The postoperative platelet distribution width is useful for predicting the prognosis in patients with esophageal squamous cell carcinoma

Correlation between platelet distribution width and long-term survival in patients with gastric cancer after radical surgery

BACKGROUND

Gastric cancer is a common digestive system tumor, and surgery is the first choice of treatment, but the long-term survival of patients after surgery is still not satisfactory. Previous studies have showed that platelet distribution width (PDW) plays an important role in the occurrence and development of tumor. This study aimed to analyze the correlation between PDW and long-term survival of patients with stage Ⅱ-ⅢA gastric cancer after radical surgery.

AIM

To explore the relationship between PDW and long-term survival in patients with stage Ⅱ-ⅢA gastric cancer after radical surgery.

METHODS

This is a prospective cohort study, in which 124 patients with gastric cancer who received surgical treatment at our hospital from January 2016 to December 2017 were included as the study subjects. All patients were followed for 5 years and their survival time was recorded. The patients were divided into three groups according to whether their PDW increased or not after surgery: PDW decrease group, PDW normal group, and PDW increase group. The clinicopathological characteristics and long-term survival of patients in different groups were compared. Point binary correlation and COX regression were used to test the correlation between postoperative PDW and long-term survival of patients and the impact of PDW on long-term survival. Receiver operating characteristic (ROC) curve analysis was performed to analyze the value of postoperative PDW in predicting long-term survival.

RESULTS

The levels of CEA, CA199, and PDW in gastric cancer patients after treatment were significantly lower than those before treatment (P < 0.05). Among 111 patients with gastric cancer, 35 (31.53%) had decreased PDW, 24 (21.62%) had normal PDW, and 52 (46.85%) had increased PDW. The rates of lymph node metastasis and advanced tumor-node-metastasis (TNM) stage (ⅢA) in the PDW increase group were significantly higher than those of the PDW normal group and PDW decrease group (P < 0.05). However, there were no statistical significant differences among the three groups in terms of age, sex, degree of differentiation, tumor diameter, depth of muscle invasion, TNM stage, and lymph node metastasis (P > 0.05). Among 111 cases of gastric cancer, 31 survived, with a survival rate of 27.93%; the survival time was 11-60 mo, and the median survival time was 43.00 (31.00, 60.00) mo. Point binary correlation test showed that PDW, lymph node metastasis, and TNM stage were positively correlated with long-term survival after radical surgery(r > 0, P < 0.05). COX regression analysis showed that after adjusting for TNM stage and lymph node metastasis, taking the normal PDW group as a reference, the increase of PDW was a risk factor for long-term survival of gastric cancer patients. The median survival time of the patients with decreased, normal, and increased PDW was 49.50 (33.00, 60.00) mo, 53.50 (49.25, 58.00) mo, and 29.00 (20.00, 35.00) mo, respectively, and the difference among the three groups was statistically significant (P < 0.05). ROC curve analysis showed that postoperative PDW level had appreciated value in predicting long-term survival of gastric cancer patients (AUC = 0.718, 95%CI: 0.614-0.822, P < 0.001).

CONCLUSION

PDW is related to the long-term survival of patients with gastric cancer after radical surgery. Increased PDW indicates that the long-term prognosis of gastric cancer patients is poor and the survival period is short. TNM stage and lymph node metastasis are also closely related to the long-term survival of gastric cancer patients.

The association of vitamin D deficiency with hemogram-derived inflammatory biomarkers in children

BACKGROUND AND AIMS

One of the extraosseous effects of vitamin D is that it is a potent modulator of inflammatory processes. Many studies have demonstrated the inverse association between vitamin D and inflammation. Therefore, we hypothesize that vitamin D deficiency may affect the inflammatory markers derived from hemogram parameters [neutrophil to lymphocyte ratio (NLR), platelet to lymphocyte ratio (PLR), lymphocyte to monocyte ratio (LMR), platelet distribution width (PDW), red blood cell distribution width (RDW)] in healthy children.

METHODS AND RESULTS

We conducted a retrospective study on healthy children. From 2015 to 2020, 16,321 children with simultaneous vitamin D and hemogram measurements were identified from electronic records. Participants were divided into 2 groups according to whether they had vitamin D deficiency or not. The relationship between vitamin D status and the levels of inflammatory markers was analyzed. All inflammatory markers showed statistically significant differences between vitamin D status (p < 0.001 for all). Vitamin D levels were significantly negatively correlated with NLR (r = -0.285), PLR (r = -0.257), PDW (r = -0.181), and positively correlated with LMR (r = 0.218), and RDW (r = 0.057). In logistic regression analysis, age (OR = 1.15, 95% CI: 1.14-1.16), gender (OR = 1.66, 95% CI: 1.54-1.78), LMR (OR = 0.96, 95% CI: 0.95-0.98), PLR (OR = 1.003, 95% CI: 1.001-1.004), and RDW (OR = 1.10, 95%CI: 1.07-1.13) were found to be independent predictors for vitamin D deficiency.

CONCLUSIONS

Statistically significant differences were detected between vitamin D status and inflammatory parameters. However, the difference between the median values of vitamin D groups was very small and the degree of correlation was very weak. Therefore, the clinical significance of the difference should be questioned.

Prognostic significance of the combination of preoperative red cell distribution width and platelet distribution width in patients with gastric cancer

BACKGROUND

Platelet distribution width (PDW) and red cell distribution width (RDW) are readily obtainable data, and are reportedly useful as prognostic indicators in some cancers. However, their prognostic significance is unclear in gastric cancer (GC).

METHODS

We enrolled 445 patients with histopathological diagnoses of gastric adenocarcinoma who had undergone curative surgeries.

RESULTS

According to the optimal cut-off value of PDW and RDW by receiver operating characteristic (ROC) analysis, we divided patients into PDW^High (≥ 16.75%), PDW^Low (< 16.75%), RDW^High (≥ 14.25%), and RDW^Low (< 14.25%) subgroups. Overall survival (OS) was significantly worse in patients with PDW^High than in those with PDW^Low (P = 0.0015), as was disease specific survival (P = 0.043). OS was also significantly worse in patients with RDW^High than in those with RDW^Low (P <  0.0001), as was disease specific survival (P = 0.0002). Multivariate analysis for OS revealed that both PDW and RDW were independent prognostic indicators. Patients were then given PDW-RDW score by adding points for their different subgroups (1 point each for PDW^High and RDW^High; 0 points for PDW^Low and RDW^Low). OS significantly differed by PDW-RDW score (P <  0.0001), as did disease specific survival (P = 0.0005). In multivariate analysis for OS, PDW-RDW score was found to be an independent prognostic indicator.

CONCLUSIONS

The prognosis of GC patients can be precisely predictable by using both PDW and RDW.

Prognostic value of platelet-related measures for overall survival in esophageal squamous cell carcinoma: A systematic review and meta-analysis

Platelet-related measures are considered important in predicting long-term outcomes in patients with esophageal squamous cell carcinoma (ESCC). We performed a systematic electronic research of studies evaluating the prognostic value of platelet-related measures in ESCC in Google Scholar, PubMed, Cochrane Library, and Embase. Then, to synthesize publications exploring the association between platelet-related measures and survival outcomes in ESCC, a meta-analysis was conducted using hazard ratio and 95 % confidence interval. In total, 14 retrospective articles were included in this study. Among them, 4 and 10 have evaluated the clinical impact of platelet count and platelet-to-lymphocyte ratio (PLR), respectively. Further, three studies reported about platelet distribution width (PDW) and mean platelet volume (MPV). Based on the synthesized results, high PLR was significantly associated with poor overall survival (OS). However, platelet count, PDW, and MPV were non-independent prognostic factors for OS. The Begg's funnel plots for PLR, PDW, and MPV indicated low publication bias.

Mean platelet volume and platelet distribution width serve as prognostic biomarkers in skull base chordoma: a retrospective study

Background

Increasing studies have demonstrated that activated platelets play an essential role in tumour progression. However, the level and prognostic role of platelet indices in chordoma patients remain unclear. The aim of the current study was to characterize the prognostic performance of platelet count (PLT), mean platelet volume (MPV) and platelet distribution width (PDW) in skull base chordoma patients.

Methods

187 primary skull base chordoma patients between January 2008 and September 2014 were enrolled in this retrospective study. The optimal cut-off values were determined by X-tile software, and the correlations between PLT, MPV, PDW and clinicopathological features were further analysed. Kaplan-Meier curve and Cox regression analysis were used for survival analysis.

Results

The values of preoperative PTL, MPV and PDW ranged from 104 to 501 × 10⁹/L, 6.7 to 14.2 fl, and 7.8 to 26.2%, respectively. Elevated PLT was associated with larger tumour volume (p = 0.002). Kaplan-Meier survival analysis revealed that increased MPV and PDW were associated with shorter overall survival (p = 0.022 and 0.008, respectively). Importantly, multivariate Cox analysis demonstrated that elevated PDW was an independent unfavourable predictive factor for overall survival (hazard ratio (HR), 2.154, 95% confidence interval (CI), 1.258–3.688, p = 0.005).

Conclusions

Our data show that elevated MPV and PDW are associated with poor outcomes in skull base chordoma and that PDW may be helpful to identify patients with high risk.