Impact of platelet to lymphocyte ratio and metabolic syndrome on the prognosis of colorectal cancer patients

You, Jie; Zhang, Huxiang; Shen, Yanyan; Chen, Chuanzhi; Liu, Wenyue; Zheng, Ming‐Hua; Poucke, Sven Van; Guo, Gui-Long; Huang, Zong-hai

doi:10.2147/ott.s132621

Cited by 18 publications

(27 citation statements)

References 49 publications

(52 reference statements)

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“…Previous studies showed the association between high PLR and female gender [ 8 ] and cancer location in the colon vs. rectum [ 8 , 29 ], which was not confirmed in our results.…”

Section: Discussioncontrasting

confidence: 99%

“…We observed lower PC and a trend to lower PLR in patients with excess BMI. These results are puzzling considering the previously described link between increased PC and metabolic syndrome in adults [ 29 ]. Increased adipose tissue interferes with platelet function directly by producing adipokines, such as leptin and adiponectin, and inducting chronic systemic low-grade inflammation [ 30 ].…”

Section: Discussionmentioning

confidence: 87%

“…Some authors suggest the association between the visceral adipose tissue area and the WBC, hsCRP, and NLR levels (but not PLR), whereas no similar observation was confirmed for subcutaneous adipose tissue areas [ 36 ]. Recently published findings indicate significantly higher PLR in the colorectal cancer patients with the metabolic syndrome; however, the results were obtained in the group of patients before surgical treatment [ 29 ]. On the other hand, results of the population-based survey conducted in almost 40,000 US citizens aged ≥60 years showed that elevated PLR values were significantly associated with the sarcopenia status and negatively associated with the skeletal muscle index [ 37 ].…”

Section: Discussionmentioning

confidence: 99%

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Clinical Characteristics of Colorectal Cancer Patients in terms of Selected Platelet Indices

et al. 2020

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Mounting evidence suggests that inflammation, immune response, and coagulation status determine many processes during the carcinogenesis pathway in colorectal cancer (CRC). Inflammation strongly promotes tumor formation, progression, and metastasis. The systemic inflammatory response (SIR) may be reflected by simple indicators evaluated on the basis of peripheral blood morphology parameters. The indices are easily obtained by the peripheral blood test and could be promising biomarkers for CRC. We present the results of the retrospective study evaluating the potential relation between the platelet indices (platelet count (PC), platelet-to-lymphocyte ratio (PLR), neutrophil platelet score (NPS), mean platelet volume (MPV), and MPV/PC ratio) and the clinicopathological features of CRC patients. The study included 247 patients (104 males and 143 females) aged 39-87 years with CRC stages II-IV. The complete blood counts with the automated differential counts were performed prior to the qualification to systemic treatment. High PC, high PLR, and NPS 0 were associated with older age and higher BMI of the patients. No link between the analyzed platelet indices and histological grade of the tumor, primary tumor location, and gender was noted. The patients aged ≥65 years were characterized by the higher MPV/PC ratio than the younger population. We observed a trend to the higher MPV/PC ratio among the patients with excessive body weight defined by BMI compared to BMI within normal limits. A higher frequency of PC>400, NPS 1 and 2, and a trend to more frequent PLR≥150 were observed in the subgroup with metastatic disease compared to individuals with CRC stages II and III. The presented results expand the knowledge on potential association between SIR parameters and other clinicopathological factors that should be considered during interpreting the prognostic and predictive value of the inflammation parameters.

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“…Previous studies showed the association between high PLR and female gender [ 8 ] and cancer location in the colon vs. rectum [ 8 , 29 ], which was not confirmed in our results.…”

Section: Discussioncontrasting

confidence: 99%

Section: Discussionmentioning

confidence: 87%

Section: Discussionmentioning

confidence: 99%

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Clinical Characteristics of Colorectal Cancer Patients in terms of Selected Platelet Indices

et al. 2020

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“…Importantly, based on the largest analysis of medical records of patients with colorectal cancer (N=1,868), high PLR and NLR have prognostic value at only advanced stages [43]. Nonetheless, the predictive value of high PLR in terms of overall survival is greater in cancer patients with comorbidities, particularly those with metabolic syndrome, which doubles the risk of cancer-related mortality [44].…”

Section: Plr In Neoplastic Prothrombotic and Metabolic Diseasesmentioning

confidence: 99%

The Platelet-to-Lymphocyte Ratio as an Inflammatory Marker in Rheumatic Diseases

et al. 2019

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The platelet-to-lymphocyte ratio (PLR) has emerged as an informative marker revealing shifts in platelet and lymphocyte counts due to acute inflammatory and prothrombotic states. PLR has been extensively examined in neoplastic diseases accompanied by immune suppression and thrombosis, which can be predicted by combined blood cell counts and their ratios. Several large observational studies have demonstrated the value of shifts in PLR in evaluating the severity of systemic inflammation and predicting infections and other comorbidities, in inflammatory rheumatic diseases. The value of PLR as an inflammatory marker increases when its fluctuations are interpreted along with other complementary hematologic indices, particularly the neutrophil-to-lymphocyte ratio (NLR), which provides additional information about the disease activity, presence of neutrophilic inflammation, infectious complications, and severe organ damage in systemic lupus erythematosus. PLR and NLR have high predictive value in rheumatic diseases with predominantly neutrophilic inflammation (e.g., Behçet disease and familial Mediterranean fever). High PLR, along with elevated platelet count, is potentially useful in diagnosing some systemic vasculitides, particularly giant-cell arteritis. A few longitudinal studies on rheumatic diseases have demonstrated a decrease in PLR in response to anti-inflammatory therapies. The main limitations of PLR studies are preanalytical faults, inadequate standardization of laboratory measurements, and inappropriate subject selection. Nonetheless, accumulating evidence suggests that PLR can provide valuable information to clinicians who encounter multisystem manifestations of rheumatic diseases, which are reflected in shifts in platelet, lymphocyte, neutrophil, or monocyte counts. Interpretation of PLR combined with complementary hematologic indices is advisable to more accurately diagnose inflammatory rheumatic diseases and predict related comorbidities.

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“…Additionally, the hemogram of the peripheral blood could be a useful diagnostic marker. For instance, the lymphocyte count [ 13 , 14 ], the systemic inflammation score (SIS) [ 15 ], the lymphocyte and monocyte ratio (LMR) [ 16 ], the neutrophil and lymphocyte ratio (NLR) [ 17 ], the platelet to lymphocyte ratio (PLR) [ 18 ], and the platelet distribution width (PDW) [ 17 ] have been reported to be correlated with disease-free survival (DFS) and overall survival (OS) in patients with CRC. However, according to the European Group on Tumor Markers (EGTM) published guidelines, CEA is more useful for postoperative surveillance than as a predictor of recurrence [ 19 ].…”

Section: Introductionmentioning

confidence: 99%

Combined use of preoperative lymphocyte counts and the post/preoperative lymphocyte count ratio as a prognostic marker of recurrence after curative resection of stage II colon cancer

et al. 2017

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PurposeDiagnostic markers for recurrence of colorectal cancer have not been established. The aim of the present study was to identify new diagnostic markers for recurrence after curative surgery of stage II colon cancer.Materials and MethodsIn this study, the prognostic values of the preoperative lymphocyte count and the post/preoperative lymphocyte count ratio (PPLR) were evaluated in 142 patients with localized colon cancer treated with surgery at a single medical center. The associations of patient demographics, blood chemistry, and serum biochemical indices with recurrence-free survival (RFS) and cancer-specific survival (CSS) were examined by univariate and multivariate analyses.ResultsReceiver operating characteristic (ROC) curve analysis showed that the optimal cut-off values of the lymphocyte count and PPLR were, respectively, 1555.2/μl and 1.151 for RFS. On univariate analysis, tumor depth of invasion, carbohydrate antigen 19-9 (CA19-9), and preoperative low lymphocyte count (≤1555.2/μl) were all correlated with poorer RFS (p < 0.05). On multivariate analysis, T4, low lymphocyte count, and low PPLR were independent predictors of poor RFS. Furthermore, the patients were categorized into four categories based on preoperative lymphocyte count high/low and PPLR high/low. Patients with a low preoperative lymphocyte count and low PPLR had the poorest RFS and CSS compared to the other patients.ConclusionThe combination of the preoperative lymphocyte count and the PPLR appears to be a potential marker for predicting recurrence of stage II colon cancer.

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Impact of platelet to lymphocyte ratio and metabolic syndrome on the prognosis of colorectal cancer patients

Cited by 18 publications

References 49 publications

Clinical Characteristics of Colorectal Cancer Patients in terms of Selected Platelet Indices

Clinical Characteristics of Colorectal Cancer Patients in terms of Selected Platelet Indices

The Platelet-to-Lymphocyte Ratio as an Inflammatory Marker in Rheumatic Diseases

Combined use of preoperative lymphocyte counts and the post/preoperative lymphocyte count ratio as a prognostic marker of recurrence after curative resection of stage II colon cancer

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