Background:Patients with ovarian cancer have high platelet counts, which correlate with disease burden, incidence, and lethality of blood clots (thrombosis). We hypothesized that elevated aggregation is associated with both increased platelet number and altered behavior of platelets in patients with ovarian cancer.Methods:Healthy controls and patients with suspected or diagnosed ovarian cancer were evaluated for complete blood counts. To evaluate the effects of platelet count versus platelet behavior, equal platelet-rich plasma (PRP) volumes versus equal platelet numbers were used in platelet aggregation assays. Arachidonic acid, adenosine diphosphate, and collagen platelet agonists were used to induce aggregation. Volunteers were grouped into healthy controls (23), benign/borderline cases (7), and cancer cases (25 ovarian, 1 colorectal, and 2 endometrial).Results:The rate and amount of platelet aggregation were higher in patients compared to healthy controls regardless of whether the same platelet number or PRP volume was used. Compared to healthy controls, patients with untreated ovarian cancer exhibited high levels of platelet activation markers, P-selectin (27.06 vs. 31.06 ng/mL,p= 0.03), and beta-thromboglobulin (3.073 vs. 4.091 µg/mL,p= 0.02) in their plasma. The significance of the elevation and its correlations with platelet number or PRP volume varied depending on the agonist. Platelet (305.88 vs. 134.12,p< 0.0001) and white blood cell (8.459 vs. 5.395,p< 0.01) counts (×109/L) were elevated pre-chemotherapy and decreased post-chemotherapy, respectively.Conclusions:Elevated platelet aggregation is caused by both altered platelet number and behavior in patients with ovarian cancer. These results support the study of antiplatelet agents for thrombosis prevention in these patients.
背景：卵巢癌患者常伴有血小板计数升高，这与疾病负荷、血栓发生率和致死率密切相关。我们假设血小板聚集功能增强与卵巢癌患者血小板数量增加及功能改变均存在关联。 方法：对健康对照者及疑似或确诊卵巢癌患者进行全血细胞计数检测。为区分血小板数量与功能的影响，在血小板聚集实验中分别采用等体积富血小板血浆与等量血小板进行检测。使用花生四烯酸、二磷酸腺苷和胶原作为血小板激动剂诱导聚集。研究对象分为健康对照组（23例）、良性/交界性病例组（7例）及恶性肿瘤组（卵巢癌25例、结直肠癌1例、子宫内膜癌2例）。 结果：无论采用等量血小板还是等体积富血小板血浆，患者组的血小板聚集速率和程度均显著高于健康对照组。与健康对照相比，未经治疗的卵巢癌患者血浆中血小板活化标志物P-选择素（27.06 vs. 31.06 ng/mL，p=0.03）和β-血小板球蛋白（3.073 vs. 4.091 µg/mL，p=0.02）水平显著升高。升高程度及其与血小板数量或富血小板血浆体积的相关性因激动剂种类而异。化疗前血小板计数（305.88 vs. 134.12，p<0.0001）和白细胞计数（8.459 vs. 5.395，p<0.01）（×10⁹/L）显著升高，化疗后均出现下降。 结论：卵巢癌患者血小板聚集功能增强是由血小板数量改变和功能异常共同导致的。这些结果为在该类患者中开展抗血小板药物预防血栓的研究提供了理论依据。
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