Plateletcrit Values Research Articles

Effect of perinatal factors on platelet indices in late preterm and term newborns

Abstract
 Aim: This study aimed to compare platelet indices between late preterm and term newborns, and to analyze their relationship with perinatal conditions. 
 Materials and Methods: Ninety-eight late preterm and 102 term newborns admitted to the neonatal intensive care unit 2018 and 2020 were retrospectively evaluated. Platelet indices including platelet count (PLT), mean platelet volume (MPV), plateletcrit (PCT), and platelet distribution width (PDW) were measured in blood samples taken on the first day of life.
 Results: There was no significant difference in the PLT, MPV, PCT, and PDW values between late preterm and term newborns. In late preterm newborns, multivariable analysis showed that maternal hypertension was significantly related to lower PLT (p=0.001). In term newborns, multivariable analysis showed that being small for gestational age (SGA), male sex and maternal hypertension were significantly related to lower PLT (p

Evaluation of diagnostic performance of haematological parameters in Behçet's disease.

Behçet's Disease (BD) is a polygenic and chronic autoinflammatory multisystemic vasculitis disease characterised by mucocutaneous, musculoskeletal, neurological, gastrointestinal and ophthalmologic lesions. There has been no specific test or serum marker to measure and determine the diagnosis and severity of BD. The study aimed to investigate the diagnostic performance of haematological parameters as MLR (monocyte to lymphocyte ratio), NLR (neutrophil to lymphocyte ratio), PLR (platelet to lymphocyte ratio), MPV (mean platelet volume), MPVPR (mean platelet volume to platelet ratio), LMR (lymphocyte to monocyte ratio), LPM (lymphocyte and platelet multiplication), WLP (lymphocyte and leukocyte multiplication), RDW (red blood cell distribution width) and PCT (plateletcrit) in BD and compare these with disease activity and clinical findings. A total of 266 participants (49 healthy control and 217 BD patients) were recruited from the rheumatology department in a single-centre as a case-control study. The laboratory data were obtained from the electronic registration database. BD Activity scores (BDCAF/Behcet's Disease Current Activity Form) were calculated. Laboratory findings of BD patients and healthy controls were compared and evaluated. RDW, Platelet, PCT, NLR and PLR values were significantly higher in patient group than in the healthy controls. However, haemoglobin, MPVPR and LMR were significantly lower in the patient group which compared with the healthy controls. LPM in BD with genital ulcers, WLP in BD with genital ulcers and arthritis, MPR in BD with uveitis, RDW in BD with thrombosis and neuro-Behçet's disease (NBD), PLR in NBD were observed to be higher. However, LMR in NBD and MPV in BD with thrombosis were lower than those without. There was a positive correlation between BDCAF score and RDW, and NLR. Haemoglobin, RDW, Platelet, PCT, NLR, LMR, PLR and MPVPR were statistically significant predictors for BD. RDW, PCT and NLR are the most valuable predictors for BD.

Is there any relationship between platelet indices and myocarditis in children?

Platelet indices are used to evaluate platelet activation and function which change in inflammatory diseases. We hypothesise that platelet indices such as plateletcrit, mean platelet volume, and platelet distribution width may be more useful as prognostic indicators for myopericarditis in children. A total of 60 children were included in this study. Group 1 consists of children with myopericarditis, Group 2 is those with respiratory infections, and Group 3 consists of control group children of similar age and gender with the patient groups. Complete blood count parameters, C-reactive protein, and troponin values of the whole study group were recorded. Myopericarditis was diagnosed based on acute chest pain, dyspnea, palpitations, heart failure signs, arrhythmia symptoms and ST/T wave change, low voltage, supraventricular tachycardia/ventricular tachycardia on ECG, or elevated troponin T/troponin I levels or functional abnormalities on echocardiography. A comparison of the platelet indices made during diagnosis and 2 weeks after treatment was done for the myopericarditis patients. There was no statistically significant difference in platelet indicies values. However, the increase in platelets and plateletcrit values after the treatment of myopericarditis was statistically significant. This study pointed out that there was a negative correlation between platelet-plateletcrit values and the troponin I-C-reactive protein. We found that platelet count and plateletcrit values increased after treatment. This is important as it is the first study in children to investigate the possible role of platelet indications for myopericarditis in children.

Can we determine recurrent epistaxis by hemogram parameters in children?

ObjectiveEpistaxis in children is a common reason for admission at otolaryngology outpatient clinics. Patients are diagnosed by clinical examination and laboratory tests. We aimed to evaluate epistaxis using simple blood parameters useful for diagnosis. Material and methodsThis study includes a retrospective analysis of 240 patients, including 120 study group and 120 healthy pediatric patients, who applied to the ENT outpatient clinic with the diagnosis of epistaxis between 2018 and 2020. This study is designed to analyze the predictive values of neutrophil-lymphocyte ratio (NLR), eosinophil-LR (ELR), platelet-LR (PLR), plateletcrit (PCT), mean platelet volume (MPV), and platelet distribution width (PDW) in pediatric epistaxis. ResultsSerological factors were assessed and no statistical associations in MPV, PDW, PLR, and ELR values were found. However, significant changes were found for PCT and NLR within the patient and control groups. The average PCT was lower in the study group in comparison to the controls (p = 0.022). The average NLR was higher in the study group in comparison to the controls (p = 0.004). ConclusionThe examination of children with epistaxis, as well as their management, following admission to the outpatient clinic continues to evolve. Although many studies have investigated the hemogram parameters and platelet indices, the PCT value has never been investigated in epistaxis. To our knowledge, our study is the first to demonstrate a relationship to PCT values and epistaxis.

Comparative Analysis of Collagen and Chitosan-based Dressing for Haemostatic and Wound Healing Application

Collagen and chitosan have haemostatic, tissue fix and wound healing properties but the poor mechanical property limits their application. Therefore, various concentrations of collagen (1-6%) and chitosan (1-2%) were used to develop biopolymer-coated gauzes, with and without glycerol as plasticiser. Glycerol-treated gauzes showed desired mechanical and adhesive property in comparison to polymer-coated gauzes alone. Developed gauzes were characterized using differential scanning calorimetry, thermal gravimetric analysis and Fourier transform infrared spectrophotometry to confirm the biopolymer coating and stability. Scanning electron microscopy showed multilayer coating of the biopolymer and faster clotting in chitosan gauzes in comparison to collagen. Surface plasmon resonance assay confirmed that chitosan exhibited more binding affinity of 65 RU in comparison to collagen, which showed 55 RU with erythrocytes. Decrease in the value of plateletcrit and mean platelet volume confirmed platelet adhesion and aggregation over the surface of polymer-coated dressings. Gamma scintigraphy studies showed 85 ± 2% formulation retention up to 12h at the wound site in comparison to 40 ± 3% retention of the radiopharmaceutical alone. Collagen and chitosan-coated gauze showed 226 ± 15s and 179 ± 12s haemostasis time, respectively, which was significantly less from 506 ± 15s in standard gauze. Chitosan gauze showed faster wound healing in comparison to the collagen-coated gauze. Chitosan and collagen-coated gauzes showed 55 ± 4% wound contraction on day seven in comparison to 25 ± 2% in the control group, while chitosan gauzes showed complete wound contraction on day fourteenth, while the collagen-coated gauze showed 90 ± 3% on the same day.

English

BACKGROUND Thrombocytopenia may either be due to increased destruction or impaired production of platelets. Platelet count alone is not enough to determine the mechanism of low platelets. Platelet indices like mean platelet volume (MPV), platelet distribution width (PDW), platelet large cell ratio (P-LCR) and platelet crit (PCT) can help determine the cause and we aimed at finding their role and function in cases of thrombocytopenia. METHODS An observational cross-sectional study of 155 patients with thrombocytopenia and 71 controls was done for a period of six months in SGT Hospital, Gurugram, to determine the mechanism behind the low platelet count with the help of these indices. RESULTS The mean values of the platelet indices (PDW, P-LCR and PCT) were found to be higher in accelerated destruction group (P < 0.05) in comparison to hypoproductive group, whereas, mean MPV values were higher in the former, but was not statistically significant. On comparison with the controls, both the groups of thrombocytopenia showed a statistically significant difference with P < 0.005 in all the four indices. Mean PCT values showed a highly significant difference between the two groups as well as with controls (P < 0.001) and also the relationship of PCT with severity of thrombocytopenia showed a direct relationship which was also significant (P < 0.001). CONCLUSIONS In distinguishing between the cause of thrombocytopenia i.e., hypoproductive or hyper destruction, platelet parameters play an important role. These platelet indices are easily available with the help of automated haematology analysers and can reduce the need for costly and invasive tests for evaluation of thrombocytopenia. KEY WORDS Mean Platelet Volume, Platelet crit, Platelet Distribution Width, Platelet Large Cell Ratio, Thrombocytopenia

Evaluation of Platelet Indices and Complete Blood Count in Canine Mammary Tumors

Background: Malignant mammary tumors in humans and bitches cause hematological disorders such as anemia, erythrocytosis, thrombocytosis, hyperproteinemia, and leucopenia. Novel studies have been conducted on the predictive and prognostic values of platelet (PLT) indices in human breast cancer (HBC). However, there is little information about the alterations in hematological parameters in canine mammary tumors (CMTs). The aims of this study were to evaluate the platelet indices and complete blood count (CBC) parameters in bitches with and without mammary tumor and to assess the above mentioned parameters with regard to histological tumor types and grades.Materials, Methods & Results: A total of 71 bitches were enrolled in this study. The bitches in the study group were divided into 2 groups which consisted of malignant epithelial mammary tumors (group EMT; n = 43) and malignant mixed mammary tumors (group MMT; n = 12). Control group (group C) consisted of clinically and gynaecologically healthy 16 bitches. Blood samples were obtained to perform the CBC and PLT indices analysis. Histopathological examinations were carried out under a light microscope. Histological tumor types and malignancy grades were classified. The bitches with mammary tumor showed significantly increased PLT values and decreased hematocrit (HCT), hemoglobin (HGB) and mean corpuscular hemoglobin (MCH) values versus the healthy ones, regardless of the tumor type. However, in comparisons with the group C, mean platelet volume (MPV) and mean corpuscular hemoglobin concentration (MCHC) values were different only in the group MMT, while plateletcrit (PCT) and mean corpuscular volume (MCV) values were different only in the group EMT. Also white blood cell (WBC), PLT and PCT values were higher than the referenced laboratory ranges in grade 3 tumors. In the presented study, MPV was considerably correlated with PLT, platelet distribution width (PDW) and PCT. Also, PCT and PLT had high sensitivity and specificity to distinct EMT and MMT from the healthy bitches.Discussion: Microcytic and hypochromic anemia occurs due to the decrease in the amount of HGB. Levels of MCV, MCH, and MCHC in the HBC group were reported to be significantly lower than in humans without breast cancer. Although anemia did not occur in EMT and MMT groups, obtained significances in the HCT, HGB, MCV, MCH, and MCHC levels between the bitches with and without mammary tumor were in line with the previous reports. In this study, WBC levels in grade 3 tumors were significantly higher than grade1 tumors (P < 0.05). Whereas levels of WBC in grade 1 and grade 2 tumors were in referenced laboratory ranges, it was higher in grade 3. Increased level of WBC in grade 3 was supposed to be due to the rise in malignancy as previously reported. Thrombocytosis was detected in 48.83% and 41.66% of the bitches in EMT and MMT groups, respectively. The higher percentage of CMTs with thrombocytosis in this study might be due to the difference in referenced upper limit of PLT in previous studies. The elapsed time between tumor formation and clinical presentation could be another influencing factor. Although PLT and PCT values were not significant according to the histological grading in this study, both parameters were found to be higher in grade 3 than the normal reference values. Further studies conducted with higher populations may lead the differences in these parameters to significance. With the support of further studies, alterations in the above mentioned parameters in bitches may contribute in the diagnosis process, management of treatment and may constitute an easy way to have an idea about the prognosis of mammary tumors.

Role of Impedance-Based Platelet Parameters and Related Ratios in Screening for Coronavirus Infection- An Institutional Experience

Introduction: Impedance based platelet parameters can be easily obtained from most automated haematology analysers. Few of these parameters, especially Platelet Count (PLT), Mean Platelet Volume (MPV) and Plateletcrit (PCT), have been shown to predict disease progression in Coronavirus Disease 2019 (COVID-19). However, data on usefulness of these parameters as predictors of COVID-19 infection, in suspected cases, is limited. Aim: To evaluate the role of impedance-based platelet parameters, like PLT, MPV, PCT, Platelet-Distribution Width (PDW), and related ratios, as predictors of COVID-19 infection in suspected cases, using real-time Reverse Transcription Polymerase Chain Reaction (rRT-PCR) as standard. Materials and Methods: Retrospective analytical cross-sectional study was conducted in September 2020, at a teaching hospital located in Mangalore, Karnataka, India. The study parameters were retrieved and/or calculated, from the medical records of 328 patients (from July 2020 to August 2020) who had undergone COVID-19 rRT-PCR testing of their respiratory samples, comprising equal number (n=164) of patients with positive and negative test results, matched for age and sex. The data were compared and analysed. Statistical Package for Social Sciences (SPSS) version 23.0 was used in statistical analysis of this study. The significance level (p-value) was set to 0.05. Results: Data of total 328 subjects (age range: 18-85 years, 164 COVID positive and 164 COVID negative subjects) was collected and analysed for comparison. Differences in PLT, PCT, and most of the calculated ratios were statistically significant between the two groups; however, Area Under Curve (AUC) for all were <0.7. PCT values were significantly lower in COVID-19 positive group, despite normal PLT (p-value=0.005). Conclusion: Impedance based platelet parameters have limited role as predictors of COVID-19 infection in suspected patients, despite of their established prognostic value. Decrease in PCT values possibly precedes occurrence of thrombocytopenia following COVID-19 infection.

The Role of Systemic Inflammatory Markers in the Diagnosis of Hyperemesis Gravidarum

This study was aimed to investigate the diagnostic value of the neutrophil-lymphocyte ratio (NLR), platelet-lymphocyte ratio (PLR), platelet distribution width (PDW), mean platelet volume (MPV), plateletcrit (PCT) and red cell distribution width (RDW) in patients with hyperemesis gravidarum (HG). We conducted this retrospective study in a tertiary center between August and December 2019.A total of 72 pregnant patients with HG and 78 pregnant women without nausea and vomiting were included in the study. Hemoglobin (Hb), white blood cell count (WBC), neutrophil count, lymphocyte count, platelet count, RDW, PDW, MPV, PCT, and CRP values were all derived from patients' medical files. The student's t-test was used to compare the normally distributed data. Mann-Whitney U test was used to compare the non-normally distributed data. The median NLR value of the HG group was 3.4 (1.1-7.2), and the control group was 1.98 (1.0-4.6). This difference was statistically significant (p<0.05). The median PLR value of the HG group (152.6 [69.8-338.1]) was significantly higher (p<0.05) than the PLR value of the control group (88.1 [48.3-201.2]). The results of this study suggest that NLR and PLR can be used as effective markers in the diagnosis of HG. The increased values of NLR and PLR also indicate that inflammation may act a crucial role in the pathogenesis of HG.

JAK2V617F, CALR and MPL515L/K mutations and plateletcrit in essential thrombocythemia: A single centre's experience.

JAK2V617F (JAK2), calreticulin (CALR) and MPL515L/K (MPL) mutations are important in essential thrombocythemia (ET) and may be associated with various clinical consequences of the disease. This study aimed to compare the clinical and haematological parameters of ET patients regarding the mentioned mutations and the role of plateletcrit (PCT). Seventy patients who were diagnosed with ET between 2005 and 2017 in a single centre were included in this descriptive study. The initial symptoms and clinical findings were retrieved from the electronic database. JAK2 gene V617F mutations, MPL gene exon 10 mutations and CALR gene exon 9 DNA sequence analyses were performed. Forty-one healthy volunteers were included to perform ROC curve analysis for interpreting PCT value. The distributions of patients according to the mutations were as follows: Thirty-seven (52.9%) patients were JAK2-positive, 15 (21.4%) were CALR-positive, 2 (2.8%) patients were positive for both CALR and JAK2, and 1 (1.4%) was only MPL-positive. Fifteen (21.4%) patients were triple-negative. The ET patients with JAK2 mutation showed a higher level of haemoglobin at the time of diagnosis. The ET patients with CALR mutation presented with higher platelet and LDH levels (P=.002 and P=.001, respectively). The PCT level was higher in the CALR-positive group when compared to the others (P=.026). A sensitivity value of 97.6% and specificity value of 98.6% were determined regarding PCT% at a cut-off value of 0.37 in ET patients. In CALR-positive patients, the sensitivity and specificity values were 100% for the PCT at a cut-off value of 0.42%. We determined that the platelet count and blood LDH level was high in the ET patient group with CALR mutation. Besides, we found that the blood haemoglobin level was higher in the ET patient group with JAK2 mutation. Additionally, the PCT level was higher in the CALR group when compared to the other patient groups.

The prognostic and predictive value of platelet parameters in diabetic and nondiabetic patients with sudden sensorineural hearing loss.

BackgroundWe aimed to evaluate the association between mean platelet volume, platelet distribution width (PDW), platelet count (PC) and plateletcrit (PCT), and the presence of sudden sensorineural hearing loss (SSNHL) and treatment response. In the literature, there is no study that investigates the platelet functions in diabetic patients with SSNHL.MethodsThe patients were retrospectively assigned into Group 1 (68 diabetic patients with SSNHL), Group 2 (63 nondiabetic patients with SSNHL) and Group 3 (64 healthy controls).ResultsPC was not significantly different between the groups (p > 0.05). MPV, PDW and PCT values were significantly higher in Group 1 as compared to Groups 2 and 3 (p < 0.05). Platelet parameters were not significantly different between the patients who were responsive and nonresponsive to the treatment. Therefore, the platelet parameters did not affect prognosis significantly in this study samples (p > 0.05).ConclusionsThis study showed that platelet parameters did not have a significant effect as a prognostic and predictive value in diabetic and nondiabetic patients with SSNHL. Further studies with more homogenous and larger study groups investigating the platelet parameters are needed to demonstrate microvascular damage and vascular alterations induced by diabetes mellitus.

Effect of classical surgical treatment under spinal anesthesia on venous thromboembolism in varicose veins patients

Aim: Although minimally invasive methods have developed rapidly in the treatment of varicose veins in recent years, high ligation + stripping (S/L), which is the classical surgical treatment, is still considered gold standard. Some thromboembolic events may occur due to varicose disease. Our aim is to determine the changes in mean platelet parameters after the procedure in patients who underwent S/L with spinal anesthesia and investigate the effect of this procedure on thromboembolic events. Methods: Patients who visited the Anesthesia Reanimation outpatient clinic of Adiyaman University Faculty of Medicine and underwent S/L with spinal anesthesia were evaluated in this retrospective cohort study. Data was collected electronically with file scanning. Patients whose hemograms were obtained before and 1 day after the operation were included. Among the laboratory tests, MPV, PLT, platelet distribution width (PDW) and plateletcrit (PCT) were noted. Results: Postoperative MPV (P<0,001) and PLT (P=0.01) values showed a significant decrease compared to the preoperative period, while PDW (P=0.194) and PCT (P=0.863) values remained similar. Conclusion: If it is assumed that varicose veins and MPV are associated with thromboembolic events, a significant decrease in postoperative MPV value in patients who underwent S / L with spinal anesthesia will reduce thromboembolic events.

Multistep analysis reveals the relationship between blood indices at the time of ovum pick-up and in vitro embryo production in heifers

The inflammatory factors of complete blood count (CBC) are associated with a decrease in the in vitro embryo production (IVP) outcome in women. The relation between the blood indices and in vitro fertilization (IVF) outcomes in bovines remains to be elucidated. Using ovum pick-up (OPU), oocytes were retrieved from heifers (n = 60) and inseminated separately with sperm. The blastocyst formation was recorded on day 7 after insemination for each animal and the blood indices were evaluated at the time of OPU. Then, heifers were classified on the basis of (1) blastocyst formation, cleaved vs. failed, or (2) inflammation, low-grade inflammation (lymphocyte counts > 5.6 × 109/L) vs. no inflammation (lymphocyte counts < 5.6 × 109/L). Oocytes derived from heifers with higher lymphocytes, red blood cells (RBC), platelets, hematocrit, red cell distribution width (RDW-SD) and plateletcrit values and lower monocytes, eosinophils, mean corpuscular hemoglobin (MCH) and MCH concentration (MCHC) successfully developed to the blastocyst stage. Heifers with low-grade inflammation numerically had a higher percentage of blastocyst formation than normal heifers. The principle component analysis (PCA) showed that blastocyst formation had the strongest positive association with RDW-cv and RDW-SD, while having a strong negative association with mean corpuscular volume (MCV), hemoglobin, MCHC and MCH. The PCA determined that the number of grade A COCs and the percentage of COCs reached the cleavage stage had a negative association with white blood cells (WBC), lymphocytes, basophils and monocytes, and a positive correlation with platelet to lymphocyte ratio, platelet distribution width (PDW) and plateletcrit. Network mapping detected close similarities between BFR and RDW-SD, MPV, and lymphocytes. The area under the receiver operating characteristic curve (AUC) identified that, eosinophils (AUC 0.80), RDW-SD (AUC 0.76), monocytes (AUC 0.76) and lymphocytes (AUC 0.76) had a good predictive ability to detect heifers with high OPU-IVP outcome (≥60%). In conclusion, these findings suggest that CBC indices at the time of OPU were associated with the IVF outcome and may be incorporated into protocols for the identification of heifers with high potential for blastocyst formation.

Can monocyte to HDL cholesterol ratio and monocyte to lymphocyte ratio be markers for inflammation and oxidative stress in patients with vitiligo? A preliminary study.

Both systemic inflammation and oxidative stress play crucial roles in the pathogenesis of vitiligo. In recent studies, monocyte to high-density lipoprotein cholesterol ratio (MHR), monocyte to lymphocyte ratio (MLR), neutrophil to lymphocyte ratio (NLR), platelet to lymphocyte ratio (PLR), mean platelet volume (MPV) and plateletcrit (PCT) have been shown to reflect inflammation and oxidative stress in chronic inflammatory and autoimmune diseases. In this study, we aimed to investigate the hematological and inflammatory parameters in patients with vitiligo and to evaluate their possible relationship with disease severity. The parameters including MHR, MLR, NLR, PLR, MPV, and PCT were retrospectively investigated in patients with vitiligo and healthy controls. Disease severity was evaluated using the vitiligo extent tensity index (VETI) score. A total of 180 patients with vitiligo, and age-gender-matched 180 healthy controls were enrolled in the study. MHR, MLR, PLR, PCT values were found to be significantly higher in patients with vitiligo (p < 0.05). MPV and NLR values showed no statistically significant difference between the two groups. A positive correlation was also detected between MHR and MLR values, disease duration, and VETI score (p < 0.05). We suggest that MHR and MLR can be used as markers of inflammation and oxidative stress in patients with vitiligo. Both markers may also reflect disease severity.

Evaluation of platelet volume indices as predictive biomarkers of microvascular complications in patients with type 2 diabetes

Patients with type 2 diabetes are known to have a higher risk of developing micro- and macrovascular complications which enhance the risk of morbidity and mortality. Increased platelet activity is postulated to be a vital mechanism in the development of vascular complications. Platelet volume indices (PVI), including mean platelet volume (MPV), platelet distribution width (PDW), and plateletcrit (PCT) are indicators of enhanced platelet activity and these may be useful markers of complications. We conducted a case-control study across 130 T2DM patients that were matched for age and gender with 130 people who did not have T2DM. Detailed demographic profile and clinical history including duration of diabetes along with complete physical examination was conducted. Fundus examination was conducted for direct ophthalmoscopy for retinopathy and Neuropathy Disability Score (NDS) was calculated to assess the severity of neuropathy. The biochemical investigations included were the platelet indices, fasting blood glucose (FPG), postprandial blood glucose, HbA1c, serum creatinine, and urine albumin. We observed that platelet indices, such as MPV, PDW, and PCT were significantly higher in diabetic individuals than in matched controls. Higher MPV, PDW, and PCT were observed in diabetic patients with microvascular complications compared with those without microvascular complications. We observed that patients with neuropathy with NDS > 6 had higher value of MPV, PDW, and PCT than compared with those with NDS < 6. There was significant difference for MPV between diabetics with and without complications and non-diabetics (p < 0.05). PDW and MPV were positively correlated with duration of diabetes. The association between MPV, PDW, and PCT and diabetic retinopathy revealed that platelet indices were significantly higher than control group in both NPDR and PDR. However, we did not observe any difference in platelet indices in NPDR and patients without diabetic retinopathy. MPV, PDW, and PCT were higher in individuals with higher HbA1clevel and the correlation was found to be statistically significant.

Evaluating the Platelet Distribution Width-to-Plateletcrit Ratio as a Prognostic Marker for Patients With Breast Cancer.

This study aimed to evaluate plateletcrit (PCT) and platelet distribution width-to-PCT ratio (PDW/PCT) as potential prognostic biomarkers in patients with breast cancer. Information of 337 patients was retrospectively reviewed. The Cox regression proportional hazards model was used to evaluate the prognostic value of PCT and PDW/PCT compared to the platelet distribution width-to-platelet count ratio (PDW/P) and red cell distribution width-to-platelet count ratio (RDW/P). Large tumor size (p<0.01), lymph node involvement, and increased PDW/P, RDW/P, and PDW/PCT (p<0.05) were significantly associated with inferior disease-free survival (DFS) according to the univariate analysis. The multivariate analysis showed that large tumor size (p<0.01) and increased PDW/PCT (p<0.05) were significant prognostic factors for poor DFS. To our knowledge, this is the first report to show that PDW/PCT is a significant prognostic factor for patients with breast cancer. Therefore, it might be an attractive biomarker providing additional prognostic information for these patients.

Reply to the letter by Beyan et al "Plateletcrit may not be an index for predicting of liver fibrosis in patients with chronic hepatitis B".

We thank BeyanC and Beyan E for their interest in our study and appreciate their comments1,2 .We agree that many factors may impact the reliability of plateletcrit (PCT) values. The data was retrospectively collected and the patients were included in a very broad time period. Thus,we also agree that some bias may exist in our study.However, to minimize the bias, we divided our patients into a derivation cohort and a validation cohort by a computer-generated randomization schedule. Byunivariate analysis and multivariate logistic regression analysis, the PCT was identified as an independent factor for significant fibrosisin the derivation cohort2 .

The association between obesity and hematologic inflammatory markers in the first trimester pregnancies

Objective Obesity is the defined as the abnormal or excessive accumulation of the fat which is harmful for the health, and its prevalence has been increasing. Many studies have shown that obesity alone leads to inflammation and causes poor gestational outcomes. In our study, we aimed to investigate the association between basic hematologic markers and obesity in the first trimester pregnancies. Methods A total of 321 pregnant women who admitted to the clinic of gynecology and obstetrics in a tertiary state hospital were included in the study. The patients were separated into three groups, which were normal weight (BMI: 18–24.9 kg/m2), overweight (BMI: 25–29.9 kg/m2), and obese (BMI&gt;30 kg/m2). Of the patients, the demographic data (age, gravida, and parity) and the parameters of hemoglobin, hematocrit, white blood cell, neutrophil, lymphocyte, platelet (PLT), eosinophil, basophil, mean platelet volume (MPV), platelet distribution width (PDW), neutrophil/lymphocyte ratio (NLR), red blood cell distribution width (RDW), plateletcrit (PCT) and platelet/lymphocyte ratio (PLR) measured in the complete blood count which was checked in the first trimester routinely during the pregnancy follow-up were analyzed. The three groups were compared in terms of inflammatory markers. Results The patients were evaluated in three groups: 108 patients with normal weight (Group 1), 109 overweight patients (Group 2) and 104 obese patients (Group 3). No significant difference was found in terms of age, parity and gravida when the demographic data were analyzed among the groups (p&gt;0.05). When the groups were compared in terms of hematologic markers, similar values were found in the markers other than white blood cell, neutrophil, lymphocyte, PLT and PCT values. The difference among white blood cell, neutrophil, lymphocyte, PLT and PCT values were between the patients with normal weight and obese patients, and the values of these markers were found higher in overweight / normal weight patient groups than the normal group (p&lt;0.05). Conclusion The values of white blood cell, neutrophil, lymphocyte, PLT and PCT which were shown to be associated with inflammation were higher in the obese patients.

Platelet parameters as an inflammatory marker in children

Introduction: Platelets which are known to play a role in inflammation change their number and shape when they are activated and this change is reflected in values of platelet indices. Testing for platelet parameters by reliable automated blood cell counters is inexpensive, easily accessible and routinely performed that had been recognized as a hallmark in the diagnosis of platelet activation during infection and inflammatory disorders. The aim of this study was to investigate the relationship between white blood cell count(WBC), which is known inflammatory marker and platelet count (PLT) and its parameters including mean platelet volume(MPV), platelet distribution width(PDW), plateletcrit (PCT) and platelet- large cell ratio (P-LCR) in all clinical setting of leukocytosis in children. Methods:White blood cell counts and all platelet parameters were evaluated in 156 children with elevated white blood cell counts (group 1) and 191children with normal white blood count (group 2) and the results of two groups were compared and statistically analysed. Results: There is a association between WBC and platelet count but there is very low correlation exist and correlation is significant. There was a significant difference between the two groups in WBC counts, PLT counts, PCT and PDW values (p0.05).Conclusion: Platelet count and PDW values are significant in infectious conditions. And no significant role of PCT, MPV and P-LCR values found in such conditions.

The Platelecrit: The Role in Differential Diagnosis of Small Renal Masses

Objective: To evaluate the importance of preoperative plateletcrit value predicting malignancy in patients who undergo open surgery due to small renal masses. Material and methods: Sixty-eight patients who underwent open partial or radical nephrectomy for renal masses were included in this retrospective study. In preoperative routine blood tests, renal ultrasonography and contrast-enhanced computed tomography were performed for all patients. Preoperative plateletcrit values were compared in patients with clear cell renal cell carcinoma (Group 1, 57 patients) and benign lesions (Group 2, 11 patients). The predictive ability of plateletcrit was analyzed by ROC-curves and Youden Index method was used to identify the cut-off value for plateletcrit. Results: The mean age of patients was 57.33±8.65 years in Group 1 and 59.32±10.59 years in Group 2 (p=0.546). The mean tumor size was 31.1 ± 5.84 mm in Group 1 and 28.07 ±6.25 mm in Group 2 (p=0.132). The median plateletcrit value was 1858,21 ±268,49 in Group 1 and 2258,01±524,35 in Group 2 (p:0.017). The area under a ROC-curve was 0.756 (p<0.05) . Conclusion: Preoperative plateletcrit values may predict renal masses that can not be distinguished radiologically. Our results must be confirmed by large and properly designed prospective, randomized trials.