Association Between Platelet Indices and Distant Metastasis in Colorectal Cancer Patients: A Cross-Sectional Study
DOI:
https://doi.org/10.67440/ahj.vi.2461Keywords:
Biomarker; Colorectal cancer; Metastasis; Mean platelet volume; Platelet distribution width; Platelet indices.Abstract
Background
Distant metastasis is the leading cause of death in colorectal cancer (CRC). Platelet activation may facilitate metastasis by protecting circulating tumor cells from immune elimination, promoting angiogenesis, and supporting tumor-cell migration. However, the relationships of platelet count (PLT), mean platelet volume (MPV), platelet distribution width (PDW), and plateletcrit (PCT) with distant metastasis remain unclear.
Objective
To investigate associations between platelet indices and distant metastasis in CRC and assess their diagnostic performance.
Methods
This retrospective cross-sectional study included 80 adults with confirmed CRC treated at Dr. Soetomo General Academic Hospital, Indonesia, between January 1, 2020, and January 1, 2025. Pretreatment platelet indices and metastatic status were obtained at initial admission. Comparative analyses and multivariable logistic regression were performed to assess associations between platelet indices and metastasis. Receiver operating characteristic (ROC) curve analysis evaluated their ability to discriminate metastatic from nonmetastatic CRC.
Results
Distant metastasis was identified in 33 patients (41.3%). Patients with metastasis had significantly higher PLT (p=0.021), lower MPV (p<0.001), and lower PDW (p<0.001), while PCT did not differ significantly (p=0.280). In multivariable analysis, PDW was the only platelet index independently associated with distant metastasis (adjusted OR=0.164; p=0.005). PDW had the best ability to tell the difference between groups (AUC=0.880), with a cutoff of <8.75%, a sensitivity of 81.8%, and a specificity of 82.9%.
Conclusions
Lower PDW independently indicated a greater likelihood of distant metastasis in CRC and showed a high level of diagnostic accuracy. As an inexpensive, noninvasive, routinely available biomarker, PDW may help identify high-risk patients and support early clinical decision-making.
