Can platelet levels be used for prognosis in non-small cell lung cancer?

This study explored whether platelet activity was useful measure of prognosis in non-small cell lung cancer.

Though there have been many advances in lung cancer treatment, 5-year survival rates remain relatively low: 14% for males and 18% for females. It is useful, therefore, to have ways of predicting who might benefit most from treatment.

Proteins such as vascular endothelial growth factor and basic fibroblast growth factor have been associated with angiogenesis, the creation of new blood vessels the tumor needs for growth. Levels of these proteins have been associated with advanced lung cancer and disease progression. It has recently been found that platelets, the substances in the blood that form clots at injury sites (such as cuts in the skin), also promote angiogenesis. Few studies have examined the role platelets play in cancer progression or whether they have any predictive value for prognosis. The current study examined vascular endothelial growth factor and platelet activity in both healthy people and lung cancer patients.

This study compared 68 patients with non-small cell lung cancer and 68 healthy subjects. Of the lung cancer patients, 38 were determined to be in Stage I or II (local disease) and 30 were Stage III or IV (spread to the lymph nodes or beyond). Survival time was measured as the time from surgery to remove their tumors to the time of death. Vascular endothelial growth factor and platelet activity were measured at the time of surgery. Average follow-up time was 5 years.

Vascular endothelial growth factor levels were 40.8 pg/10⁶ in lung cancer patients compared to 21.9 pg/10⁶ in healthy subjects. Average platelet activity was 2.5 times higher in lung cancer patients compared to healthy subjects.

High platelet activity in lung cancer was associated with increased lymph node involvement, increased disease stage, and disease aggression. Patients with higher lymph node involvement had a 95% increased chance of mortality (death) during the study follow-up compared to those with no or low lymph node involvement. Similarly, those with stage III or IV disease had a 73% increased chance of mortality during the study follow-up compared to those with stage I or II disease. Patients with high platelet activity were 3 times more likely to have lower overall survival times than patients with lower platelet activity. 

This study concluded that platelet activity may be useful for predicting prognosis in lung cancer.