Prognostic significance of mean platelet volume in lung cancer patients: A meta-analysis

Abstract

\n Background Lung cancer is the most prevalent cancer globally with a grim prognosis alongside a very high number of cancer-related deaths. Mean platelet volume (MPV) is the measure of platelet size and is considered a surrogate marker of platelet activation. Low MPV indicates exhausted platelets causing worse outcomes in cancer patients. As the correlation between platelet count/platelet size and lung cancer prognosis still remains a topic of debate, this meta-analysis was done to comprehensively evaluate the prognostic significance of MPV among lung cancer patients.Methods A systematic search of electronic databases PubMed, Embase, and Google scholar and additional sources for relevant studies were done with no language restrictions from inception to 7th May 2021. Overall Survival (OS) and Disease-Free Survival (DFS)/Progression-Free Survival (PFS) and hazard ratio (HR) with 95% Confidence Interval (CI) were pooled to evaluate the relation of MPV with OS/DFS. Subgroup analysis based on cancer type, clinical stage, sample size, median age, cut-off value, and study region was done to identify the cause of significant heterogeneity.Results Eleven studies with 2421 lung cancer patients were included in our analysis. Our analysis showed no significant association between MPV levels with OS (H.R.:1.07, 95%C.I.:0.84–1.35, p\u2009=\u20090.60) and DFS/PFS (HR:1.04, 95%C.I.:0.68–1.60, p\u2009=\u20090.84). Under subgroup analysis, studies conducted in countries other than China (HR:1.53, 95% C.I.=1.14–2.03, p\u2009<\u20090.001, I2\u2009=\u200942.11%) and studies with advanced-stage lung cancer patients (HR: 1.84, 95% C.I.=1.19–2.82, p-value\u2009=\u20090.01, I2\u2009=\u20090%) showed significant association between MPV levels and worse DFS/PFS.Conclusion Pretreatment MPV levels did not show prognostic significance except in advanced lung cancer cases. Large multicentric studies with large samples and long follow-up times are necessary.