Does the Platelet Index Have a Guiding Role in the Association of Cancer and Pulmonary Thromboembolism?

The diagnostic value of the D-dimer test varies with variable platelet numbers and functions in patients suffering from cancer and concomitant pulmonary thromboembolism (PTE). This requires easy and reliable evaluation tests. In this study, we aimed to investigate the hypothesis that platelet functions may be more guiding in the prediction and diagnosis of PTE rather than the number of platelets in cancer pa- tients.

The clinical, laboratory and radiological findings of all patients diagnosed with PTE were retrieved, retrospectively. Comparisons were performed between “can- cer-free” and “cancer” patients. The patients were also evaluated according to their active and remission status.

The data of 232 patients with PTE were reviewed. 172 patients were cancer- free and 60 were diagnosed with cancer. The mean values of D-dimer, mean platelet volume (MPV) and platelet distribution width (PDW) were found to be significantly higher in patients with cancer (P=0.015, P=0.026, and P=0.023; respectively). On the other hand, mean platelet counts were significantly higher in patients without cancer (P=0.05). It was also observed that the mean values of D-dimer, Troponin-I, MPV, and PDW were found to be significantly higher in patients with active cancer (P=0.05, P=0.044, P=0.05, and P=0.042; respectively). However, the mean platelet counts were significantly higher in patients with cancer who were in remission (P=0.05).

The morphological characteristics of the platelets are more determinant than the number of platelets in cancer patients with PTE. Platelet indexes such as MPV and PDW may be useful in the prediction, diagnosis, and follow-up of PTE in patients with cancer.