P-Selectin As A Marker of Platelet Activation in Africans with Prostate Cancer: A Cross-Sectional Study.

Abstract

Background: Platelets are components of blood involved in processes such as inflammation, metastasis and atherosclerosis by the use of adhesion molecules.sP-Selectin is a cellular adhesion molecule that promotes platelet-tumor cell interactions, venous thromboembolism and tumor metastasis. High plasma levels independently predict venous thrombosis in cancer patients and are known to play a major role in tumor metastasis. No study has determined the levels and associations of sP-selectin in prostate cancer patients in Africa. Objectives: To evaluate sP-selectin levels in prostate cancer patients and assess the associations with increased values. Methods: We prospectively enrolled 88 histologically diagnosed prostate cancer patients, reviewed their case notes for duration of presentingsymptoms, PSA at diagnosis, evidence of metastatic disease and history of comorbid states. Also, 40 healthy male controls were enrolled. Full blood count was done using EDTA samples and citrated samples for sP-selectin determination using ELISA for both groups of subjects. Results: We found significantly reduced haemoglobin in cases than controls (10.79 ± 2.20 vs 13.59 ± 2.20g/dl; p= 0.001), sP-selectin was significantly higher in cases (57.86 ± 69.92vs 25.83 ± 9.72 ng/l; p =0.01). Twenty four patients (27.3%) had sP-selectin levels >53.1ng/ml (mean 114.3 ± 171.1ng/mL). sP-selectin was significantly higher in patients whose BMI was > 25g/m 2 (p=0.03), those with 2 or more co-morbidities (p=0.02) and more so in patients with diabetes mellitus (p=0.009). sP-selectin was increased in metastatic cancer patients, although not significantly. Conclusion: The findings from this study indicate that there is increased platelet activation in prostate cancer patients as measured by sP-selectin, indicating a significant cardiovascular risk in these patients. Platelet activation was significantly associated with higher BMI and presence of co-morbidities. The ability of sPselectin to predict metastasis and risk of VTE in this environment needs to be elucidated in studies with larger cohorts.