Mean platelet volume/platelet count ratio in combination with tumor markers in colorectal cancer: a retrospective clinical study

Abstract

Background Mean platelet volume (MPV) is a marker of platelet activation, which is usually negatively correlated with platelet count (PC). The ratio of MPV to PC (MPV/PC) has an essential role in the diagnosis of multiple malignancies. However, only a few studies investigated the value of MPV/PC in colorectal cancer (CRC) and the combination of MPV/PC with tumor markers in CRC. This retrospective clinical study aimed to evaluate the diagnostic value of MPV/PC and tumor markers (CA72-4, CA125, CA199) used alone or in combination in CRC. Methods 200 patients with CRC and 317 patients with colorectal benign polypus pathologically diagnosed during 2019/01/04 to 2022/06/30 were included. Hematological and pathological parameters of the above patients were collected, data were analyzed with Student’s t-test, one-way ANOVA or Kruskal-Wallis H test and receiver operating characteristic (ROC) curve, and ROC curve was used to evaluate the diagnostic value of tumor markers and MPV/PC used alone or in combination in CRC. Results The MPV/PC in CRC group was significantly lower than the control group (P < 0.0001). Among the three tumor markers, higher CA125 was correlated with distant metastasis and lower differentiation (P < 0.05), increased CA72-4 indicated positive nerve invasion (P = 0.0174), and elevated CA199 was associated with lymphatic metastasis and positive vascular invasion (P < 0.05). For subgroups regarding tumor anatomical location, both CA125 and CA199 were higher in colon cancer group than rectum cancer group (P = 0.0322, P = 0.0094). MPV/PC was associated with tumor infiltration, regional lymph node metastasis, differentiation and nerve invasion (P < 0.05) and the combination of MPV/PC with the three tumor markers produced a larger AUC with higher sensitivity, specificity and Yuden index than MPV/PC or the three tumor markers used alone to distinguish between CRC and colorectal polyps. Conclusion Preoperative MPV/PC in peripheral blood of patients with CRC was lower than the control group. Meanwhile, the combined detection of tumor markers with MPV/PC can improve the diagnostic value of CRC, revealing the potential of MPV/PC as a promising screening tool in CRC early diagnosis.

Clinical Value of Mean Platelet Volume to Platelet Ratio (MPR) in Distinguishing Mass-Forming Chronic Pancreatitis and Pancreatic Cancer

“…According to previous research, MPR combined with tumor markers has already been applied in the differential diagnosis of benign and malignant lesions. Zhang et al combined MPR with CA125, CA724 and CA19-9, and confirmed that MPR combined with tumor markers could better distinguish colorectal cancer from colorectal polyps than MPR alone, and that this combination was also able to predict the differentiation, nerve invasion and vascular invasion of colorectal cancer [32]. Therefore, we introduced a combined index of MPR and CA19-9.…”

Emerging Role of Tumor-Educated Platelets as a New Liquid Biopsy Tool for Colorectal Cancer

“… 59 MPV/TPC was associated with tumor infiltration and regional lymph node metastasis in CRC. 53 TPC/PLR was associated with depth of infiltration, 60 and this infiltration was associated with poor prognosis in postsurgical CRC patients. 61 Nowadays, some prediction models, like the ColonFlag model, have been introduced that use blood-based parameters (including PLC), age and sex combined with machine-learning techniques to differentiate high-risk from low-risk CRC patients.…”

“… 52 Other studies showed that CRC patients, compared to the adenomatous polyp group, have higher MPV levels. 53 , 54 Qian et alreported that in non-metastatic CRC, the pre- and post-treatment ratio of MPV is a prognostic factor for overall survival. 55 Despite the contradictory findings of the MPV levels in cancer cases and healthy individuals, it is agreed by the majority of researches that reduced MPV is a good prognostic biomarker for cancer cases.…”

“…Some studies suggested that platelet indices compared to each other or other blood variables yield better results. Studies have shown that preoperative MPV/TPC in the peripheral blood of CRC cases is low, 53 , 57 High levels of pretreatment TPC to lymphocyte count ratio (PLR) is associated with poor overall survival in CRC patients, 58 and decreased TPC/PLR shows good prognosis in patients with oligometastatic colorectal cancer. 59 MPV/TPC was associated with tumor infiltration and regional lymph node metastasis in CRC.…”