Thrombocytosis as a prognostic factor in inflammatory breast cancer

• Published in: Breast cancer research and treatment Vol. 166; no. 3; pp. 819 - 832
• Main Authors: Harano, Kenichi, Kogawa, Takahiro, Wu, Jimin, Yuan, Ying, Cohen, Evan N., Lim, Bora, Reuben, James M., Ueno, Naoto T.
• Format: Journal Article
• Language: English
• Published: New York Springer US 01.12.2017; Springer; Springer Nature B.V
• Subjects: Adult; Aged; Aged, 80 and over; Analysis; Blood Platelets - pathology; Bone morphogenetic proteins; Breast cancer; Cancer research; Chemokine CXCL1 - blood; Clinical Trial; Cytokines; Cytokines - blood; Development and progression; Female; Hemostasis; Humans; Inflammation; Inflammatory Breast Neoplasms - blood; Inflammatory Breast Neoplasms - complications; Inflammatory Breast Neoplasms - epidemiology; Inflammatory Breast Neoplasms - pathology; Medical prognosis; Medical records; Medicine; Medicine & Public Health; Middle Aged; Neoplasm Staging; Oncology; Prognosis; Proportional Hazards Models; Regression analysis; Survival; Thrombocytosis; Thrombocytosis - blood; Thrombocytosis - complications; Thrombocytosis - epidemiology; Thrombocytosis - pathology; Transforming growth factor; Transforming Growth Factor beta1 - blood; Transforming growth factor-b; Transforming growth factors; Tumor Microenvironment - genetics; Growth-regulated oncogene; Inflammatory breast cancer; Thrombocytosis; Platelet; Transforming growth factor β
• ISSN: 0167-6806; 1573-7217
• DOI: 10.1007/s10549-017-4463-6

Purpose Platelets are essential components of hemostasis and also play an important role in the tumor microenvironment. The purposes of our research were to examine the role of thrombocytosis in inflammatory breast cancer (IBC) and to know which cytokine drives thrombocytosis. Methods We reviewed the medical records of 3654 patients with stage I–III breast cancer treated between 1998 and 2013, including 230 patients (6%) with IBC. We used Chi-squared test or Fisher’s exact test to compare the variables between patients with and without thrombocytosis. Multivariate Cox regression models were used to determine the association of thrombocytosis with overall survival. We also examined baseline serum cytokine levels in 81 patients with primary IBC to determine the association of inflammatory cytokines with thrombocytosis. Results We found that thrombocytosis was the only variable that predicted prognosis. Fifty-five patients (1.5%) had thrombocytosis. Thrombocytosis was more prevalent in patients with IBC than in those with non-IBC (3.4% vs. 1.4%, p  = 0.015). In patients with IBC, thrombocytosis was associated with worse overall survival [hazard ratio 2.38, 95% confidence interval (CI) 1.05–5.4, p  = 0.0378]. Circulating levels of growth-regulated oncogene (GRO) (odds ratio 1.003, 95% CI 1.001–1.005, p  = 0.0019) and transforming growth factor β (TGF-β) (odds ratio 1.3, 95% CI 1.128–1.499, p  = 0.0003) were associated with thrombocytosis. Conclusions Thrombocytosis was more prevalent in patients with IBC than in those with non-IBC and it was associated with poor prognosis. GRO and TGF-β were associated with thrombocytosis in IBC.