Abstract
Mean platelet volume (MPV) is an inflammatory marker indicative of platelet activation. There are several studies that suggest an association between the neoplastic process and cancer metastasis. We performed a retrospective analysis to investigate the role of MPV as a prognostic informative marker in gallbladder cancer. This study included 73 patients who underwent treatment for gallbladder cancer with curative or palliative intent. MPV was obtained and statistically analysed to investigate the association between the nodal status (N), the overall stage as per the American Joint Committee on Cancer (AJCC) staging system, perineural invasion, and differentiation of the tumor. The statistical analysis was done using SPSS Statistics, version 23 (IBM Corp., Armonk, NY). We found that the MPV values were significantly high in node-positive cases (OR = 3.623, 95% CI = 7.778-1.687, p value = −0.0001), cases in the advanced stage (OR = 3.623, 95% CI = 7.778-1.687, p value = 0.0001), cases with perineural invasion (OR = 3.396, 95% CI = 8.319-1.387, p value = −0.0001), and poor differentiation (OR = 2.327, 95% CI = 4.651-1.164, p value = −0.002 ). MPV is an inexpensive and convenient inflammatory marker that correlates with nodal positivity in the staging and prognostication of gallbladder cancer. This marker can be used to ascertain the risk status of gallbladder cancer.
Highlights
Gallbladder cancer is the most common cancer of the hepatobiliary system, with an incidence of 1.2% of the total cancer diagnoses, accounting for approximately 165,087 deaths and 1.7% of the total cancer deaths in 2018 [1].Review began 06/23/2021 Review ended 07/04/2021 Published 07/14/2021The presentation of gallbladder cancer is often confusing, which causes delay in diagnosis
Surgery can provide a complete cure when performed in the early stage of the disease, with simple cholecystectomy sufficing for in situ carcinoma or T1a, with a more radical resection needed in the advanced stage if possible where a negative margin is to be obtained, requiring a resection of the liver and bile ducts via a local lymphadenectomy [3,4]
An increase in Mean platelet volume (MPV) values is generally regarded as the clumping of platelets, which is one of the features of the inflammation processes, which enables the oncogenesis via generation of genetic-material-damaging agents like reactive oxygen species and promotes dissemination and invasion of cancer cells via production of chemokines and various other agents
Summary
The presentation of gallbladder cancer is often confusing, which causes delay in diagnosis. It is often discovered incidentally after a simple cholecystectomy or when it causes ascites or jaundice at a very advanced stage [2]. It tends to be unresectable, with a dismal prognosis at stages I, II, III, and IV (60%, 50%, 20%-25%, and 5%-15%, respectively) [3]. Other markers, which are not generally used, are CA 15-3, CA 242, and Mac-2BP. These have been found to have variable sensitivity and specificity [5,6]
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