Journal of Obstetrics and Gynaecology
ISSN: 0144-3615 (Print) 1364-6893 (Online) Journal homepage: http://www.tandfonline.com/loi/ijog20
Confounding factors should be considered in mean platelet volume evaluation in endometrial cancer E. Varol & M. Ozaydin To cite this article: E. Varol & M. Ozaydin (2014) Confounding factors should be considered in mean platelet volume evaluation in endometrial cancer, Journal of Obstetrics and Gynaecology, 34:5, 455-455 To link to this article: http://dx.doi.org/10.3109/01443615.2013.874985
Published online: 10 Jan 2014.
Submit your article to this journal
Article views: 50
View related articles
View Crossmark data
Full Terms & Conditions of access and use can be found at http://www.tandfonline.com/action/journalInformation?journalCode=ijog20 Download by: [University of California, San Diego]
Date: 08 November 2015, At: 06:20
Journal of Obstetrics and Gynaecology, July 2014; 34: 455 © 2014 Informa UK, Ltd. ISSN 0144-3615 print/ISSN 1364-6893 online
LETTER TO THE EDITOR
Confounding factors should be considered in mean platelet volume evaluation in endometrial cancer E. Varol & M. Ozaydin
Downloaded by [University of California, San Diego] at 06:20 08 November 2015
Department of Cardiology, Faculty of Medicine, Suleyman Demirel University, Isparta, Turkey
Dear Sir, We read the paper by Oge and colleagues (2013) with great interest. They compared the mean platelet volume (MPV) in patients with advanced-stage endometrial cancer, early-stage endometrial cancer and healthy controls. In their study, MPV in all patients with endometrial cancer was slightly higher than in the controls. MPV was also significantly higher in patients with advanced-stage endometrial cancer than in patients with early-stage endometrial cancer. Although the study is retrospective, the sample size is large and we congratulate the authors for this study. However, we want to make a minor criticism about this study from the methodological aspect. MPV is associated with many confounding factors. There are significant associations of MPV with cardiovascular diseases and cardiovascular risk factors, including smoking, obesity, hypertension, diabetes mellitus, prediabetes, coronary artery disease, metabolic syndrome, stroke, and there are also significant associations of MPV with rheumatic and inflammatory diseases (Vizioli et al. 2009; Varol et al. 2013; Gasparyan et al. 2011). Although they considered the body mass index, they did not mention the smoking status, blood pressure levels, levels of glucose and cholesterol and any possible cardiovascular, inflammatory and rheumatic diseases. In addition, the patients and control subjects were overweight and they did not mention the presence and incidence of metabolic syndrome. Previous studies showed that hypertension, hypercholesterolaemia, diabetes mellitus, prediabetes, smoking, metabolic syndrome and cardiovascular, inflammatory and rheumatic diseases increase MPV (Vizioli L et al. 2009; Varol et al. 2013; Gasparyan et al. 2011). As a result, these factors should be considered. MPV is universally available with routine blood counts by automated haemograms and a simple and easy method of assessing platelet function. In comparison with smaller ones, larger platelets have more granules, aggregate more rapidly with collagen, have higher thromboxane A2 levels and express more glycoprotein Ib and IIb/IIIa receptors (Vizioli et al. 2009; Park et al. 2002). Tumours can produce cytokines, such as interleukin interferon-gamma and tumour necrosis factor, which in turn affects platelets production in bone marrow. Previous studies
showed that interleukin-6 (IL-6) levels were elevated in patients with endometrial cancer (Bellone et al. 2005). Platelet size is regulated at the level of the megakaryocyte. Researchers reported that cytokines such as interleukin-3 or interleukin-6 influence megakaryocyte ploidy and can lead to the production of more reactive and larger platelets (Debili et al. 1993). So IL-6, which is increased in patients with endometrial cancer can cause an increase in MPV values by stimulating the megakaryocyte ploidy. We believe that MPV can be affected by many inflammatory and cardiovascular risk factors. All these confounding factors should be considered in evaluating the MPV in endometrial cancers. Declaration of interest: The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the paper.
References Bellone S, Watts K, Cane’ S, Palmieri M, Cannon MJ, Burnett A et al. 2005. High serum levels of interleukin-6 in endometrial carcinoma are associated with uterine serous papillary histology, a highly aggressive and chemotherapy-resistant variant of endometrial cancer. Gynecologic Oncology 98:92–98. Debili N, Masse JM, Katz A, Guichard J, Breton-Gorius J, Vainchenker W. 1993. Effects of the recombinant hematopoietic growth factors interleukin-3, interleukin-6, stem cell factor, and leukemia inhibitory factor on the megakaryocytic differentiation of CD34 ⫹ cells. Blood 82:84–95. Gasparyan AY, Ayvazyan L, Mikhailidis DP, Kitas GD. 2011. Mean platelet volume: a link between thrombosis and inflammation? Current Pharmaceutical Design 17:47–58. Oge T, T Yalcin O, Ozalp SS, Isikci T. 2013. Platelet volume as a parameter for platelet activation in patients with endometrial cancer. Journal of Obstetrics and Gynaecology 33:301–304. Park Y, Schoene N, Harris W. 2002. Mean platelet volume as an indicator of platelet activation: methodological issues. Platelets 13:301–306. Varol E, Icli A, Kocyigit S, Erdogan D, Ozaydin M, Dogan A. 2013. Effect of smoking cessation on mean platelet volume. Clinical and Applied Thrombosis/Hemostasis 19:315–319. Vizioli L, Muscari S, Muscari A. 2009. The relationship of mean platelet volume with the risk and prognosis of cardiovascular diseases. International Journal of Clinical Practice 63:1509–1515.
Correspondence: E. Varol, Department of Cardiology, Faculty of Medicine, Suleyman Demirel University, Isparta, Turkey. E-mail: drercanvarol@ yahoo.com DOI: 10.3109/01443615.2013.874985
ISSN: 0144-3615 (Print) 1364-6893 (Online) Journal homepage: http://www.tandfonline.com/loi/ijog20
Confounding factors should be considered in mean platelet volume evaluation in endometrial cancer E. Varol & M. Ozaydin To cite this article: E. Varol & M. Ozaydin (2014) Confounding factors should be considered in mean platelet volume evaluation in endometrial cancer, Journal of Obstetrics and Gynaecology, 34:5, 455-455 To link to this article: http://dx.doi.org/10.3109/01443615.2013.874985
Published online: 10 Jan 2014.
Submit your article to this journal
Article views: 50
View related articles
View Crossmark data
Full Terms & Conditions of access and use can be found at http://www.tandfonline.com/action/journalInformation?journalCode=ijog20 Download by: [University of California, San Diego]
Date: 08 November 2015, At: 06:20
Journal of Obstetrics and Gynaecology, July 2014; 34: 455 © 2014 Informa UK, Ltd. ISSN 0144-3615 print/ISSN 1364-6893 online
LETTER TO THE EDITOR
Confounding factors should be considered in mean platelet volume evaluation in endometrial cancer E. Varol & M. Ozaydin
Downloaded by [University of California, San Diego] at 06:20 08 November 2015
Department of Cardiology, Faculty of Medicine, Suleyman Demirel University, Isparta, Turkey
Dear Sir, We read the paper by Oge and colleagues (2013) with great interest. They compared the mean platelet volume (MPV) in patients with advanced-stage endometrial cancer, early-stage endometrial cancer and healthy controls. In their study, MPV in all patients with endometrial cancer was slightly higher than in the controls. MPV was also significantly higher in patients with advanced-stage endometrial cancer than in patients with early-stage endometrial cancer. Although the study is retrospective, the sample size is large and we congratulate the authors for this study. However, we want to make a minor criticism about this study from the methodological aspect. MPV is associated with many confounding factors. There are significant associations of MPV with cardiovascular diseases and cardiovascular risk factors, including smoking, obesity, hypertension, diabetes mellitus, prediabetes, coronary artery disease, metabolic syndrome, stroke, and there are also significant associations of MPV with rheumatic and inflammatory diseases (Vizioli et al. 2009; Varol et al. 2013; Gasparyan et al. 2011). Although they considered the body mass index, they did not mention the smoking status, blood pressure levels, levels of glucose and cholesterol and any possible cardiovascular, inflammatory and rheumatic diseases. In addition, the patients and control subjects were overweight and they did not mention the presence and incidence of metabolic syndrome. Previous studies showed that hypertension, hypercholesterolaemia, diabetes mellitus, prediabetes, smoking, metabolic syndrome and cardiovascular, inflammatory and rheumatic diseases increase MPV (Vizioli L et al. 2009; Varol et al. 2013; Gasparyan et al. 2011). As a result, these factors should be considered. MPV is universally available with routine blood counts by automated haemograms and a simple and easy method of assessing platelet function. In comparison with smaller ones, larger platelets have more granules, aggregate more rapidly with collagen, have higher thromboxane A2 levels and express more glycoprotein Ib and IIb/IIIa receptors (Vizioli et al. 2009; Park et al. 2002). Tumours can produce cytokines, such as interleukin interferon-gamma and tumour necrosis factor, which in turn affects platelets production in bone marrow. Previous studies
showed that interleukin-6 (IL-6) levels were elevated in patients with endometrial cancer (Bellone et al. 2005). Platelet size is regulated at the level of the megakaryocyte. Researchers reported that cytokines such as interleukin-3 or interleukin-6 influence megakaryocyte ploidy and can lead to the production of more reactive and larger platelets (Debili et al. 1993). So IL-6, which is increased in patients with endometrial cancer can cause an increase in MPV values by stimulating the megakaryocyte ploidy. We believe that MPV can be affected by many inflammatory and cardiovascular risk factors. All these confounding factors should be considered in evaluating the MPV in endometrial cancers. Declaration of interest: The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the paper.
References Bellone S, Watts K, Cane’ S, Palmieri M, Cannon MJ, Burnett A et al. 2005. High serum levels of interleukin-6 in endometrial carcinoma are associated with uterine serous papillary histology, a highly aggressive and chemotherapy-resistant variant of endometrial cancer. Gynecologic Oncology 98:92–98. Debili N, Masse JM, Katz A, Guichard J, Breton-Gorius J, Vainchenker W. 1993. Effects of the recombinant hematopoietic growth factors interleukin-3, interleukin-6, stem cell factor, and leukemia inhibitory factor on the megakaryocytic differentiation of CD34 ⫹ cells. Blood 82:84–95. Gasparyan AY, Ayvazyan L, Mikhailidis DP, Kitas GD. 2011. Mean platelet volume: a link between thrombosis and inflammation? Current Pharmaceutical Design 17:47–58. Oge T, T Yalcin O, Ozalp SS, Isikci T. 2013. Platelet volume as a parameter for platelet activation in patients with endometrial cancer. Journal of Obstetrics and Gynaecology 33:301–304. Park Y, Schoene N, Harris W. 2002. Mean platelet volume as an indicator of platelet activation: methodological issues. Platelets 13:301–306. Varol E, Icli A, Kocyigit S, Erdogan D, Ozaydin M, Dogan A. 2013. Effect of smoking cessation on mean platelet volume. Clinical and Applied Thrombosis/Hemostasis 19:315–319. Vizioli L, Muscari S, Muscari A. 2009. The relationship of mean platelet volume with the risk and prognosis of cardiovascular diseases. International Journal of Clinical Practice 63:1509–1515.
Correspondence: E. Varol, Department of Cardiology, Faculty of Medicine, Suleyman Demirel University, Isparta, Turkey. E-mail: drercanvarol@ yahoo.com DOI: 10.3109/01443615.2013.874985
