Platelet Indices in Uterine Leiomyoma Compared with other Major Gynecological Diseases
Journal of Advances in Medicine and Medical Research,
Page 164-176
DOI:
10.9734/jammr/2020/v32i2430764
Abstract
Aims: The aim of this study was to determine whether platelet indices are of value when diagnosing uterine leiomyomas.
Study Design: Prospective study.
Place and Duration of Study: Elena Doamna Obstetrics and Gynecology University Hospital, Iasi, Romania, between January 2017 and December 2017.
Methodology: In this study 98 patients were selected from 140 consecutive screened patients and operated upon; 53 of the operated-on patients had uterine leiomyoma (Group 1) and 45 had severe non-leiomyoma gynecological disease (Group 2). Complete blood count, just before the intervention was studied.
Results: The RDW-CV, PLT and PCT values were significantly higher (P = .017, P = .05, P = .001, respectively) in leiomyoma patients, whereas WBC, RBC, MPV, PDW, P-LCR, NLR, PLR were not significantly different between the 2 groups. The inflammatory indices WBC, NLR and PLR were not significantly higher in leiomyoma patients compared with non-leiomyoma patients, despite the fact that leiomyoma also has an inflammatory cause. Although leiomyomas were accompanied by acute or chronic blood loss, only RDW-CV was significantly higher (P = .017) in leiomyoma patients, whereas HCT and RBC values were not significantly different between the 2 groups.
Conclusion: The RDW-CV, PLT and PCT values were significantly higher in leiomyoma patients, whereas WBC, RBC, MPV, PDW, P-LCR, NLR, PLR were not significantly different. Still, the specificity of RDW-CV, PLT and PCT was not high enough to allow using them as diagnostic tools for leiomyoma.
Keywords:
- Uterine leiomyoma
- platelet indices
- white blood cells count
- red blood cells count
- hematocrit.
How to Cite
CovaliR., SocolovD., PavaleanuI., CarauleanuA., & SocolovR. (2020). Platelet Indices in Uterine Leiomyoma Compared with other Major Gynecological Diseases. Journal of Advances in Medicine and Medical Research, 32(24), 164-176. https://doi.org/10.9734/jammr/2020/v32i2430764
References
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Bailey SER, Ukoumunne OC, Shephard E, Hamilton W. How useful is thrombocytosis in predicting and underlying cancer in primary care? Fam Pract. 2017;34(1):4-10.
doi: 10.1093/fampra/cmw100. Epub 2016 Sep 28.
Sherma D, Singh G. Thrombocytosis ingynecological cancers. J Cancer Res Ther. 2017;13(2):193-197.
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Fu S, Niu Y, Zhang X, Zhang JR, Liu ZP, Wang RT. Squamous cell carcinoma antigen, platelete distribution width, and prealbumin collectively as a marker of squamous cell carcinoma. Cancer Biomark. 2018;21(2):317-321.
DOI: 10.3233/CBM-170442.
Nakamura K, Nakayama K, Tatsumi N et al. Prognostic significance of pre-treatment neutrophil-to-lymphocyte and platelet-to-lymphocyte ratios in non-surgically treated uterine cervical carcinoma. Mol Clin Oncol. 2018;9(2):138-144.
DOI: 10.3892/mco/2018.1646. Epub 2018 Jun 5.
Zhu B, Chen Y, Shen X, Liu X, Guo SW. Anti-platelet therapy holds promises in treating adenomyosis: experimental evidence. Reprod Biol Endocrinol. 2016;14(1):66.
DOI: 10.1186/s12958/-016-0198-1.
Kurtoglu E, Kokcu A, Celik H, Sari S, Tosun M. Platelet indices may be useful in discrimination of benign and malign endometrial lesions and early and advanced stage endometrial cancer. Asian Pac J Cancer Prev.2015;16(13):5397-400. DOI: 10/7314/apjcp.2015.16.13.5397.
Forget P, Khalifa C, Defour JP et al. What is the normal value of the neutrophil-to-lymphocyte ratio? BMC Res Notes. 2017;10-12.
Published online 2017 Jan 3.
DOI: 10.1186/s13104-016-2335-5.
Giovanetti TV, Nascimento do AJ, Paula de JP. Platelet indices: laboratory and clinical applications. Rev Bras Hematol Hemoter. 2011;33(2):164-165.
DOI: 10.5581/1516-8484.20110040.
Ganguli S, Faintuch S, Salazar GM, Rabkin DJ. Postembolisation syndrome: changes in white blood cell counts immediately after uterine artery embolization. J Vasc Interv Radiol. 2008;19(3):443-5.
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Hou R, Wang L, Li S et al. Pilot study: safety and effectiveness of simple ultrasound-guided high-intensity focused ultrasound ablating uterine leiomyoma with a diameter greater than 10cm. Br J Radiol. 2018;91(1082):20160950.
Epub 2017 Nov 21.
Ono Y, Hidaka T, Fukuta K et al. A case of myomatous erythrocytosis syndrome associated with a large uterine leiomyoma. Case Rep Obstet Gynecol. 2014;602139.
DOI: 10.1155/2014/602755.
Epub 2017 Jan 14.
De Boer J, Velders G, Aliredjo R, Scheenjes E, Flinsenberg TWH. Polycythaemia in a patient with uterus myomatosus. Ned Tijdschr Geneeskd. 2017;161:D1161.
Wang L, Jia J, Lin L et al. Predictive value of hematological markers of systemic inflammation for managing cervical cancer. Oncotarget. 2017;8(27):44824-44832.
DOI: 10.18632/oncotarget.14027.
Yayla Abide C, Bostanci Ergen E, Cogendez E et al. Evaluation of complete blood count parameters to predict endometrial cancer. J Clin Lab Anal. 2018; 22438.
DOI: 10.1002/jcla.22438.
Epub ahead of print.
Weilbach C, Scheinichen D, Jüttner B, Schürholz, Piepenbrock S. Excessive blood loss after abdominal hysterectomy – use of recombinant factor VIIa. Anasthesiol Intensivmed Notfallmed Schnerther. 2004;39(11):672-5.
Hnat RF, Anderson GG, Alonzo DR. Diffuse intravascular coagulation associated with a degenerating myoma during pregnancy. Obstet Gynecol. 1967;29(2):207-10.
Kitao K, Ohara N, Funakoshi T et al. Comsumptive coagulopathy that developed in a pregnant woman with degenerated uterine leiomyoma: case report. Clin Exp Obstet Gynecol. 2005;32(4):250.
Harris MG, Bannatyne P, Russel P, Atkinson K, Rickard KA, Kronenberg H. Chronic consumptive coagulopathy with a uterine leiomyoma. Aust NZ Obstet Gynaecol. 1982;22(1):54-8.
Caputo R, Kanbour-Shakir A. Chronic disseminated intravascular coagulation caused by a uterine leiomyoma. A case report. J Reprod Med. 1993;38(9):737-40.
Taneichi A, Fujiwara H, Mizoguchi Y et al. Disseminated intravascular coagulopathy caused by uterine leiomyoma with sarcoma-like findings on magnetic resonance imaging. Case Rep Obstet Gynecol. 2014;978743.
DOI: 10.1155/2014/978743.
Liang M, Wang H, Zhang Y, Lu S, Wang Z. Expression and functional analysis of platelet-derived growth factor in uterine leiomyomata. Cancer Biol Ther. 2006;5(1):28-33.
Epub 2006 Jan 12.
Suo G, Jiang Y, Cowan B, Wang JY. Platelet-derived growth factor C is upregulated in human uterine fibroids and regulates uterine smooth muscle cell growth. Biol Reprod. 2009;81(4):749-58.
DOI: 10.1095/biolreprod.109.076888.
Aricigil M, Dündar MA, Yücel A, Arbag H, Aziz SK. Can platelet and leukocyte indicators give us an idea about distant metastasis in nasopharyngeal cancer? Prague Med Rep. 2017;118(1):49-59.
DOI: 10.14712/23362936.2017.5.
Li H, Wang Y, Liu Z et al. Lack of association between platelet indices and disease stage in osteosarcoma at diagnosis. PLoS One. 2017;12(4): e0174668.
DOI:10.1371/journal.pone.0174668. eCollection 2017.
Dincel O, Bayraktar C. Evaluation of platelet indices as a useful marker in papillary thyroid carcinoma. Bratisl Lek Listy. 2017;118(3):153-155.
DOI: 10.4149/BLL_2017_030.
Li S, Cao W, Sun X. Role of platelet parameters on neovascular glaucoma: a retrospective case-control study in China. PLoS One. 2016;11(12):e0166893. DOI:10.1371/journal.pone.0166893. eCollection 2016.
Shilpi K, Potekar RM. A study of platelet indices in type 2 diabetes mellitus patients. Indian J Hematol Blood Transfus. 2018;34(1):115-120.
DOI:10.1007/s12288-017-0825-9. Epub 2017 May 8.
Liang Q, Lei XJ, Li HB et al. Regression analysis of red cell distribution width and mean platelet volume in patients with acute myocardial infarction. Nan Fang Yi Ke Da Xue Xue Bao. 2017;37(8):1022-1027.
Ersoy AO, Ozler S, Oztas E, Ersoy E, Kirbas A, Danisman N. The association between placenta praevia and leukocyte and platelet indices – a case control study. Ginekol Pol. 2016;87(5):367-71.
DOI: 10.5603/GP.2016.0006.
Yücel B, Ustun B. Neutrophil to lymphocyte ratio, platelet to lymphocyte ratio, mean platelet volume, red cell distribution width and plateletcrit in preeclampsia. Pregnancy Hypertens. 2017;7:29-32.
DOI: 10.1016/j.preghy.2016.12.002.
Epub 2016 Dec 23.
Karateke A, Kaplaoglu M, Baloglu A. Relations of platelet indices with endometrial hyperplasia and endometrial cancer. Asian Pac J Cancer Prev. 2015;16(12):4905-8.
Peng F, Li Z, Yi C et al. Platelet index levels and cardiovascular mortality in incident peritoneal dialysis patients: a cohort study. Platelets. 2017;28(6):576-584.
DOI:10.1080/09537104.2016.1246716. Epub 2016 Nov 20.
Isik H, Aynioglu O, Sahbaz A et al. Can plateletcrit, an underestimated platelet parameter, be related with preterm labour? J Obstet Gynaecol. 2015;35(7):676-80. DOI:10.3109/01443615.2105.1004530. Epub 2015 Feb 16.
Sarangi R, Pradhan S, Dhanawat A, Ptanayak R, Benia G. Thrombocytosis in children: clinico-hematological profile from a single centre in eastern India. J Lab Physicians. 2018;10(1):34-37.
DOI: 10.4103/JLP.JLP_90_17.
Song A, Eo W, Lee S. Comparison of selected inflammation-based prognostic markers in relapsed or refractory metastatic colorectal cancer patients. World J Gastroenterol. 2015;21(43):12410-20.
DOI:10.3748/wjg.v21.i43.12410
Neal CP, Cairns V, Jones MJ et al. Prognostic performance of inflammation-based prognostic indices in patients with resectable colorectal liver metastases. Med Oncol. 2015;32(5):144.
DOI:10.1007/s12032-015-0590-2.
Epub 2015 Mar 26.
Kwon HC, Kim SH, Oh SY et al. Clinical significance of preoperative neutrophil-lymphocyte versus platelet-lymphocyte ratio in patients with operable colorectal cancer. Biomarkers. 2012;17(3):216-22.
DOI:10.3109/1354750X.2012.656705. Epub 2012 Mar 17.
Yang W, Wang X, Zhang W et al. Neutrophil-lymphocyte ratio and platelet-lymphocyte ratio are 2 new inflammatory markers associated with pulmonary involvement and disease activity in patients with dermatomyositis. Clin Chim Acta. 2017;465:11-16.
DOI: 10.1016/j.cca.2016.12.007.
Epub 2016 Dec 10.
Prodromidou A, Andreakos P, Kazakos C, Vlachos DE, Perrea D, Pergialiotis V. The diagnostic efficacy of platelet-to lymphocyte ratio and neutrophil-to-lymphocyte ratio in ovarian cancer. Inflamm Res. 2017;66(6):467-475.
DOI:10.1007/s00011-017-1026-6.
Epub 2017 Mar 4.
Mazza MG, Lucchi S, Tringali AGM, Rossetti A, Botti ER, Clerici M. Neutrophil/lymphocyte ratio and platelet/lymphocyte ratio in mood disorders: a meta-analysis. Prog Neuropsychopharmacol Biol Psychiatry. 2018;84(Pt A):229-236.
DOI: 10.1016/j.pnpbp.2018.03.012.
Epub ahead of print.
Durmus E, Kivrak T, Gerin F, Sunbul M, Sari I, Erdogan O. Neutrophil-to-lymphocyte ratio and platelet-to-lymphocyte ratio are predictors of heart failure. Arq Bras Cardiol. 2015;105(6):606-613.
DOI: 10.5935/abc.20150126.
Huang XZ, Chen WJ, Zhang X et al. An elevated platelet-to-lymphocyte ratio predicts poor prognosis and clinicopathological characteristics in patients with colorectal cancer: a meta-analysis. Dis Markers. 2017;1053125. Published online 2017 Apr 26.
DOI: 10.1155/2017/1053125.
Machairas N, Kostakis ID, Prodromidou A et al. Trends in white blood cell and platelet indices in a comparison of patients with papillary thyroid carcinoma and multinodular goiter.
Tayfur C, Burcu DC, Gulten O et al. Association between platelet to lymphocyte ratio, plateletcrit and the presence and severity of hyperemesis gravidarum. J Obstet Gynaecol Res. 2017;43(3):498- 504.
DOI: 10.1111/jog.13228.
Epub 2017 Feb 4
Kalemci S, Akin F, Sarihan A, Sahin C, Zeybek A, Yilmaz N. The relationship between hematological parameters and the severity level of chronic obstructive lung disease. Pol Arch Intern Med.; 2018.
DOI: 10.20452/pamw.4198
Epub ahead of print
Epub 2015 Dec 23.
Butkiewicz AM, Kemona H, Dymicka-Piekarska V, Matowicka-Karna J, Radziwon P, Lipska A. Platelet count, mean platelet volume and thrombocytopoietic indices in healthy women and men. Thromb Rs. 2006;118(2):199-204.
DOI:10.1016/j.thromres.2005.06.021. Epub 2005 Sep 1.
Bailey SER, Ukoumunne OC, Shephard E, Hamilton W. How useful is thrombocytosis in predicting and underlying cancer in primary care? Fam Pract. 2017;34(1):4-10.
doi: 10.1093/fampra/cmw100. Epub 2016 Sep 28.
Sherma D, Singh G. Thrombocytosis ingynecological cancers. J Cancer Res Ther. 2017;13(2):193-197.
DOI: 10.4103/0973-1482.189234.
Fu S, Niu Y, Zhang X, Zhang JR, Liu ZP, Wang RT. Squamous cell carcinoma antigen, platelete distribution width, and prealbumin collectively as a marker of squamous cell carcinoma. Cancer Biomark. 2018;21(2):317-321.
DOI: 10.3233/CBM-170442.
Nakamura K, Nakayama K, Tatsumi N et al. Prognostic significance of pre-treatment neutrophil-to-lymphocyte and platelet-to-lymphocyte ratios in non-surgically treated uterine cervical carcinoma. Mol Clin Oncol. 2018;9(2):138-144.
DOI: 10.3892/mco/2018.1646. Epub 2018 Jun 5.
Zhu B, Chen Y, Shen X, Liu X, Guo SW. Anti-platelet therapy holds promises in treating adenomyosis: experimental evidence. Reprod Biol Endocrinol. 2016;14(1):66.
DOI: 10.1186/s12958/-016-0198-1.
Kurtoglu E, Kokcu A, Celik H, Sari S, Tosun M. Platelet indices may be useful in discrimination of benign and malign endometrial lesions and early and advanced stage endometrial cancer. Asian Pac J Cancer Prev.2015;16(13):5397-400. DOI: 10/7314/apjcp.2015.16.13.5397.
Forget P, Khalifa C, Defour JP et al. What is the normal value of the neutrophil-to-lymphocyte ratio? BMC Res Notes. 2017;10-12.
Published online 2017 Jan 3.
DOI: 10.1186/s13104-016-2335-5.
Giovanetti TV, Nascimento do AJ, Paula de JP. Platelet indices: laboratory and clinical applications. Rev Bras Hematol Hemoter. 2011;33(2):164-165.
DOI: 10.5581/1516-8484.20110040.
Ganguli S, Faintuch S, Salazar GM, Rabkin DJ. Postembolisation syndrome: changes in white blood cell counts immediately after uterine artery embolization. J Vasc Interv Radiol. 2008;19(3):443-5.
DOI: 10.1016/j.jvir.2007.11.021.
Hou R, Wang L, Li S et al. Pilot study: safety and effectiveness of simple ultrasound-guided high-intensity focused ultrasound ablating uterine leiomyoma with a diameter greater than 10cm. Br J Radiol. 2018;91(1082):20160950.
Epub 2017 Nov 21.
Ono Y, Hidaka T, Fukuta K et al. A case of myomatous erythrocytosis syndrome associated with a large uterine leiomyoma. Case Rep Obstet Gynecol. 2014;602139.
DOI: 10.1155/2014/602755.
Epub 2017 Jan 14.
De Boer J, Velders G, Aliredjo R, Scheenjes E, Flinsenberg TWH. Polycythaemia in a patient with uterus myomatosus. Ned Tijdschr Geneeskd. 2017;161:D1161.
Wang L, Jia J, Lin L et al. Predictive value of hematological markers of systemic inflammation for managing cervical cancer. Oncotarget. 2017;8(27):44824-44832.
DOI: 10.18632/oncotarget.14027.
Yayla Abide C, Bostanci Ergen E, Cogendez E et al. Evaluation of complete blood count parameters to predict endometrial cancer. J Clin Lab Anal. 2018; 22438.
DOI: 10.1002/jcla.22438.
Epub ahead of print.
Weilbach C, Scheinichen D, Jüttner B, Schürholz, Piepenbrock S. Excessive blood loss after abdominal hysterectomy – use of recombinant factor VIIa. Anasthesiol Intensivmed Notfallmed Schnerther. 2004;39(11):672-5.
Hnat RF, Anderson GG, Alonzo DR. Diffuse intravascular coagulation associated with a degenerating myoma during pregnancy. Obstet Gynecol. 1967;29(2):207-10.
Kitao K, Ohara N, Funakoshi T et al. Comsumptive coagulopathy that developed in a pregnant woman with degenerated uterine leiomyoma: case report. Clin Exp Obstet Gynecol. 2005;32(4):250.
Harris MG, Bannatyne P, Russel P, Atkinson K, Rickard KA, Kronenberg H. Chronic consumptive coagulopathy with a uterine leiomyoma. Aust NZ Obstet Gynaecol. 1982;22(1):54-8.
Caputo R, Kanbour-Shakir A. Chronic disseminated intravascular coagulation caused by a uterine leiomyoma. A case report. J Reprod Med. 1993;38(9):737-40.
Taneichi A, Fujiwara H, Mizoguchi Y et al. Disseminated intravascular coagulopathy caused by uterine leiomyoma with sarcoma-like findings on magnetic resonance imaging. Case Rep Obstet Gynecol. 2014;978743.
DOI: 10.1155/2014/978743.
Liang M, Wang H, Zhang Y, Lu S, Wang Z. Expression and functional analysis of platelet-derived growth factor in uterine leiomyomata. Cancer Biol Ther. 2006;5(1):28-33.
Epub 2006 Jan 12.
Suo G, Jiang Y, Cowan B, Wang JY. Platelet-derived growth factor C is upregulated in human uterine fibroids and regulates uterine smooth muscle cell growth. Biol Reprod. 2009;81(4):749-58.
DOI: 10.1095/biolreprod.109.076888.
Aricigil M, Dündar MA, Yücel A, Arbag H, Aziz SK. Can platelet and leukocyte indicators give us an idea about distant metastasis in nasopharyngeal cancer? Prague Med Rep. 2017;118(1):49-59.
DOI: 10.14712/23362936.2017.5.
Li H, Wang Y, Liu Z et al. Lack of association between platelet indices and disease stage in osteosarcoma at diagnosis. PLoS One. 2017;12(4): e0174668.
DOI:10.1371/journal.pone.0174668. eCollection 2017.
Dincel O, Bayraktar C. Evaluation of platelet indices as a useful marker in papillary thyroid carcinoma. Bratisl Lek Listy. 2017;118(3):153-155.
DOI: 10.4149/BLL_2017_030.
Li S, Cao W, Sun X. Role of platelet parameters on neovascular glaucoma: a retrospective case-control study in China. PLoS One. 2016;11(12):e0166893. DOI:10.1371/journal.pone.0166893. eCollection 2016.
Shilpi K, Potekar RM. A study of platelet indices in type 2 diabetes mellitus patients. Indian J Hematol Blood Transfus. 2018;34(1):115-120.
DOI:10.1007/s12288-017-0825-9. Epub 2017 May 8.
Liang Q, Lei XJ, Li HB et al. Regression analysis of red cell distribution width and mean platelet volume in patients with acute myocardial infarction. Nan Fang Yi Ke Da Xue Xue Bao. 2017;37(8):1022-1027.
Ersoy AO, Ozler S, Oztas E, Ersoy E, Kirbas A, Danisman N. The association between placenta praevia and leukocyte and platelet indices – a case control study. Ginekol Pol. 2016;87(5):367-71.
DOI: 10.5603/GP.2016.0006.
Yücel B, Ustun B. Neutrophil to lymphocyte ratio, platelet to lymphocyte ratio, mean platelet volume, red cell distribution width and plateletcrit in preeclampsia. Pregnancy Hypertens. 2017;7:29-32.
DOI: 10.1016/j.preghy.2016.12.002.
Epub 2016 Dec 23.
Karateke A, Kaplaoglu M, Baloglu A. Relations of platelet indices with endometrial hyperplasia and endometrial cancer. Asian Pac J Cancer Prev. 2015;16(12):4905-8.
Peng F, Li Z, Yi C et al. Platelet index levels and cardiovascular mortality in incident peritoneal dialysis patients: a cohort study. Platelets. 2017;28(6):576-584.
DOI:10.1080/09537104.2016.1246716. Epub 2016 Nov 20.
Isik H, Aynioglu O, Sahbaz A et al. Can plateletcrit, an underestimated platelet parameter, be related with preterm labour? J Obstet Gynaecol. 2015;35(7):676-80. DOI:10.3109/01443615.2105.1004530. Epub 2015 Feb 16.
Sarangi R, Pradhan S, Dhanawat A, Ptanayak R, Benia G. Thrombocytosis in children: clinico-hematological profile from a single centre in eastern India. J Lab Physicians. 2018;10(1):34-37.
DOI: 10.4103/JLP.JLP_90_17.
Song A, Eo W, Lee S. Comparison of selected inflammation-based prognostic markers in relapsed or refractory metastatic colorectal cancer patients. World J Gastroenterol. 2015;21(43):12410-20.
DOI:10.3748/wjg.v21.i43.12410
Neal CP, Cairns V, Jones MJ et al. Prognostic performance of inflammation-based prognostic indices in patients with resectable colorectal liver metastases. Med Oncol. 2015;32(5):144.
DOI:10.1007/s12032-015-0590-2.
Epub 2015 Mar 26.
Kwon HC, Kim SH, Oh SY et al. Clinical significance of preoperative neutrophil-lymphocyte versus platelet-lymphocyte ratio in patients with operable colorectal cancer. Biomarkers. 2012;17(3):216-22.
DOI:10.3109/1354750X.2012.656705. Epub 2012 Mar 17.
Yang W, Wang X, Zhang W et al. Neutrophil-lymphocyte ratio and platelet-lymphocyte ratio are 2 new inflammatory markers associated with pulmonary involvement and disease activity in patients with dermatomyositis. Clin Chim Acta. 2017;465:11-16.
DOI: 10.1016/j.cca.2016.12.007.
Epub 2016 Dec 10.
Prodromidou A, Andreakos P, Kazakos C, Vlachos DE, Perrea D, Pergialiotis V. The diagnostic efficacy of platelet-to lymphocyte ratio and neutrophil-to-lymphocyte ratio in ovarian cancer. Inflamm Res. 2017;66(6):467-475.
DOI:10.1007/s00011-017-1026-6.
Epub 2017 Mar 4.
Mazza MG, Lucchi S, Tringali AGM, Rossetti A, Botti ER, Clerici M. Neutrophil/lymphocyte ratio and platelet/lymphocyte ratio in mood disorders: a meta-analysis. Prog Neuropsychopharmacol Biol Psychiatry. 2018;84(Pt A):229-236.
DOI: 10.1016/j.pnpbp.2018.03.012.
Epub ahead of print.
Durmus E, Kivrak T, Gerin F, Sunbul M, Sari I, Erdogan O. Neutrophil-to-lymphocyte ratio and platelet-to-lymphocyte ratio are predictors of heart failure. Arq Bras Cardiol. 2015;105(6):606-613.
DOI: 10.5935/abc.20150126.
Huang XZ, Chen WJ, Zhang X et al. An elevated platelet-to-lymphocyte ratio predicts poor prognosis and clinicopathological characteristics in patients with colorectal cancer: a meta-analysis. Dis Markers. 2017;1053125. Published online 2017 Apr 26.
DOI: 10.1155/2017/1053125.
Machairas N, Kostakis ID, Prodromidou A et al. Trends in white blood cell and platelet indices in a comparison of patients with papillary thyroid carcinoma and multinodular goiter.
Tayfur C, Burcu DC, Gulten O et al. Association between platelet to lymphocyte ratio, plateletcrit and the presence and severity of hyperemesis gravidarum. J Obstet Gynaecol Res. 2017;43(3):498- 504.
DOI: 10.1111/jog.13228.
Epub 2017 Feb 4
Kalemci S, Akin F, Sarihan A, Sahin C, Zeybek A, Yilmaz N. The relationship between hematological parameters and the severity level of chronic obstructive lung disease. Pol Arch Intern Med.; 2018.
DOI: 10.20452/pamw.4198
Epub ahead of print
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