Reduced Mean Platelet Volume Levels Predict Shorter Survival in Patients with Resectable Pancreatic Ductal Adenocarcinoma and Type 2 Diabetes

Overview

Journal BMC Gastroenterol

Publisher Biomed Central

Specialty Gastroenterology

Date 2020 May 13

PMID 32393273

Citations 2

Authors

Ji-Bin Yin

Na Li

Ming-Ming Cui

Xin Wang

Rui-Tao Wang

Affiliations

Soon will be listed here.

Abstract

Background: Type 2 diabetes mellitus (T2DM) increased the risk of developing pancreatic cancer. Pancreatic ductal adenocarcinoma (PDAC) is the most common neoplastic disease originating from the pancreas. Increasing evidence indicates that platelets activation plays a prominent role in tumor and T2DM. Mean platelet volume (MPV) is an indicator of activated platelets and is altered in several cancers. The current study aimed to evaluate the prognostic role of MPV in resectable PDAC patients with T2DM.

Methods: Eight hundred and three patients with PDAC were included in this retrospective study. We determined the optimal cutoff value of MPV for 5-year overall survival (OS) using the receiver operating characteristic (ROC) method. The associations between MPV levels and clinical characteristics were analyzed. Kaplan-Meier survival analysis and Cox's proportional hazard regression model were used to evaluate the prognostic value of MPV for OS.

Results: Compared to the PDAC patients without T2DM, MPV levels were significantly higher in the PDAC patients with T2DM. Moreover, MPV was significantly associated with the differentiation between T2DM and non-T2DM. In addition, Kaplan-Meier analysis found that patients with low MPV levels had a poorer 5-year OS than patients with high MPV levels in diabetic patients. Multivariate analyses revealed that MPV was an independent prognostic factor for OS in patients with T2DM. However, the independent prognostic role of MPV was not observed in patients without T2DM.

Conclusion: MPV independently predicts poor survival in PDAC patients with T2DM. Prospective studies are required to confirm the role of MPV in PDAC.

Citing Articles

Pancreatic Cancer and Platelets Crosstalk: A Potential Biomarker and Target.

Mai S, Inkielewicz-Stepniak I Front Cell Dev Biol. 2021; 9:749689.

PMID: 34858977 PMC: 8631477. DOI: 10.3389/fcell.2021.749689.

Platelets: The Emerging Clinical Diagnostics and Therapy Selection of Cancer Liquid Biopsies.

Meng Y, Sun J, Zheng Y, Zhang G, Yu T, Piao H Onco Targets Ther. 2021; 14:3417-3428.

PMID: 34079287 PMC: 8164876. DOI: 10.2147/OTT.S311907.

References

Mezouar S, Frere C, Darbousset R, Mege D, Crescence L, Dignat-George F . Role of platelets in cancer and cancer-associated thrombosis: Experimental and clinical evidences. Thromb Res. 2016; 139:65-76. DOI: 10.1016/j.thromres.2016.01.006. View

Song W, Tian C, Wang K, Zhang R, Zou S . Preoperative platelet lymphocyte ratio as independent predictors of prognosis in pancreatic cancer: A systematic review and meta-analysis. PLoS One. 2017; 12(6):e0178762. PMC: 5456351. DOI: 10.1371/journal.pone.0178762. View

Malvezzi M, Bertuccio P, Levi F, La Vecchia C, Negri E . European cancer mortality predictions for the year 2014. Ann Oncol. 2014; 25(8):1650-6. DOI: 10.1093/annonc/mdu138. View

Rahn S, Zimmermann V, Viol F, Knaack H, Stemmer K, Peters L . Diabetes as risk factor for pancreatic cancer: Hyperglycemia promotes epithelial-mesenchymal-transition and stem cell properties in pancreatic ductal epithelial cells. Cancer Lett. 2017; 415:129-150. DOI: 10.1016/j.canlet.2017.12.004. View

Qiu J, Yu Y, Fu Y, Ye F, Xie X, Lu W . Preoperative plasma fibrinogen, platelet count and prognosis in epithelial ovarian cancer. J Obstet Gynaecol Res. 2012; 38(4):651-7. DOI: 10.1111/j.1447-0756.2011.01780.x. View

Turgut O, Zorlu A, Kilicli F, Cinar Z, Yucel H, Tandogan I . Atrial fibrillation is associated with increased mean platelet volume in patients with type 2 diabetes mellitus. Platelets. 2012; 24(6):493-7. DOI: 10.3109/09537104.2012.725876. View

Mitrugno A, Sylman J, Ngo A, Pang J, Sears R, Williams C . Aspirin therapy reduces the ability of platelets to promote colon and pancreatic cancer cell proliferation: Implications for the oncoprotein c-MYC. Am J Physiol Cell Physiol. 2016; 312(2):C176-C189. PMC: 5336594. DOI: 10.1152/ajpcell.00196.2016. View

Shen X, Xia Y, Lian L, Zhou C, Li X, Han S . Mean platelet volume provides beneficial diagnostic and prognostic information for patients with resectable gastric cancer. Oncol Lett. 2016; 12(4):2501-2506. PMC: 5038875. DOI: 10.3892/ol.2016.4913. View

Pollak M, Schernhammer E, Hankinson S . Insulin-like growth factors and neoplasia. Nat Rev Cancer. 2004; 4(7):505-18. DOI: 10.1038/nrc1387. View

10.

Kumagai S, Tokuno J, Ueda Y, Marumo S, Shoji T, Nishimura T . Prognostic significance of preoperative mean platelet volume in resected non-small-cell lung cancer. Mol Clin Oncol. 2014; 3(1):197-201. PMC: 4251106. DOI: 10.3892/mco.2014.436. View

11.

Ekici H, Malatyalioglu E, Kokcu A, Kurtoglu E, Tosun M, Celik H . Do Leukocyte and Platelet Counts Have Benefit for \Preoperative Evaluation of Endometrial Cancer?. Asian Pac J Cancer Prev. 2015; 16(13):5305-10. DOI: 10.7314/apjcp.2015.16.13.5305. View

12.

Suzuki K, Aiura K, Kitagou M, Hoshimoto S, Takahashi S, Ueda M . Platelets counts closely correlate with the disease-free survival interval of pancreatic cancer patients. Hepatogastroenterology. 2004; 51(57):847-53. View

13.

Kemal Y, Demirag G, Ekiz K, Yucel I . Mean platelet volume could be a useful biomarker for monitoring epithelial ovarian cancer. J Obstet Gynaecol. 2014; 34(6):515-8. DOI: 10.3109/01443615.2014.912620. View

14.

Miyamoto R, Oda T, Hashimoto S, Kurokawa T, Kohno K, Akashi Y . Platelet × CRP Multiplier Value as an Indicator of Poor Prognosis in Patients With Resectable Pancreatic Cancer. Pancreas. 2016; 46(1):35-41. DOI: 10.1097/MPA.0000000000000697. View

15.

Ma J, Sawai H, Matsuo Y, Ochi N, Yasuda A, Takahashi H . IGF-1 mediates PTEN suppression and enhances cell invasion and proliferation via activation of the IGF-1/PI3K/Akt signaling pathway in pancreatic cancer cells. J Surg Res. 2009; 160(1):90-101. DOI: 10.1016/j.jss.2008.08.016. View

16.

Zhang S, Yao L, Wang W, Xu J, Xu H, Jin W . Tumor-Infiltrating Platelets Predict Postsurgical Survival in Patients with Pancreatic Ductal Adenocarcinoma. Ann Surg Oncol. 2018; 25(13):3984-3993. DOI: 10.1245/s10434-018-6727-8. View

17.

Seretis C, Youssef H, Chapman M . Hypercoagulation in colorectal cancer: what can platelet indices tell us?. Platelets. 2014; 26(2):114-8. DOI: 10.3109/09537104.2014.894969. View

18.

Unubol M, Ayhan M, Guney E . The relationship between mean platelet volume with microalbuminuria and glycemic control in patients with type II diabetes mellitus. Platelets. 2011; 23(6):475-80. DOI: 10.3109/09537104.2011.634934. View

19.

Abali G, Akpinar O, Soylemez N . Correlation of the coronary severity scores and mean platelet volume in diabetes mellitus. Adv Ther. 2013; 31(1):140-8. DOI: 10.1007/s12325-013-0081-9. View

20.

Gasparyan A, Ayvazyan L, Mikhailidis D, Kitas G . Mean platelet volume: a link between thrombosis and inflammation?. Curr Pharm Des. 2011; 17(1):47-58. DOI: 10.2174/138161211795049804. View