Platelet Activation and Platelet Indices as Markers for Disease Progression in Women with Breast Cancer

Background: Several studies have reported the role of platelet activation, platelet volume (MPV) and other indices in breast cancer but the data is inconsistent and diverse. The aim of this study was to systematically evaluate the role of platelet activation and platelet volume indices in women with BC as predictors of cancer progression and poor prognosis. Methods: The patients were recruited from our local oncology center from 2019 to 2020 following ethics approval. In total, 80 patients with locally invasive BC, 20 metastatic, and 100 controls were recruited. ADP-induced platelet activation was assessed by light-transmission aggregometry. Platelet P-selectin (CD62P) expression with and without ADP stimulation was assessed by flowcytometry. The comprehensive analysis of platelet count and platelet volume indices (PVIs) (MPV, PDW, MPV/P and PDW/P) was conducted. Data was analyzed in relation to tumor pathology, hormone receptors (ER, PR, HER-2) and proliferation index Ki-67. Regression analyses were conducted to predict poor prognosis, tumor aggression and metastatic potential. Results: We found a 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. Univariate regression analysis showed significance for ADP MA, CD62P+ADP, MPV and PDW/P. Conclusion: MPV/P and PDW/P can be used as simple low-cost predictors of cancer progression and poor prognosis. We conclude platelet activation and specific platelet indices can help predict prognosis in females with BC.