Does diabetes affect paraneoplastic thrombocytosis in colorectal cancer?

Author:

Herczeg Gyorgy1ORCID,Somogyi Aniko2ORCID,Herold Magdolna2ORCID,Fodor Agnes1ORCID,Rosta Klara3ORCID,Dank Magdolna4ORCID,Lang Zsolt5ORCID,Herold Zoltan67ORCID

Affiliation:

1. Department of General Surgery, Szent Imre University Teaching Hospital , Budapest , Hungary

2. Department of Internal Medicine and Haematology, Semmelweis University , Budapest , Hungary

3. Department of Obstetrics and Gynecology, Medical University of Vienna , Vienna , Austria

4. Department of Internal Medicine and Oncology, Division of Oncology, Semmelweis University , Budapest , Hungary

5. Department of Biomathematics and Informatics, University of Veterinary Medicine Budapest , Budapest , Hungary

6. Department of Internal Medicine and Haematology, Semmelweis University , Szentkiralyi utca 46. , H-1088 Budapest , Hungary

7. Department of Internal Medicine and Oncology, Division of Oncology, Semmelweis University , Tomo utca 25-29. , H-1083 Budapest , Hungary

Abstract

Abstract Background A large variety of factors can affect colorectal cancer (CRC) survival, including type 2 diabetes mellitus (T2DM) and paraneoplastic thrombocytosis. Although several common factors play a role in their development and platelets are damaged in both diseases, the combined relationship of the three conditions was never investigated previously. Methods A prospective, real-life observational cohort study was conducted with the inclusion of 108 CRC patients and 166 voluntary non-CRC subjects. Plasma interleukin-6 and thrombopoietin levels were measured. Results Study participants were divided into cohorts based on the presence of T2DM. Platelet count (p < 0.0500) and interleukin-6 (p < 0.0100) level were significantly higher in the CRC groups. Thrombopoietin level was higher in the T2DM, CRC, and CRC + T2DM groups (p < 0.0500). Analysis of parameter changes over time and survival models revealed that neither platelet count, interleukin-6, nor thrombopoietin levels were affected by T2DM. Death of patients was associated with higher baseline platelet count (p = 0.0042) and interleukin-6 level (p < 0.0001). Conclusion Although the independent, disease-worsening effect of paraneoplastic thrombocytosis and T2DM is known, the coexistence of the two did not further impair the survival of CRC patients, suggesting that T2DM has no significant effect over paraneoplastic thrombocytosis.

Publisher

Walter de Gruyter GmbH

Subject

General Medicine

Reference62 articles.

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2. Josa V, Krzystanek M, Eklund AC, Salamon F, Zarand A, Szallasi Z, et al. Relationship of postoperative thrombocytosis and survival of patients with colorectal cancer. Int J Surg. 2015;18:1–6. 10.1016/j.ijsu.2015.03.005.

3. Stone RL, Nick AM, McNeish IA, Balkwill F, Han HD, Bottsford-Miller J, et al. Paraneoplastic thrombocytosis in ovarian cancer. N Engl J Med. 2012;366(7):610–8. 10.1056/NEJMoa1110352.

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5. International Diabetes Federation: IDF Diabetes Atlas, 9th edition. Brussels, Belgium: International Diabetes Federation; 2019 [cited 2020 Apr 15]. Available from: https://www.diabetesatlas.org

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