Abstract Number: LPB0141
Meeting: ISTH 2021 Congress
Background: Ex-vivo activation of platelet was reported in women with breast cancer (BC). Mixed evidence from literature exists that mean platelet volume (MPV) is higher in cancer vs benign breast tumors and maybe associated with larger tumors, higher stage and poorer prognosis. Predictive markers are required to identify high-risk patients who may develop metastasis.
Aims: To systematically evaluate platelet activation and platelet volume indices in women with BC in chemo-naïve locally invasive and metastatic disease.
Methods: Patients were recruited from oncology center at our local hospital between 2019 to 2020 following ethics approval. Patient groups included: 80 locally invasive BC patients (stages I,II,III), 20 metastatic (stage IV) and 100 age-matched controls. Platelet activation in response to ADP was assessed by light-transmission aggregometry. Platelet P-selectin (CD62P) expression with and without ADP stimulation was assessed by flowcytometry. Comprehensive analysis of platelet count and all platelet volume indices (PVIs) (MPV, PDW, MPV/P and PDW/P). Data were analyzed in relation to tumor pathology, hormone receptors (ER, PR, HER-2) and proliferation index Ki-67. Regression analyses were conducted for prediction of poor prognosis, tumor aggression and metastatic potential.
Results: There was significant increase in platelet aggregation (MA), CD62P expression, CD62P+ADP, MPV, PDW, MPV/P and PDW/P in the metastatic group compared to the locally invasive group (Table1). Tumor size and grade were significantly correlated with ADP-MA, CD62P, CD62P+ADP, MPV, PDW, MPV/P and PDW/P. The area under curve showed (0.98, 0.9, 0.97, 0.93, 0.66, 0.7, 0.8, 0.73) for ADP MA, CD-62, CD-62P+ADP, CD-62P Diff., MPV, PDW, MPV/P, PDW/P) respectively. Univariate regression analysis showed significance for MA, CD62P, CD62P+ADP, CD-62P Diff., PLTs count, MPV, PDW, MPV/P, PDW/P (Table2).
|Parameters / Groups||Control group||Locally invasive BC group||Metastatic BC group||P value|
|Platelets 109/L Mean ±SD||234 ± 43||11.8 ± 1.6||10.5 ± 1.4||≤0.001|
|MPV fL Mean ±SD||10.9 ± 0.9||14.6 ± 1.5||16.7 ± 1.1||0.02|
|PDW fL Mean ±SD||13.9 ± 2.17||16.1 ± 3.9||18.4 ± 5.2||0.044|
|MPV/P fL/109/L Mean ±SD||0.048 ± 0.01||1.3 ± 0.25||1.6 ± 0.16||≤0.001|
|PDW/P fL/109/L Mean ±SD||0.067 ± 0.01||1.43 ± 0.03||1.77 ± 0.2||0.044|
|APD MA % Mean ±SD||54.7 ± 12.1||73.7 ± 19||115 ± 5||≤0.001|
|CD-62P % Mean ±SD||2.7 ± 1.3||3.5 ± 1.4||6.9 ± 1.9||0.02|
|CD-62P + ADP % Mean ±SD||23.4 ± 10||46.8 ± 17.7||81.5 ± 5||≤0.001|
|CD-62P Diff. Mean ±SD||20.5 ± 10||43.5 ± 18.5||74.5 ± 5.5||0.001|
|Parameters||P value||OR||Lower 95% CI||Higher 95% CI|
|CD-62P + ADP||0.001||1.3||1.126||1.502|
Conclusions: PVIs (MPV/P and PDW/P) can be used as simple, easily available and low cost predictors for cancer progression and poor prognosis. Also, MA and CD62P+ADP can be regarded significant predictors for metastatic BC.
To cite this abstract in AMA style:Tera Y, Azzam H, Abousamra N, Zaki M, Eltantawy A, Awad M, Ghoneim H, Othman M. Platelet Activation and Platelet Indices as Markers for Disease Progression in Women with Breast Cancer [abstract]. Res Pract Thromb Haemost. 2021; 5 (Suppl 2). https://abstracts.isth.org/abstract/platelet-activation-and-platelet-indices-as-markers-for-disease-progression-in-women-with-breast-cancer/. Accessed November 29, 2021.
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