Red blood cell distribution width is associated with sarcopenia risk in early-stage non-small cell lung cancer.

BACKGROUND: Sarcopenia has received increasing attention in non-small cell lung cancer (NSCLC). Red blood cell distribution width (RDW) is a significant component of the complete blood count and indicates the heterogeneity of erythrocyte volume. Little information is known about RDW in relation to sarcopenia in early-stage (IA-IIIA) NSCLC. The purpose of the present study was to investigate the association between RDW and sarcopenia risk in early-stage NSCLC patients. METHODS: This study included 378 patients with pathologically confirmed stage IA-IIIA NSCLC. Sarcopenia was defined by measuring the skeletal muscle index (SMI) at the eleventh thoracic vertebra level. The maximum Youden index on the receiver operating characteristic (ROC) curve was used to estimate the cutoff value for RDW to predict sarcopenia. Logistic regression analyses were carried out to assess the independent risk factors for sarcopenia in NSCLC. RESULTS: The ROC curve indicated that the best cutoff point for RDW to predict sarcopenia was 12.9 (sensitivity of 43.80% and specificity of 76.76%, respectively). Moreover, there were significant differences in hemoglobin (p < 0.001), comorbidities (p = 0.001), histological type (p = 0.002), and cancer stage (p = 0.032) between the high RDW and low RDW groups. Logistic regression analyses revealed that high RDW is an independent risk factor for sarcopenia in early-stage NSCLC. CONCLUSION: RDW is associated with sarcopenia risk in early-stage NSCLC.

Reduced mean platelet volume levels predict shorter survival in patients with resectable pancreatic ductal adenocarcinoma and type 2 diabetes.

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.

Platelet Indices in Colorectal Cancer Patients with Synchronous Liver Metastases.

AIMS: Liver metastases occur in approximately 25% of colorectal cancer (CRC) patients and cause more than 90% of deaths in CRC. Platelets play a crucial role in cancer progression and metastases. We aimed to investigate the relationship between platelet indices and CRC with synchronous liver metastases. METHODS: We conducted a retrospective clinical study including 206 CRC patients without metastases and 200 CRC patients with synchronous liver metastases from January 1, 2015, to December 31, 2017. Data of the patients' clinicopathological characteristics were collected. RESULTS: Platelet distribution width (PDW) was decreased in CRC patients with liver metastases compared with CRC patients without liver metastases. In addition, the prevalence of liver metastases reduced as PDW quartiles increased. After adjusting for other risk factors, the odds ratios (95% confidence intervals) for CRC liver metastases according to PDW quartiles were 1.000, 0.289 (0.156-0.535), 0.482 (0.271-0.860), and 0.190 (0.101-0.358). CONCLUSIONS: Compared with CRC patients without metastases, PDW is reduced in CRC patients with liver metastases. Moreover, PDW was independently associated with the presence of CRC liver metastases.

Preoperative platelet distribution width predicts breast cancer survival.

BACKGROUND: Breast cancer is one of the most commonly diagnosed cancers, and the fourth leading cause of cancer deaths in females worldwide. Activated platelets play a key role in tumor growth and tumor metastasis. Platelet distribution width (PDW) is a platelet index, and is altered in patients with malignancies. The aim of this study was to explore whether PDW can effectively predict death outcome of breast cancer patients. STUDY DESIGN: The clinical data of 271 breast cancer patients in our hospital between January 2009 and December 2009 were retrospectively analyzed. Survival analysis was performed using the log-rank test and Cox proportional hazards regression analysis. RESULT: There were significant correlations between increased PDW and tumor size, molecular subtype, differentiation grade, and cancer stages (T, N, or TNM). Moreover, survival analysis revealed that the overall survival of patients with PDW > 16.8%, which was significantly shorter than those with PDW ⩽ 16.8%. Multivariate analysis indicated that PDW > 16.8% predicts a poor overall survival of breast cancer patients. CONCLUSIONS: Elevated PDW may serve as a marker of adverse prognosis in breast cancer. However, these data are preliminary and should be interpreted with caution pending validation by additional clinical and molecular/genomics studies in various populations.

Reduced mean platelet volume is associated with poor prognosis in esophageal cancer.

BACKGROUND: Esophageal cancer (EC) is the sixth most common cause of death from cancer. Altered mean platelet volume (MPV) levels were found in patients with malignancies. OBJECTIVE: The present study investigated whether MPV can predict the survival in EC patients. MEHTODS: The clinical data of 236 consecutive EC patients between January 2009 and December 2009 in our center were retrospectively analyzed. The overall survival rate was estimated using Kaplan-Meier method. Cox proportional hazards models were fitted to model the relationships between patient characteristics and prognosis. RESULTS: Decreased MPV was significantly correlated with tumor location and tumor differentiation (p< 0.001). Moreover, survival analysis revealed that the overall survival of patients with MPV ⩽ 7.4 fL was significantly shorter than that of those with MPV > 7.4 fL. Multivariate analysis identified MPV as an independent poor prognostic factor for overall survival. CONCLUSIONS: Reduced MPV is associated with worse survival outcome in EC.

Cancer antigen 15-3, platelet distribution width, and fibrinogen in combination to distinguish breast cancer from benign breast disease in non-conclusive mammography patients.

Breast cancer is the most frequently diagnosed cancer and the leading cause of cancer death among females. However, mammographic diagnosis is sometimes non-conclusive with a Breast imaging Reporting and Data System (Bi-RaDS) result of 0. Cancer antigen 15-3 (CA15-3) is the most widely used serum tumor marker for breast cancer screening. Platelet distribution width (PDW) is an early indicator of platelet activation. Fibrinogen contributed to angiogenesis and distant metastasis. The aim of this study was to investigate the ability of CA15-3, PDW, and fibrinogen individually or in combination, to distinguish breast cancer from benign breast disease. 200 consecutive patients with breast cancer and 187 patients with benign breast disease were included in this retrospective study. Patients' characteristics and hematologic tests data at initial diagnosis were collected. The benefit of adding PDW and fibrinogen to a model with only CA15-3 was evaluated as an increased in the area under the curve (AUC) obtained by receiver operating curve (ROC). CA15-3, PDW and fibrinogen are higher in breast cancer patients than in patients with benign breast disease. Single biomarkers had AUC values ranging from 0.687 for fibrinogen to 0.810 for CA15-3. In addition, the combination of PDW, CA15-3, and fibrinogen increased the AUC to 0.900 (0.866-0.928) (p<0.0001), significantly higher than those of any single marker. In conclusion, the combined use of CA15-3, PDW and fibrinogen may be clinically useful in discriminating between breast cancer and benign breast disease in non-conclusive mammography patients.

Decreased mean platelet volume predicts poor prognosis in invasive bladder cancer.

BACKGROUND: Altered mean platelet volume (MPV) is implicated in a wide range of cancers. However, the prognostic role of MPV in muscle-invasive bladder cancer (MIBC) remains largely unknown. The purpose of this study was to elucidate the predictive significance of MPV in MIBC. METHOD: The retrospective study included 218 consecutive MIBC patients between January 2009 and December 2009. The relationships between MPV and clinicopathological characteristics were analyzed. Kaplan-Meier method and Cox regression were used to evaluate the prognostic impact of MPV. RESULT: Of the 218 patients, low MPV levels were detected in 141 (64.7 %) patients. Reduced MPV was associated with T stage and histology grade (p < 0.05). In the Kaplan-Meier analysis, decreased MPV was significantly associated with a poorer overall survival (p = 0.007). In the multivariate Cox model, decreased MPV was an independent prognostic index for overall survival (HR=2.023, 95% CI=1.050-3.897, p = 0.025). CONCLUSION: MPV is easily available in routine blood test. Our results demonstrated that reduced MPV could be regarded as a potential prognosis indicator for clinical outcome in MIBC.

Melatonin receptor 1B gene polymorphism rs10830963 and gestational diabetes mellitus among a Chinese population - a meta-analysis of association studies.

INTRODUCTION: Studies have been conducted to investigate the association between rs10830963 of MTNR1B and the risk of gestational diabetes mellitus (GDM), but with inconclusive results. We aimed to clarify these controversies, especially with regard to the association in the Chinese population. MATERIAL AND METHODS: A systemic literature reference search inclusive to August 12, 2016 yielded 35 articles, from which 11 studies met the inclusion criteria for the final meta-analysis, including 3889 patients with GDM and 6708 controls. RESULTS: We found statistically significant associations between rs10830963 and GDM using odds ratios (ORs) and 95% confidence intervals (CIs) [GG genotype vs. CC genotype: OR = 1.70, 95% CI: 1.38-2.10; G allele vs C allele: OR = 1.27, 95% CI: 1.20-1.36; GG+CG vs. CC (dominant model): OR = 1.31, 95% CI: 1.20-1.44; GG vs CG+CC (recessive model): OR = 1.41, 95% CI: 1.26-1.58]. In subgroup analyses stratified by ethnicity, we also observed rs10830963 to be associated with significantly increased risk of GDM in all genetic models in the Chinese population. CONCLUSIONS: Our meta-analysis indicated that the rs10830963 polymorphism might serve as a risk factor of GDM in the Chinese population.

Platelet Distribution Width and Serum Albumin Levels for Discrimination of Thyroid Cancer From Benign Thyroid Nodules

Thyroid cancer is the most rapidly increasing cancer type among women and the second among men. Early detection greatly improves the prognosis. For this purpose, the platelet distribution width (PDW), an early indicator of platelet activation, might be useful. The aim of this study was to investigate the ability of PDW and serum albumin levels individually or in combination to distinguish between thyroid cancer and benign thyroid nodules. A total of 265 patients with thyroid cancer and 243 with benign thyroid nodules were included in a development set. Then, two groups of 130 cases were enrolled in a validation set. Patient characteristics and hematologic test data at initial diagnosis were collected. Receiver operating characteristic curves (ROC), area under the curve (AUC) values, sensitivity and specificity were estimated. Albumin levels are significantly lower and PDW significantly higher in patients with thyroid cancer compared to the benign cases. Moreover, PDW values prominently differed among three types of thyroid cancer. In addition, the combination of PDW and albumin exhibited a significantly larger AUC than either marker alone (p < 0.001). In conclusion, the combined use of PDW and albumin might be useful in distinguishing thyroid cancer from benign thyroid nodules. This promising approach could be helpful in early detection of thyroid cancer.

Platelet distribution width correlates with prognosis of non-small cell lung cancer.

Platelets play a multifaceted role in cancer progression and metastasis. Mean platelet volume (MPV) and platelet distribution width (PDW) are commonly used platelet parameters from routine blood test. The aim of the present study was to investigate the correlation between platelet indices and prognosis in patients with non-small cell lung cancer (NSCLC). A total of 270 patients who were diagnosed with NSCLC between January 2009 and December 2009 were retrospectively analyzed. Patients' characteristics and hematologic tests data at initial diagnosis were collected. The overall survival rate was estimated using Kaplan-Meier method. The prognostic analysis was carried out with univariate and multivariate Cox regressions model. Reduced PDW was significantly correlated with T stage, N stage, TNM stage, and histological type of the disease. Moreover, survival analysis showed that the overall survival of patients with PDW ≥ 16.3% was significantly longer than that of those with PDW < 16.3% (P < 0.001). In multivariate Cox regression model, age, sex, TNM stage, and PDW were identified as independent prognostic factors for overall survival (for PDW, P < 0.001). In conclusion, reduced PDW is an unfavorable predictive factor of NSCLC patient survival. Further studies are warranted.

Platelet distribution width correlates with prognosis of gastric cancer.

BACKGROUND: Activated platelets promote tumor cell growth, aberrant angiogenesis, and invasion. However, the value of platelet indices for predicting survival in gastric cancer remains unknown. The goal of this study was to investigate the predictive significance of platelet indices in gastric cancer. RESULT: Reduced platelet distribution width (PDW) was significantly correlated with age, carcinoembryonic antigen, tumor stage, nodule stage, and tumor-nodule-metastases stage. Moreover, decreased PDW correlated with a shorter overall survival in gastric cancer. Multivariate analysis identified PDW as an independent prognostic factor for overall survival (hazard ratio: 0.493, 95% confidence interval: 0.319-0.761, p = 0.001). METHOD: A total of 294 patients with gastric cancer were retrospectively analyzed between January 2009 and December 2009. The association between platelet indices and overall survival were evaluated. The prognostic analysis was carried out with Cox regression model. CONCLUSION: PDW is easily available with routine blood counts. Our data revealed that reduced PDW is unfavorable prognostic factor in gastric cancer. Further studies are warranted.

Laparoscopic Low Anterior Resection of the Rectum with Transanal Prolapsing Specimen Extraction: Early Experience with 23 Patients.

OBJECTIVE: For laparoscopic low anterior resection of the rectum, a small additional incision is needed to extract the specimen. We describe an adjustment technique, which inserted the anvil and extracted the specimen through transanal pathway. METHODS: Between July 2010 and July 2012, 23 patients underwent laparoscopic rectal surgery with transanal anvil insertion and transanal prolapsing specimen extraction. All perioperative data and short-term outcomes were recorded in a database. RESULTS: The mean patient age was 61.3 years (range 47-68 years). Of the 23 patients, 17 underwent resection for rectal carcinoma and 6 had tubulovillous adenomas. No intraoperative complications occurred. The mean operative time was 137 minutes (range 118-170 minutes). The distal margins, circumferential resection margins, and lymph node dissections were oncologically adequate for all malignancies. One patient experienced anastomotic leakage (4.3%), treated conservatively. One male patient with benign prostatic hyperplasia suffered from postoperative urinary retention. The average postoperative hospital stay was 11.3 days (range 7-21 days). No patients experienced anal dysfunction. At a median follow-up of 26 months, there were no tumor recurrences. CONCLUSION: The technique of transanal prolapsing specimen extraction for laparoscopic low anterior resection of the rectum is feasible and safe for selected patients.

Giant peritoneal loose body in the pelvic cavity confirmed by laparoscopic exploration: a case report and review of the literature.

A 51-year-old previously healthy male underwent a routine medical examination. Computed tomography and ultrasonography showed an oval-shaped mass that was about 50 × 40 mm in size in the left iliac fossa. Prior to surgery, the lesion was suspected to be a teratoma with core calcification or stromal tumor derived from the rectosigmoid colon. During the procedure, a yellow-white, egg-shaped mass was discovered that was completely free from the pelvic cavity in front of the rectum. The giant, peritoneal loose body was taken out through the enlarged port site. Histological examination showed that the mass consisted of well-circumscribed, unencapsulated, paucicellular tissue, with an obviously hyalinized fibrosclerotic center. A giant peritoneal body is extremely rare. We report such a case and review previously published literature.

Delta-catenin promotes the proliferation and invasion of colorectal cancer cells by binding to E-cadherin in a competitive manner with p120 catenin.

δ-Catenin is the only member of the p120 catenin (p120ctn) subfamily whose normal pattern of expression is restricted to the brain. Similar to p120ctn, δ-catenin can bind to the juxtamembrane domain of E-cadherin. We examined the expression of δ-catenin, p120ctn, and E-cadherin using immunohistochemistry in 95 cases of colorectal cancer (CRC) and 15 normal colon tissues. Co-immunoprecipitation was used to examine whether δ-catenin competed with p120ctn to bind E-cadherin in CRC cells. The effects of δ-catenin overexpression or siRNA-mediated knockdown on the proliferation and invasive ability of CRC cells were investigated using the MTT and Matrigel invasion assays. The results showed that positive δ-catenin expression was significantly more frequent in CRC compared to normal colon tissues and associated with poor differentiation, stage III-IV disease, and lymph node metastasis in CRC (all P < 0.05). In two CRC cell lines, δ-catenin bound to E-cadherin in competition with p120ctn. Overexpression of δ-catenin promoted the proliferation and invasion of CRC cells; knockdown of δ-catenin reduced CRC cell proliferation and invasion. In conclusion, we speculate that overexpression of δ-catenin reduces the expression of E-cadherin and alters the balance between E-cadherin and p120ctn, which in turn affects the formation of intercellular adhesions and promotes invasion and metastasis in CRC.

[Phthalic acid esters (PAEs) pollution in farmland soils: a review].

The environmental pollution and food safety problems caused by phthalic acid esters (PAEs) have been attracted 'extensive attention around the world. As a large PAEs producer and consumer, China is facing severe PAEs environmental pollution problems. This paper reviewed the present pollution status of six PAEs classified by the U.S. Environmental Protection Agency as the priority pollutants in China farmland soils, analyzed the sources of these six PAEs in this country, and discussed the absorption and accumulation characteristics of the PAEs in different crops as well as the bio-toxic effects of PAEs pollutants. The PAEs concentrations in China farmland soils are significantly higher those in the farmland soils of the United States and European countries. The main sources of PAEs in China farmland soils are atmospheric deposition, agricultural films, sewage sludge application, and wastewater irrigation. There exist significant differences in the characteristics of PAEs absorption, accumulation, and distribution among different crops. PAEs not only have negative effects on soil quality, crop growth, and crop physiological and biochemical properties, but also possess bio-accumulative characteristics. The weaknesses in current researches were pointed out, and the suggestions for the further researches were given, e. g., to expand the scope of PAEs pollution survey, to explore the toxic mechanisms of PAEs on crops, and to develop the techniques for in situ remediation of PAEs-polluted soils.

[Distribution characteristics of phthalic acid esters in soils and peanut kernels in main peanut producing areas of Shandong Province, China].

Surface soil (0-20 cm) and peanut kernel samples were collected in four main peanut producing areas of Shandong Province, and the contents of six PAEs chemicals that classified by the U. S. Environmental Protection Agency as priority pollutants were determined by gas chromatography (GC). The results indicated that the total concentration of six PAEs (sigma PAEs) ranged from 0.34 to 2.81 mg x kg(-1), and the mean was 1.22 mg x kg(-1). In four different areas, the order of sigmaPAEs concentration in soil was hilly area of middle southern Shandong > western plain of Shandong > Jiaodong Peninsula > northern plain of Shandong. The concentration of DBP in four main peanut producing areas of Shandong Province seriously exceeded the control limit in USA. The content of PAEs ranged from 0.17 to 0.66 mg x kg(-1) in peanut kernels, with the average value 0.34 mg x kg(-1) which was less than the suggested targets in USA and Europe and of low health risk. DEHP and DBP were the main components of PAEs both in soils and peanut kernels, with higher percentage content and detection rate. The sigma PAEs contents in soils or peanut kernels under plastic mulching were significantly higher than that of open field cultivation pattern. The PAEs concentrations in peanut kernels and soils had significant correlation, with the Pearson coefficient 0. 786 (sigma PAEs), 0.747 (DBP) and 0.511 (DEHP), respectively.

[Expression and significance of RECK, metalloproteinase-9 and vascular endothelial growth factor-C in colorectal cancer].

OBJECTIVE: To investigate the expression of reversion-inducing cysteine-rich protein with Kazal motifs (RECK), matrix metalloproteinase-9 (MMP-9), and vascular endothelial growth factor-C (VEGF-C) in colorectal cancer. METHODS: S-P immunohistochemistry was used to detect the expression of RECK, MMP-9 and VEGF-C in colorectal cancer specimen. Colorectal mucosal tissue at least 10 cm away from the tumor was used as control. RESULTS: The positive expression of RECK in colorectal cancer was significantly lower than that in the controls(53.3% vs. 100%, P<0.05). Both MMP-9 and VEGF-C were over expressed compared with the controls(86.7% vs. 23.3% and 71.7% vs. 13.3% respectively, P<0.01). The expression of RECK was negatively correlated with that of MMP-9 and VEGF-C, and the expression of MMP-9 was positively correlated with that of VEGF-C. There were significant associations between the expression of these proteins and lymph node metastasis, distant metastasis, and TNM staging (all P<0.05). CONCLUSIONS: RECK expression is low in colorectal cancer, while MMP-9 and VEGF-C expressions are high. Combined testing of these 3 markers is important in the evaluation of tumor metastasis and invasion, and is helpful in the prediction of the prognosis.