Abstract
Objectives: Multiple blood parameters are used to determine the prognosis of renal cell carcinoma (RCC). Mean platelet volume/platelet count (MPV/PC) ratio is related to disease progression in various cancers. Our study tried to evaluate the prognostic value of the MPV/PC ratio in RCC patients who underwent surgery. Methods: We retrospectively reviewed 89 patients who underwent radical or partial nephrectomy for RCC in a single institution. Baseline characteristics and MPV/PC ratios were analyzed. The optimal cut-off value of the MPV/PC ratio was determined by a receiver operating characteristic (ROC) curve, and our patients were divided into low and high MPV/PC ratio groups. The Kaplan–Meier survival curve and Cox proportional hazards model were applied for progression-free survival (PFS) and overall survival (OS) analyses. Harell’s C-index was used to compare the prognostic values of the MPV/PC ratio, MPV and PC. Results: Lower MPV/PC ratios were correlated with more advanced tumor stages and worse outcomes. The optimal cut-off value of the preoperative MPV/PC ratio was 0.034 (sensitivity 84.6%, specificity 56.6%). The Kaplan–Meier survival curve revealed that low MPV/PC ratios were associated with worse PFS (p = 0.007) and OS (p = 0.017). Multivariate analysis showed that low MPV/PC ratios were an independent unfavorable factor for PFS (p = 0.044) and OS (p = 0.015). Harell’s C-indexes showed that the prognostic value of the MPV/PC ratio was significantly better than MPV and PC (p < 0.001). Conclusion: Low MPV/PC ratios are an independent, unfavorable risk factor for disease progression and overall survival in patients undergoing surgery for RCC.
Highlights
The receiver operating characteristic (ROC) curve analysis showed that the Mean platelet volume/platelet count (MPV/platelet count (PC)) ratio cut-off value of 0.034 was able to predict the renal cell carcinoma (RCC) disease progression with a sensitivity of 84.6% and a specificity of 56.6% (AUC = 0.723, 95% CI: 0.554–0.891, p = 0.011)
Univariate analysis showed that low Mean platelet volume (MPV)/PC ratios clearly correlated with progression-free survival (PFS) (HR 6.521, 95% CI 1.424–29.854, p = 0.016) (Table 2)
Further multivariate analysis demonstrated that the MPV/PC ratio and the pathological stage were independent predictive factors of a poor PFS (HR 5.391, 95% CI 1.049–27.700, p = 0.044; HR 18.261, 95% CI 3.769–88.475, p < 0.001)
Summary
The prognosis of advanced RCC is poor due to chemotherapy and radiotherapy resistance. Because of the prevalence of RCC and the difficulties in treatment for advanced disease, it’s important to search for clinically available biomarkers to determine its prognosis in daily practice. Several parameters based on blood tests, including hemoglobin, neutrophil level and calcium concentration, have shown their value for providing additional prognostic information for advanced/metastatic RCC [1]. Activated platelets may account for oncogenesis and progression of RCC [2]. Total platelet count (PC) is dynamic in the human body, balanced by the megakaryopoiesis of bone marrow cells and the consumption rates under different conditions, such as inflammation or microthrombosis formation in tumor microenvironments [7,8,9]. A progressive disease status may be masked by normal PC, due to its effective compensation [10]
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