Longitudinal changes in personalized platelet count metrics are good indicators of initial 3-year outcome in colorectal cancer

Table 1 Baseline complete blood count measurements and anamnestic data of the 835 colorectal cancer patients

Parameter	mean ± SD or number of observations	Number of missing	Available
Age (yr)	65.31 ± 11.00	0	100%
Male: Female	468: 367 (56.05%: 43.95%)	0	100%
White blood cell count (109/L)	8.74 ± 3.55	0	100%
Neutrophil count (109/L)	6.25 ± 3.37	169	79.76%
Eosinophil count (109/L)	0.18 ± 0.37	173	79.28%
Basophil count (109/L)	0.04 ± 0.03	173	79.28%
Monocyte count (109/L)	0.56 ± 0.29	147	82.40%
Lymphocyte count (109/L)	1.69 ± 0.78	147	82.40%
Red blood cell count (1012/L)	4.50 ± 0.58	0	100%
Hemoglobin (g/L)	122.34 ± 23.97	0	100%
Hematocrit (L/L)	0.38 ± 0.06	0	100%
Mean corpuscular volume (fL)	83.45 ± 9.71	0	100%
Mean corpuscular hemoglobin (pg)	27.15 ± 4.12	0	100%
Mean corpuscular hemoglobin concentration (g/L)	324.25 ± 24.05	0	100%
Red blood cell distribution width (%)	14.95 ± 2.86	62	92.57%
Platelet count (109/L)	341.19 ± 131.66	0	100%
AJCC stage[21]		0	100%
I	107 (12.81%)
II	214 (25.63%)
III	187 (22.40%)
IV	327 (39.16%)
Regional lymph node metastasis	445 (%)	0	100%
Distant metastasis		0	100%
At the time of diagnosis	326 (39.04%)
Later with the course of the disease	102 (12.22%)
Location of the tumor[22]		0	100%
Left-sided	273 (32.69%)
Right-sided	246 (29.46%)
Rectum	297 (35.57%)
Multiplex	19 (2.28%)
Chemotherapy		0	100%
Adjuvant	248 (29.70%)
Metastatic	331 (39.64%)
First line	126 (15.09%)
Second line	98 (11.74%)
Third line or above	104 (12.46%)
Radiotherapy		0	100%
Preoperative	63 (7.54%)
Postoperative	64 (7.66%)
Both	5 (0.60%)
Usage of		0	100%
Biological agents	229 (27.43%)
Regorafenib/trifluridine-tipiracil	55 (6.59%)
Medical history		0	100%
Diabetes mellitus	210 (25.15%)
Hypertension	568 (68.02%)
Major cardiovascular event(s) prior to CRC	156 (18.68%)
Thyroid disease (in euthyroid state)	84 (10.06%)
Appendicitis/appendectomy	145 (17.36%)
Cholelithiasis/cholecystectomy	194/123 (23.23%)/(14.73%)
Concomitant therapy		0	100%
Platelet aggregation inhibition	158 (18.92%)
Statin	155 (18.56%)
Antihypertensive agents	530 (63.47%)

Table 2 Comparison of the different baseline complete blood count ratios by anamnestic and clinicopathological data

Grouping factor	LMR	NLR	HPR	RPR	PLR
Sex
Male	3.30 ± 2.22c	4.69 ± 3.94a	0.45 ± 0.21d	0.051 ± 0.020a	58.96 ± 30.01c
Female	3.90 ± 1.88	4.05 ± 3.14	0.38 ± 0.18	0.047 ± 0.025	66.87 ± 25.68
Location of the tumor[22]
Left-sided	3.64 ± 2.50	4.55 ± 3.48	0.43 ± 0.21d,1	0.049 ± 0.027	61.06 ± 32.31
Right-sided	3.34 ± 1.96	4.54 ± 3.09	0.35 ± 0.19	0.048 ± 0.020	67.49 ± 28.98
Rectum	3.64 ± 1.81	4.24 ± 4.21	0.47 ± 0.19d,2	0.050 ± 0.019	59.19 ± 22.49a,2
Multiplex	4.03 ± 1.42	2.69 ± 1.05	0.45 ± 0.17	0.056 ± 0.014	68.17 ± 32.28
AJCC stage[21]
I	4.12 ± 2.10b,3	3.42 ± 2.99	0.49 ± 0.22a,4	0.054 ± 0.026a,3	63.22 ± 26.54
II	3.47 ± 1.55	4.23 ± 3.13	0.43 ± 0.17	0.051 ± 0.018	61.18 ± 23.52
III	3.82 ± 2.53	3.82 ± 2.29	0.42 ± 0.18	0.049 ± 0.015	63.47 ± 25.45
IV	3.29 ± 2.11	5.21 ± 4.50	0.39 ± 0.22d,3	0.047 ± 0.027	62.60 ± 33.47
Regional lymph node metastasis
No	3.59 ± 1.78	4.17 ± 3.64	0.44 ± 0.20b	0.051 ± 0.021a	62.58 ± 25.96
Yes	3.52 ± 2.35	4.59 ± 3.57	0.40 ± 0.20	0.048 ± 0.023	62.38 ± 30.47
Distant metastasis
None	3.76 ± 2.14a,5	3.83 ± 2.71d,5	0.45 ± 0.19c,5	0.051 ± 0.020a,5	62.38 ± 24.59
At the time of diagnosis	3.29 ± 2.11	5.21 ± 4.51	0.39 ± 0.22	0.047 ± 0.027	62.69 ± 33.51
Later with the course of the disease	3.62 ± 1.80	4.23 ± 3.27	0.42 ± 0.17	0.049 ± 0.016	62.51 ± 26.06
Radiotherapy
None	3.48 ± 2.15a,6	4.55 ± 3.72a,6	0.40 ± 0.20a,6	0.048 ± 0.022	62.94 ± 29.18
Preoperative	3.73 ± 2.06	4.11 ± 3.67	0.53 ± 0.24d,7	0.055 ± 0.033	56.41 ± 23.60
Postoperative	4.29 ± 1.38	3.00 ± 1.43	0.48 ± 0.16	0.051 ± 0.015	61.32 ± 22.12
Both	4.17 ± 1.55	2.53 ± 0.94	0.52 ± 0.10	0.049 ± 0.010	87.02 ± 18.13
Chemotherapy
None	3.29 ± 1.89a,8	5.06 ± 5.01b,8	0.42 ± 0.23	0.050 ± 0.023	60.61 ± 33.77
Adjuvant	3.82 ± 2.30	3.86 ± 2.57	0.44 ± 0.18	0.050 ± 0.017	63.73 ± 24.96
Metastatic	3.57 ± 1.89	4.29 ± 2.77	0.40 ± 0.20	0.047 ± 0.026	63.14 ± 25.95
Usage of biological agents
No	3.52 ± 2.16	4.53 ± 3.87	0.42 ± 0.21	0.050 ± 0.025a	61.96 ± 28.46
Yes	3.67 ± 1.93	4.03 ± 2.66	0.41 ± 0.17	0.046 ± 0.014	64.16 ± 28.26
Usage of regorafenib/trifluridine-tipiracil
No	3.58 ± 2.12	4.38 ± 3.66	0.42 ± 0.21	0.049 ± 0.023a	62.96 ± 28.66
Yes	3.21 ± 1.66	4.67 ± 2.85	0.41 ± 0.17	0.045 ± 0.012	55.65 ± 23.33
Type 2 diabetes mellitus
No	3.58 ± 2.09	4.41 ± 3.70	0.42 ± 0.20	0.048 ± 0.019	63.62 ± 29.85
Yes	3.47 ± 2.13	4.41 ± 3.38	0.43 ± 0.21	0.052 ± 0.031	58.87 ± 23.31
History of major CV event
No	3.60 ± 2.19	4.44 ± 3.78	0.42 ± 0.20	0.048 ± 0.023a	62.68 ± 29.21
Yes	3.38 ± 1.67	4.24 ± 2.82	0.43 ± 0.23	0.053 ± 0.022	61.80 ± 24.86
History of cholecystectomy
No	3.49 ± 2.03a	4.50 ± 3.75a	0.42 ± 0.20	0.049 ± 0.020	61.81 ± 29.09
Yes	4.02 ± 2.47	3.78 ± 2.55	0.42 ± 0.21	0.052 ± 0.035	66.61 ± 23.76

^aP < 0.05.

^bP < 0.01.

^cP < 0.001.

^dP < 0.0001.

¹Right-sided vs left-sided tumors.

²Right-sided tumors vs rectal cancer.

³Stage I vs Stage IV.

⁴Stage I vs Stage III.

⁵None vs at the time of diagnosis.

⁶None vs postoperative radiotherapy.

⁷None vs preoperative radiotherapy.

⁸None vs adjuvant chemotherapy.

LMR: Lymphocyte-to-monocyte ratio; NLR: neutrophil-to-lymphocyte ratio; HPR: Hemoglobin-to-platelet ratio; RPR: Red blood cell distribution width (RDW)-to-platelet ratio; PLR: Platelet-to-lymphocyte ratio; AJCC: American Joint Committee on Cancer; CV: Cardiovascular. Of the total 835 study subjects, 82.40%, 79.04%, 92.57%, and 79.76% of LMR, NLR, RPR, and PLR were only available for statistical analysis, respectively.

Table 3 Complete blood count ratios at least 4-6 weeks after primary tumor removal surgery (n = 644)

Parameter	mean ± SD	Number of missing	Available %
Time since tumor removal surgery (mo)	2.21 ± 1.88	–	–
Lymphocyte-to-monocyte ratio	4.01 ± 1.95	107	82.49%
Neutrophil-to-lymphocyte ratio	3.59 ± 2.82	273	55.32%
Hemoglobin-to-platelet ratio	0.48 ± 0.19	0	100%
Red blood cell distribution width-to-platelet ratio	0.058 ± 0.023	212	65.30%
Platelet-to-lymphocyte ratio	67.60 ± 28.82	266	56.46%
Personalized platelet count, relative to “at-diagnosis”	0.91 ± 0.27	0	100%