Hypercoagulation in colorectal cancer: What can platelet indices tell us?

Abstract

Colorectal cancer, as all solid malignancies, is accompanied by changes in the haemostatic mechanism favoring the establishment of a thrombotic potential, with platelets playing a key-role in this framework; they further link colorectal cancer progression and hypercoagulation with the immune-response against the neoplastic spread. Under this rationale, various studies have assessed the use of platelet indices as prognostic markers of the biological behavior of colorectal cancer, demonstrating significant results. We herein attempt to summarize in a narrative and critical approach the relevant available data and the underlying pathophysiology, stressing the necessity of a more thorough understanding and future implementation of platelet indices in all stages of care we deliver to colorectal cancer patients.

Predicting the presence of colon cancer in members of a health maintenance organisation by evaluating analytes from standard laboratory records

“…Platelets have been implicated in CRC carcinogenesis and progression in several studies, although the exact mechanism by which platelets contribute to CRC incidence and metastasis is not known (Guillem-Llobat et al , 2014; Seretis et al , 2015). Possible mechanisms include transport of cancer cells through intravasation and extravasation in and out of vessels and promoting cancer cell aggregation (Stegner et al , 2014; Seretis et al , 2015; Patrignani and Patrono, 2016). Platelets also induce epithelial–mesenchymal transition of cancer cells, thereby enhancing their metastatic ability (Patrignani and Patrono, 2016).…”

Platelet distribution width correlates with prognosis of non-small cell lung cancer

“…However, total platelet count is determined by the balance between the rate of production and consumption of platelets. A normal platelet count could conceal the presence of highly hypercoagulative and pro-inflammatory cancer phenotypes in the presence of efficient compensatory mechanisms 9 .…”

Platelet distribution width correlates with prognosis of gastric cancer

“…However, total platelet count is determined by the balance between the rate of production and consumption of platelets. A normal platelet count could conceal the presence of highly hypercoagulative and pro-inflammatory cancer phenotypes in the presence of efficient compensatory mechanisms [10]. …”