Abstract
Purpose
The significance of thrombocytosis and raised C-reactive protein (CRP) as prognostic markers in esophageal cancer is unclear.
Methods
We prospectively studied 50 consecutive patients with esophageal cancer and analyzed the relation of preoperative platelet count and CRP levels with the clinico-pathological characteristics and stage of the disease. The platelet count of 319 × 109/L for thrombocytosis and CRP level >6 mg/dl were taken as cut-off values.
Results
The incidence of thrombocytosis as well as raised CRP level was 50 %. Eighty percent of patients with thrombocytosis had raised CRP levels. None of patients with early disease (stage I) had thrombocytosis while patients with advanced stage were associated with thrombocytosis, 81.81 % in stage III and 100 % in stage IV (p < 0.001). The incidence of elevated CRP levels has shown progressive linear co-relation with the stage of carcinoma, i.e., 0 % in pathological stage I, 16.67 % in stage II, 45.45 % in stage III, and 100 % in stage IV disease (p = 0.011). Patients with thrombocytosis and patients with raised CRP were associated with pathological nodal metastases in 84.61 % cases (p 0.005) and 61.53 % (p 0.030), respectively.
Conclusion
Thrombocytosis alone or in combination with raised CRP had progressive linear relation with the stage of esophageal carcinoma.
Similar content being viewed by others
References
Kamangar F, Dores GM, Anderson WF. Patterns of cancer incidence, mortality, and prevalence across five continents: defining priorities to reduce cancer disparities in different geographic regions of the world. J Clin Oncol. 2006;24:2137–50.
Murthy NS, Chaudhry K, Rath GK. Burden of cancer and projections for 2016, Indian scenario: gaps in the availability of radiotherapy treatment facilities. Asian Pacific J Cancer Prev. 2008;9:671–7.
Seigel R, Naishadham D, Jemal A. Cancer statistics, 2013. CA Cancer J Clin. 2013;63:11–30.
Nozoe T, Saeki H, Sugimachi K. Significance of preoperative elevation of serum C-reactive protein as an indicator of prognosis in esophageal carcinoma. Am J Surg. 2001;182:197–201.
Ikeda M, Furukawa H, Imamura H, Shimizu J, Ishida H, Masutani S, et al. Poor prognosis is associated with thrombocytosis in patients with gastric cancer. Ann Surg Oncol. 2002;9:287–91.
Shimada H, Oohira G, Okazumi S, Matsubara H, Nabeya Y, Hayashi H, et al. Thrombocytosis associated with poor prognosis in patients with esophageal carcinoma. J Am Coll Surg. 2004;198:737–41.
Aminian A, Karimian F, Mirsharifi R, Alibakhshi A, Dashti H, Jahangiri Y, et al. Significance of platelet count in esophageal carcinomas. Saudi J Gastroenterol. 2011;17:134–7.
Ikeda M, Natsugoe S, Ueno S, Baba M, Aikou T. Significant host- and tumor-related factors for predicting prognosis in patients with esophageal carcinoma. Ann Surg. 2003;238:197–202.
Castell JV, Gomes-Lechon MJ, David M, et al. Acute phase response of human hepatocytes: regulation of acute-phase protein synthesis by interleukin-6. Hepatology. 1990;12:1179–86.
Gockel I, Dirksen K, Messow CM, Junginger T. Significance of preoperative C-reactive protein as a parameter of the perioperative course and long-term prognosis in squamous cell carcinoma and adenocarcinoma of the oesophagus. World J Gastroenterol. 2006;12:3746–375.
Lukaszewicz-Zając M, Mroczko B, Kozłowski M, Nikliński J, Laudański J, Siewko M, et al. Comparative evaluation of serum C-reactive protein (CRP) levels in the different histological subtypes of esophageal cancer (squamous cell carcinoma and adenocarcinoma of esophagus). J Clin Lab Anal. 2012;26:73–81.
Nakano T, Chahinian AP, Shinjo M, et al. Interleukin 6 and its relationship to clinical parameters in patients with malignant pleural mesothelioma. Br J Cancer. 1998;77:907–12.
Shimada H, Takeda A, Shiratori T, Nabeya Y, Okazumi S, Matsubara H, et al. Prognostic significance of serum thymidine phosphorylase concentration in esophageal squamous cell carcinoma. Cancer. 2002;94:1947–54.
Griffiths L, Stratford IJ. Platelet-derived endothelial cell growth factor thymidine phosphorylase in tumor growth and response to therapy. Br J Cancer. 1997;76:689–93.
Igarashi M, Dhar DK, Kubota H, Yamamoto A, El-Assal O, Nagasue N. The prognostic significance of microvessel density and thymidine phosphorylase expression in squamous cell carcinoma of the esophagus. Cancer. 1998;82:1225–32.
Canna K, McArdle PA, McMillan DC, McNicol AM, Smith GW, McKee RF, et al. The relationship between tumor T-lymphocyte infiltration, the systemic inflammatory response and survival in patients undergoing curative resection for colorectal cancer. Br J Cancer. 2005;92:651–4.
McMillan DC, Canna K, McArdle CS. Systemic inflammatory response predicts survival following curative resection of colorectal cancer. Br J Surg. 2003;90:215–9.
Conflict of Interest
The authors declare that they have no competing interests.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Verma, G.R., Thiagarajan, S., Gupta, R. et al. Thrombocytosis and Raised CRP Levels Predicts Advanced Stage in Esophageal Carcinoma. J Gastrointest Canc 46, 350–355 (2015). https://doi.org/10.1007/s12029-015-9750-z
Published:
Issue Date:
DOI: https://doi.org/10.1007/s12029-015-9750-z