Correlation between bone metastasis and thrombocytosis in pulmonary adenocarcinoma patients

Abstract

Thrombocytosis is commonly observed in patients exhibiting a variety of malignancies, including pulmonary, gastrointestinal and hepatic cancer. In the present study, the correlation between distant metastasis and thrombocytosis was retrospectively reviewed in 308 cases of histopathologically confirmed pulmonary adenocarcinoma. The patients were classified as having thrombocytosis or not, based on their platelet counts upon diagnosis; thrombocytosis was documented in 82/308 patients (26.6%). A log-rank test indicated a statistically significant difference in survival between patients exhibiting thrombocytosis compared with patients not exhibiting thrombocytosis (P<0.001). In addition, the occurrence of distant metastasis and the survival period were correlated with the presence of thrombocytosis upon diagnosis. In descending order of frequency, metastases were documented at the following sites: Lymph nodes (218/308 patients; 70.8%), bone (138/308 patients; 44.8%), lung (93/308 patients; 30.2%), brain (67/308 patients; 21.8%), liver (46/308 patients; 4.9%), adrenal glands (11/308 patients; 3.6%) and kidneys (5/308 patients; 1.6%). Bone metastasis occurred significantly more frequently in patients exhibiting thrombocytosis (50/82 patients: 61.0%; P<0.05) compared with patients not exhibiting thrombocytosis (88/226 patients; 38.9%). Furthermore, according to univariate analysis, thrombocytosis, weight loss, an Eastern Cooperative Oncology Group performance status score of ≥2 points, anemia, increased erythrocyte sedimentation rate, and increased alkaline phosphatase (AKP) and carcinoembryonic protein (CEA) levels were risk factors for bone metastasis. According to multivariate analysis, thrombocytosis, weight loss, and increased AKP and CEA levels were correlated with bone metastasis. Therefore, patients exhibiting pulmonary adenocarcinoma and thrombocytosis have a higher risk of bone metastasis compared with patients not exhibiting thrombocytosis.

Prognostic Significance of Neutrophil-to-Lymphocyte Ratio and Platelet-to-Lymphocyte Ratio in Oncologic Outcomes of Esophageal Cancer: A Systematic Review and Meta-analysis

“…8,33,34 Proinflammatory cytokines such as interleukin 1 and interleukin 6 can promote megakaryocyte proliferation, resulting in thrombocytosis, which has been considered a negative prognostic marker in several cancers. 32,[35][36][37][38][39][40] Evaluation of the associations of pretreatment NLR and PLR with clinicopathologic parameters showed that both were associated with deeper tumor invasion and lymph node metastasis, but not with tumor differentiation or vascular invasion. Lymph node metastasis is the single most important prognostic factor in esophageal cancer patients and is associated with poorer survival.…”

Longitudinal analysis of complete blood count parameters in advanced‐stage lung cancer patients

“…Our results are in line with an Asian study, performed on a cohort of Chinese patients, which also identified the phenomenon of pulmonary adenocarcinomaassociated thrombocytosis in bone metastatic patients. 37 With regard to bone metastases, the role of platelets in skeletal metastases and in bone remodeling including osteoclastogenesis and bone resorption remains controversial. However, although the mechanisms are not yet fully understood, blocking platelet aggregation has been reported to inhibit the progression of skeletal metastases.…”

Platelet count as a predictor of metastasis and venous thromboembolism in patients with cancer

“…It has also been reported that patients with adenocarcinomas have an increased likelihood of metastasis and accompanying thrombocytosis; for instance, Zhang et al . documented that 26.6% of 308 cases of histopathologically-confirmed lung adenocarcinomas presented with accompanying thrombocytosis [58]. Pedersen et al .…”

“…Zhang et al . also demonstrated via log rank tests that there was a significant difference in survival between patients with and without thrombocytosis, as the former had an increased risk of bone metastases [58]. …”