Abstract
Mounting evidence suggests that inflammation, immune response, and coagulation status determine many processes during the carcinogenesis pathway in colorectal cancer (CRC). Inflammation strongly promotes tumor formation, progression, and metastasis. The systemic inflammatory response (SIR) may be reflected by simple indicators evaluated on the basis of peripheral blood morphology parameters. The indices are easily obtained by the peripheral blood test and could be promising biomarkers for CRC. We present the results of the retrospective study evaluating the potential relation between the platelet indices (platelet count (PC), platelet-to-lymphocyte ratio (PLR), neutrophil platelet score (NPS), mean platelet volume (MPV), and MPV/PC ratio) and the clinicopathological features of CRC patients. The study included 247 patients (104 males and 143 females) aged 39-87 years with CRC stages II-IV. The complete blood counts with the automated differential counts were performed prior to the qualification to systemic treatment. High PC, high PLR, and NPS 0 were associated with older age and higher BMI of the patients. No link between the analyzed platelet indices and histological grade of the tumor, primary tumor location, and gender was noted. The patients aged ≥65 years were characterized by the higher MPV/PC ratio than the younger population. We observed a trend to the higher MPV/PC ratio among the patients with excessive body weight defined by BMI compared to BMI within normal limits. A higher frequency of PC > 400, NPS 1 and 2, and a trend to more frequent PLR ≥ 150 were observed in the subgroup with metastatic disease compared to individuals with CRC stages II and III. The presented results expand the knowledge on potential association between SIR parameters and other clinicopathological factors that should be considered during interpreting the prognostic and predictive value of the inflammation parameters.
Highlights
In 1863, Rudolf Virchow hypothesized that chronic inflammation could sustain cell proliferation contributing to cancerogenesis [1]
Patients with metastatic disease had higher white blood cell (WBC) and neutrophil count (NC) compared to individuals with colorectal cancer (CRC) stages II and III after radical resection (Table 3)
We noted a higher frequency of platelet count (PC) > 400, neutrophil platelet score (NPS) 1 and 2, and a trend to more frequent platelet-to-lymphocyte ratio (PLR) ≥ 150 in the subgroup with stage IV disease (Table 4)
Summary
In 1863, Rudolf Virchow hypothesized that chronic inflammation could sustain cell proliferation contributing to cancerogenesis [1]. Mounting evidence established the role of inflammatory and thrombotic processes in all stages of carcinogenesis in colorectal cancer. The local cancer-related inflammation is reflected in the systemic inflammatory response (SIR). Besides their physiological role in hemostasis, platelets contribute various pathological processes including inflammation, atherosclerosis, and cancer metastasis via the release of cytokines and chemokines and expression of several adhesion receptors [2]. Tumor cells secrete a plethora of bioactive mediators contributing to platelet activation, e.g., cysteine proteinases, ADP [3] or IL-6 [4]. Activated platelets secrete several tumor growth and proangiogenic factors involved in the cancerogenesis, including transforming growth factor β, platelet-derived growth factor, vascular endothelial growth factor, epidermal growth factor, and angiopoietin [6]. Circulating tumor cells avoid the immune surveillance and promote their extravasation and metastasis formation by being coated by blood
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
