Predictive Value Of Preoperative Platelet Distribution Width On Two Years Recurrence Rate In Colorectal Cancer Undergoing Resection

ObjectiveSince the association between inflammation and cancer was first proposed by Virchow in 1863,it had been controversial for a century until the past 20 years when the researchers had realized that the inflammatory was related to the behavior of tumors closely.Inflammatory aids in the proliferation and survival of malignant cells,promotes angiogenesis and metastasis,subverts adaptive immune responses,and alters responses to chemotherapeutic agents,leading to a decline in anti-tumor capacity.Platelet is the key factor in inflammatory,and at the same time,they are also recognized for their central role in the entire development of the tumor.Platelet promotes the proliferation and differentiation of tumor cells from multiple ways and increases the invasion ability of tumor cells.Elevated platelets are associated with a poor prognosis in various types of cancer,while antiplatelet therapy can reduce the chance of metastasis in patients with colon cancer.Platelets are divided into two types: resting platelets and activated platelets,and platelet activation is the main body that exerts these functions.Activated platelets typically constitute a minor fraction of the total platelet population.For this reason,platelet count can’t accurately represent platelet activity.At present,it is considered that another indicator of platelet called platelet distribution width(PDW)can represent platelet activation level.Therefore,the purpose of this study is to evaluate whether the preoperative platelet distribution width(PDW)can be a prognostic indicator on two year recurrence rate in colorectal cancers after operation.MethodsA total of 144 colorectal cancer patients who accepted surgical treatment in Luoyang Central Hospital Affiliated to Zhengzhou University were retrospectively analyzed from Jun.2014 to Jan.2016.The patients were divided into low PDW group(PDW ≤17.1)and high PDW group(PDW >17.1)according to the PDW extracted from peripheral venous blood to evaluate two year recurrence rate.The prognostic analysis was carried out with univariate analysis and Cox regression model to investigate whether PDW was an independent risk factor for early postoperative two-year recurrence in patients with colorectal cancer.Results1.The two year recurrence rate of patients with high preoperative PDW(n=40)was significantly better than the low preoperative PDW(45.00% vs.17.31%).The difference of two year recurrence rate between high preoperative PDW and low preoperative PDW was statistically significant(P<0.001).2.The tumor N stage,TNM stage,tissue differentiation,CEA and preoperative PDW showed a statistical correlation with two year recurrence rate in univariate analysis.Further multivariate analysis indicated that preoperative PDW,tumor differentiation,and CEA were independent predictor of prognosis.Conclusions1.The higher-level preoperative PDW in colorectal patients can predict the higher two year recurrence rate after operation.2.A higher preoperative PDW is a bad prognostic factor in colorectal cancer,which may be a prognostic maker in resectable colorectal cancer...