Retrospective Study
Copyright ©The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Jul 16, 2022; 10(20): 6825-6844
Published online Jul 16, 2022. doi: 10.12998/wjcc.v10.i20.6825
Longitudinal changes in personalized platelet count metrics are good indicators of initial 3-year outcome in colorectal cancer
Zoltan Herold, Magdolna Herold, Julia Lohinszky, Attila Marcell Szasz, Magdolna Dank, Aniko Somogyi
Zoltan Herold, Attila Marcell Szasz, Magdolna Dank, Division of Oncology, Department of Internal Medicine and Oncology, Semmelweis University, Budapest 1083, Hungary
Zoltan Herold, Magdolna Herold, Julia Lohinszky, Aniko Somogyi, Department of Internal Medicine and Hematology, Semmelweis University, Budapest 1088, Hungary
Author contributions: Herold Z, Somogyi A, and Dank M built the study design; Herold Z and Herold M were involved in the collection of patient data; Herold Z performed the statistical analysis of data; Herold Z, Herold M, and Szasz AM interpreted the data; Lohinszky J and Dank M were involved in patient selection; Herold Z prepared the draft of the manuscript; all authors were involved in manuscript editing and reviewing; Herold Z and Dank M received funding; Somogyi A supervised the study; all authors have read and agreed to the published version of the manuscript.
Supported by the New National Excellence Program of the Hungarian Ministry for Innovation and Technology from the source of the National Research, Development and Innovation Fund, No. UNKP-20-4-I; and the Hungarian National Research, Development and Innovation Office, No. NVKP_16-1-2016-0042.
Institutional review board statement: The study was approved by the Regional and Institutional Committee of Science and Research Ethics, Semmelweis University (SE TUKEB 21-14/1994, approval date of latest modification: February 23, 2021).
Informed consent statement: Patient data was retrieved anonymously from the medical database of Semmelweis University in a retrospective manner. A general consent form for academic assessment studies of all admitted patients was signed upon their treatment back in those years. Signed patient informed consent for further research at that time was not required given the anonymized, de-identified data.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Data sharing statement: The datasets used and/or analyzed during the current study are available from the corresponding author on reasonable request.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Zoltan Herold, MSc, PhD, Research Scientist, Division of Oncology, Department of Internal Medicine and Oncology, Semmelweis University, Tomo u. 25-29, Budapest 1083, Hungary. herold.zoltan@med.semmelweis-univ.hu
Received: October 15, 2021
Peer-review started: October 15, 2021
First decision: December 12, 2021
Revised: December 23, 2021
Accepted: May 22, 2022
Article in press: May 22, 2022
Published online: July 16, 2022
Processing time: 262 Days and 16.6 Hours
ARTICLE HIGHLIGHTS
Research background

Abnormal pre- and/or post-operative platelet count, lymphocyte-to-monocyte ratio (LMR), neutrophil-to-lymphocyte ratio (NLR), hemoglobin-to-platelet ratio (HPR), red blood cell count distribution width-to-platelet ratio (RPR), and platelet-to-lymphocyte ratio (PLR) values are associated with shorter overall and progression free survival times of colorectal cancer (CRC) patients. However, only a limited number of former studies have investigated how these parameters change during disease progression.

Research motivation

It was hypothesized that platelet count, LMR, NLR, HPR, RPR, and PLR of CRC patients with shorter or longer survival times do change differently.

Research objectives

The aim of the study was to identify tendencies within the longitudinal changes of platelet count, LMR, NLR, HPR, RPR, and PLR of CRC patients with different disease outcomes and clinicopathological properties.

Research methods

A retrospective observational study was conducted with the inclusion of 835 CRC patients. Platelet counts, LMR, NLR, HPR, RPR, and PLR were recorded as follows: (1) At the time of CRC diagnosis; (2) After primary tumor removal surgery; and (3) Every 6 mo postoperatively. In addition to LMR, NLR, HPR, RPR, and PLR, two newly defined personalized platelet count metrics was also introduced: pPLTD and pPLTS, which were defined as the platelet count ratio relative to the one measured at the time of CRC diagnosis and the one measured after tumor removal surgery, respectively.

Research results

Although the single time-point measurement of all complete blood count metrics had been associated with a worse survival of CRC patients, only the longitudinal changes of LMR, NLR, HPR, and the personalized platelet metrics showed a significant effect on patient survival. Most abnormal changes were observed in the first 3-year period after the diagnosis of CRC, which coincided with most of the CRC-related deaths. Different patterns in the investigated metrics could have been identified in those patients who died or survived.

Research conclusions

pPLTD, pPLTS, LMR, NLR, and HPR are good markers for patient survival, and their change to abnormal values are effective markers of disease progression. Therefore, their use in the routine oncology care may alert the practicing oncologist for further therapy decisions in a timely manner.

Research perspectives

The current study provided enough evidence for a future prospective study, which should investigate the usefulness of pPLTD, pPLTS, LMR, NLR, and HPR in routine oncology care, as potential markers for disease progression.