin YY, Qin JQ, Lin FQ. Mean platelet volume/platelet count ratio in colorectal cancer: a retrospective clinical study. BMC Cancer. 2019;19:314.CrossRef
17.
go back to reference Deng Q, Long Q, Liu Y, Yang Z, Du Y, Chen X. Prognostic value of preoperative peripheral blood mean platelet volume/platelet count ratio (MPV/PC) in patients with resectable cervical cancer. BMC Cancer. 2021;21:1282.CrossRef Deng Q, Long Q, Liu Y, Yang Z, Du Y, Chen X. Prognostic value of preoperative peripheral blood mean platelet volume/platelet count ratio (MPV/PC) in patients with resectable cervical cancer. BMC Cancer. 2021;21:1282.CrossRef
18.
go back to reference Alsalman A, Al-Mterin MA, Abu-Dayeh A, Alloush F, Murshed K, Elkord E. Associations of Complete Blood Count Parameters with Disease-Free Survival in Right- and Left-Sided Colorectal Cancer Patients,Journal of personalized medicine,12(2022). Alsalman A, Al-Mterin MA, Abu-Dayeh A, Alloush F, Murshed K, Elkord E. Associations of Complete Blood Count Parameters with Disease-Free Survival in Right- and Left-Sided Colorectal Cancer Patients,Journal of personalized medicine,12(2022).
19.
go back to reference Abeles RD, Mullish BH, Forlano R, Kimhofer T, Adler M, Tzallas A, et al. Derivation and validation of a cardiovascular risk score for prediction of major acute cardiovascular events in non-alcoholic fatty liver disease; the importance of an elevated mean platelet volume. Volume 49. Alimentary pharmacology & therapeutics; 2019. pp. 1077–85. Abeles RD, Mullish BH, Forlano R, Kimhofer T, Adler M, Tzallas A, et al. Derivation and validation of a cardiovascular risk score for prediction of major acute cardiovascular events in non-alcoholic fatty liver disease; the importance of an elevated mean platelet volume. Volume 49. Alimentary pharmacology & therapeutics; 2019. pp. 1077–85.
20.
go back to reference Gu M, Zhai Z, Huang L, Zheng W, Zhou Y, Zhu R, Shen F, Yuan C. Pre-treatment mean platelet volume associates with worse clinicopathologic features and prognosis of patients with invasive breast cancer, Breast cancer (Tokyo, Japan), 23 (2016)752–760. Gu M, Zhai Z, Huang L, Zheng W, Zhou Y, Zhu R, Shen F, Yuan C. Pre-treatment mean platelet volume associates with worse clinicopathologic features and prognosis of patients with invasive breast cancer, Breast cancer (Tokyo, Japan), 23 (2016)752–760.
21.
go back to reference Li N, Yu Z, Zhang X, Liu T, Sun YX, Wang RT, Yu KJ. Elevated mean platelet volume predicts poor prognosis in colorectal cancer. Sci Rep. 2017;7:10261.CrossRef Li N, Yu Z, Zhang X, Liu T, Sun YX, Wang RT, Yu KJ. Elevated mean platelet volume predicts poor prognosis in colorectal cancer. Sci Rep. 2017;7:10261.CrossRef
22.
go back to reference Chang J, Lin G, Ye M, Tong D, Zhao J, Zhu D, Yu Q, Zhang W, Li W. Decreased mean platelet volume predicts poor prognosis in metastatic colorectal cancer patients treated with first-line chemotherapy: results from mCRC biomarker study. BMC Cancer. 2019;19:15.CrossRef Chang J, Lin G, Ye M, Tong D, Zhao J, Zhu D, Yu Q, Zhang W, Li W. Decreased mean platelet volume predicts poor prognosis in metastatic colorectal cancer patients treated with first-line chemotherapy: results from mCRC biomarker study. BMC Cancer. 2019;19:15.CrossRef
23.
go back to reference Sun SY, Zhao BQ, Wang J, Mo ZX, Zhao YN, Wang Y, He J. The clinical implications of mean platelet volume and mean platelet volume/platelet count ratio in locally advanced esophageal squamous cell carcinoma,Diseases of the esophagus: official journal of the International Society for Diseases of the Esophagus,31(2018). Sun SY, Zhao BQ, Wang J, Mo ZX, Zhao YN, Wang Y, He J. The clinical implications of mean platelet volume and mean platelet volume/platelet count ratio in locally advanced esophageal squamous cell carcinoma,Diseases of the esophagus: official journal of the International Society for Diseases of the Esophagus,31(2018).
24.
go back to reference Cho SY, Yang JJ, You E, Kim BH, Shim J, Lee HJ, Lee WI, Suh JT, Park TS. Mean platelet volume/platelet count ratio in hepatocellular carcinoma. Platelets. 2013;24:375–7.CrossRef Cho SY, Yang JJ, You E, Kim BH, Shim J, Lee HJ, Lee WI, Suh JT, Park TS. Mean platelet volume/platelet count ratio in hepatocellular carcinoma. Platelets. 2013;24:375–7.CrossRef
25.
go back to reference Omar M, Tanriverdi O, Cokmert S, Oktay E, Yersal O, Pilancı KN, et al. Role of increased mean platelet volume (MPV) and decreased MPV/platelet count ratio as poor prognostic factors in lung cancer. Clin Respir J. 2018;12:922–9.CrossRef Omar M, Tanriverdi O, Cokmert S, Oktay E, Yersal O, Pilancı KN, et al. Role of increased mean platelet volume (MPV) and decreased MPV/platelet count ratio as poor prognostic factors in lung cancer. Clin Respir J. 2018;12:922–9.CrossRef
26.
go back to reference Shi H, Wang H, Pan J, Liu Z, Li Z. Comparing prognostic value of preoperative platelet indexes in patients with resectable gastric cancer. Sci Rep. 2022;12:6480.CrossRef Shi H, Wang H, Pan J, Liu Z, Li Z. Comparing prognostic value of preoperative platelet indexes in patients with resectable gastric cancer. Sci Rep. 2022;12:6480.CrossRef
27.
go back to reference Hold GL, El-Omar EM. Genetic aspects of inflammation and cancer. Biochem J. 2008;410:225–35.CrossRef Hold GL, El-Omar EM. Genetic aspects of inflammation and cancer. Biochem J. 2008;410:225–35.CrossRef
28.
go back to reference Maletzki C, Emmrich J. Inflammation and immunity in the tumor environment, Digestive diseases (Basel, Switzerland), 28 (2010)574–578. Maletzki C, Emmrich J. Inflammation and immunity in the tumor environment, Digestive diseases (Basel, Switzerland), 28 (2010)574–578.
29.
go back to reference Itzkowitz SH, Yio X. Inflammation and cancer IV. Colorectal cancer in inflammatory bowel disease: the role of inflammation, american journal of physiology. Gastrointest liver Physiol. 2004;287:G7–17.CrossRef Itzkowitz SH, Yio X. Inflammation and cancer IV. Colorectal cancer in inflammatory bowel disease: the role of inflammation, american journal of physiology. Gastrointest liver Physiol. 2004;287:G7–17.CrossRef
30.
go back to reference Shebl FM, Hsing AW, Park Y, Hollenbeck AR, Chu LW, Meyer TE, Koshiol J. Non-steroidal anti-inflammatory drugs use is associated with reduced risk of inflammation-associated cancers: NIH-AARP study, PloS one, 9 (2014) e114633. Shebl FM, Hsing AW, Park Y, Hollenbeck AR, Chu LW, Meyer TE, Koshiol J. Non-steroidal anti-inflammatory drugs use is associated with reduced risk of inflammation-associated cancers: NIH-AARP study, PloS one, 9 (2014) e114633.
31.
go back to reference Keum N, Giovannucci E. Global burden of colorectal cancer: emerging trends, risk factors and prevention strategies, Nature reviews. Gastroenterol Hepatol. 2019;16:713–32. Keum N, Giovannucci E. Global burden of colorectal cancer: emerging trends, risk factors and prevention strategies, Nature reviews. Gastroenterol Hepatol. 2019;16:713–32.
32.
go back to reference Olenius T, Koskenvuo L, Koskensalo S, Lepistö A, Böckelman C. Long-term survival among colorectal cancer patients in Finland, 1991–2015: a nationwide population-based registry study. BMC Cancer. 2022;22:356.CrossRef Olenius T, Koskenvuo L, Koskensalo S, Lepistö A, Böckelman C. Long-term survival among colorectal cancer patients in Finland, 1991–2015: a nationwide population-based registry study. BMC Cancer. 2022;22:356.CrossRef
33.
go back to reference Lang D, Ciombor KK. Diagnosis and management of rectal Cancer in patients younger than 50 years: rising Global Incidence and Unique Challenges. J Natl Compr Cancer Network: JNCCN. 2022;20:1169–75.CrossRef Lang D, Ciombor KK. Diagnosis and management of rectal Cancer in patients younger than 50 years: rising Global Incidence and Unique Challenges. J Natl Compr Cancer Network: JNCCN. 2022;20:1169–75.CrossRef
34.
go back to reference Zahran AM, Hetta HF, Zahran ZAM, Rashad A, Rayan A, Mohamed DO et al. Prognostic Role of Monocytic Myeloid-Derived Suppressor Cells in Advanced Non-Small-Cell Lung Cancer: Relation to Different Hematologic Indices, Journal of immunology research, 2021 (2021) 3241150. Zahran AM, Hetta HF, Zahran ZAM, Rashad A, Rayan A, Mohamed DO et al. Prognostic Role of Monocytic Myeloid-Derived Suppressor Cells in Advanced Non-Small-Cell Lung Cancer: Relation to Different Hematologic Indices, Journal of immunology research, 2021 (2021) 3241150.
35.
go back to reference Jin Z, Sinicrope FA. Mismatch repair-deficient Colorectal Cancer: building on checkpoint blockade. J Clin oncology: official J Am Soc Clin Oncol. 2022;40:2735–50.CrossRef Jin Z, Sinicrope FA. Mismatch repair-deficient Colorectal Cancer: building on checkpoint blockade. J Clin oncology: official J Am Soc Clin Oncol. 2022;40:2735–50.CrossRef
Metadata
Title
Mean platelet volume/platelet count ratio in combination with tumor markers in colorectal cancer: a retrospective clinical study
Authors
Huan Zhang
Fan Lin
Zhuocai Wang
Publication date
01-12-2023
Publisher
BioMed Central
Published in
BMC Cancer / Issue 1/2023
Electronic ISSN: 1471-2407
DOI
https://doi.org/10.1186/s12885-023-10585-z

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