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

Main Article Content

Yousra Tera
Hanan Azzam
Nashwa Abousamra
Marwa Zaki
Ahmed Eltantawy
Mohamed Awad
Hayam Ghoneim
Maha Othman


Breast cancer, Platelet activation, Platelet indices, Metastasis, Cancer prognosis


Background:  Several studies reported the role platelet activation, platelet volume (MPV) and other  Indices in breast cancer but the data is inconsistent and/or 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 for cancer progression and poor prognosis.

Methods: Patients were recruited from our local oncology center between 2019 to 2020 following ethics approval. 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 flow cytometry. A comprehensive analysis of platelet count and platelet volume indices (PVIs) (MPV, PDW, MPV/P and PDW/P) was conducted. Data were analyzed in relation to tumor pathology, hormone receptors (ER, PR, HER-2) and proliferation index Ki-67. Regression analyses were conducted for the prediction of 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 for cancer progression and poor prognosis. We conclude platelet activation and specific platelet indices can help predict prognosis in females with BC.


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