In this study, we assessed and checked the prognostic value of preoperative PLT and MPV in 468 ESCC patients. However, the predictive value of PLT combined with MPV for postsurgery survival in ESCC has not been yet investigated. Recent studies revealed that MPV levels were relatively higher in tumor patients than in normal controls and associated with poor prognosis in some gastrointestinal neoplasms. On the other hand, high MPV reflected an abnormal rate of platelet production and stimulation. Patients with thrombocytosis have been reported to have worse prognosis in multiple solid tumors, such as ovarian cancer, endometrial cancer, gastric cancer, and colorectal cancer. Platelet count (PLT) and mean platelet volume (MPV) are two main characteristics to evaluate platelet activation. In the past decade, platelet activation has been demonstrated as a crucial biological process in carcinogenesis and metastasis. Thus, it is important to recognize effective and easy-obtained biomarkers for ESCC prognosis. Although several studies had identified certain survival-related biomarkers, they were less powerful and hardly able to be converted to clinical use. The tumor node metastasis (TNM) staging, especially the status of lymph node metastasis, is currently the best predictor for ESCC patient survival. Despite the progress in radical resection and adjuvant therapy (radiation and chemotherapy), ESCC still shows a poor 5-year survival rate of less than 30 %. The dominant histopathological type of EC is squamous cell carcinoma (ESCC) in Chinese patients, which covers 90 % of all cases. In China, esophageal cancer is the fourth leading cause of all cancer deaths, representing a major problem of public health in some high-risk rural areas. In conclusion, we considered that COP-MPV is a promising predictor for postoperative survival in ESCC patients.Īmong the most lethal malignancies, esophageal cancer (EC) ranks the sixth worldwide, leading to approximately 400,000 deaths in 2012. In subgroup analyses for early (stages I and II) and locally (stage III) advanced stage patients, COP-MPV was found significantly associated with OS and DFS in each group ( P = 0.025 and P = 0.018 for OS and P = 0.029 and P = 0.002 for DFS). Moreover, the combination of the preoperative PLT and MPV (COP-MPV) was calculated as follows: patients with both PLT (≥212 × 10 9 L −1) and MPV (≥10.6 fL) elevation were assigned a score of 2, and patients with one or neither were assigned a score of 1 and 0. By utilizing univariate and multivariate Cox proportional hazard analyses, we found that PLT and MPV were significantly associated with overall survival (OS) and disease-free survival (DFS) of ESCC patients, with optimal cutoff values of 212 and 10.6, respectively. A total of 468 patients who were diagnosed with ESCC between December 2005 and December 2008 were retrospectively analyzed in this study. Known inflammatory indices (NLR and PLR) were also calculated. Multiple laboratory tests were evaluated including those reflecting red blood cell parameters (hemoglobin (Hb), mean corpuscular volume (MCV), mean corpuscular hemoglobin concentration (MCHC), and red blood cell distribution width (RDW)), platelet morphological parameters (mean platelet volume (MPV) and platelet count (PLT)), blood coagulation status (D-dimer), and tumor biomarker (CA19-9). The aim of this study is to search the most powerful prognostic factor from routine blood test for esophageal squamous cell cancer (ESCC) patients.
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