{ "abstract": "Background: Systemic inflammation and thrombosis drive morbidity in gastric cancer (GC). The association between neutrophil-platelet aggregates (NPAs) and nutritional/body composition alterations remains poorly understood. Aims: To evaluate the association of NPAs with GC severity, patients nutrition, and body composition. Methods: In this prospective cohort, newly diagnosed patients and healthy controls were recruited. Tumor staging was based on the AJCC 8th edition, classified as early stage (I/II) and advanced disease (III/IV). Body composition was assessed by computed tomography; malnutrition and cachexia were defined by Global Leadership Initiative on Malnutrition (GLIM) criteria. We analyzed NPAs (CD66b+/CD41a+) and within these aggregates, the expression of P-selectin, activated GPIIb/IIIa (PAC-1), C-type lectin-like receptor-2 (CLEC-2), and podoplanin (PDPN) via flow cytometry (expressed as %). Statistics: Kruskal-Wallis with Dunn’s post-hoc and Spearman’s correlation (p < 0.05). Results: We evaluated 69 subjects; 29 healthy controls (55.2% male; median 55.0 years, IQR 50.0-62.0;) and 40 gastric cancer patients (60.0% male; median 62.0 years, IQR 48.0-70.0). 16 patients(40.0%) had early-stage disease (I/II) and 19 (47.5%) had advanced-stage disease (III/IV). Malnutrition was present in 29 patients (72.5%), cachexia in 16 (40.0%), and myosteatosis in 18 (45.0%). Compared with controls (29.3; 22.8–46.3), total NPAs were increased in patients with advanced-stage disease (49.5; 37.4–63.6; p = 0.004), cachexia (46.6; 29.6–61.8; p = 0.04), and those without myosteatosis (44.6; 28.5–50.0; p = 0.05). P-selectin expression in NPAs was elevated in both early-stage (53.1; 41.8–81.8; p = 0.02) and advanced-stage disease (61.1; 37.8–79.6; p = 0.008), as well as in patients with cachexia (67.5; 47.4–83.2; p = 0.001), without cachexia (51.4; 38.0–80.6; p = 0.02), mild (65.6; 47.0–84.6; p = 0.003) or severe malnutrition (69.3; 43.2–85.7; p = 0.002), and without myosteatosis (61.1; 41.2–83.9; p = 0.0003), compared with controls (29.7; 23.9–45.8). Visceral Fat Index (r = −0.4, p = 0.004) and Subcutaneous Fat Index (r = −0.4, p = 0.02) were inversely correlated with P-selectin expression. Compared with controls (64.2; 37.6–77.9), CLEC-2 expression in NPAs was increased in advanced-stage disease (90.9; 81.3–97.2; p = 0.0002), cachexia (90.8; 77.5–96.3; p = 0.0004), mild (88.2; 70.6–97.8; p = 0.01) and severe malnutrition (82.6; 75.7–90.9; p = 0.03), and in patients with (82.8; 69.3–93.2; p = 0.02) or without myosteatosis (83.2; 75.8–95.3; p = 0.0018). Visceral Fat Index was inversely correlated with CLEC-2 expression (r = −0.4, p = 0.03). PDPN expression in NPAs was consistently higher than in controls (4.5; 3.2–8.0) across all subgroups, including early-stage (13.8; 10.0–17.8; p < 0.0001) and advanced-stage disease (13.5; 6.8–16.7; p = 0.0003), patients with (13.2; 7.7–20.4; p = 0.0002) or without cachexia (13.5; 9.3–17.1; p < 0.0001), mild (14.0; 11.6–18.7; p < 0.0001) or severe malnutrition (12.3; 6.4–16.9; p = 0.006), and with (13.6; 10.0–17.5; p < 0.0001) or without myosteatosis (13.2; 7.1–18.7; p < 0.0001). PAC-1 expression differed only in patients with severe malnutrition (0.7; 0.1–1.8; p = 0.02). Conclusion: NPA-mediated platelet activation (P-selectin/CLEC-2) occurs early in GC and intensifies not only in advanced disease, but also, and particularly, with cachexia. These findings suggest an association between thromboinflammation and metabolic derangement in GC.", "abstract_shown": true, "affiliations": [ "Universidade Estadual de Campinas (UNICAMP), Campinas, Brazil" ], "article_type": null, "arxiv": null, "author_total": 17, "authors": [ { "affs": [ 0 ], "name": "Jose OLIVEIRA" }, { "affs": [ 0 ], "name": "Renata CONTRICIANI" }, { "affs": [ 0 ], "name": "Leo KIM" }, { "affs": [ 0 ], "name": "Larissa CARRILHO" }, { "affs": [ 0 ], "name": "Sandra BRANBILLA" }, { "affs": [ 0 ], "name": "Barbara CIPRIANO" }, { "affs": [ 0 ], "name": "Bruna ROBISON" }, { "affs": [ 0 ], "name": "Fabiana DA SILVA" }, { "affs": [ 0 ], "name": "Nicole NOVAIS" }, { "affs": [ 0 ], "name": "Fabíola ZARPELÃO" }, { "affs": [ 0 ], "name": "Juliana PEZZUTTI" }, { "affs": [ 0 ], "name": "Ananda SILVA" }, { "affs": [ 0 ], "name": "Luiz LOPES" }, { "affs": [ 0 ], "name": "Nelson ANDREOLLO" }, { "affs": [ 0 ], "name": "Maria MENDES" }, { "affs": [ 0 ], "name": "José CARVALHEIRA" }, { "affs": [ 0 ], "name": "Fernanda ORSI" } ], "bibtex": "https://research.draconitic.com/paper/3vp01pmsvsycj.bib", "cited_by": 0, "doi": "10.1016/j.htct.2026.108075", "fulltext_url": "http://www.sciencedirect.com/science/article/pii/S2531137926018225", "id": "3vp01pmsvsycj", "issns": [ "2531-1379", "2531-1387" ], "landing_url": "https://doi.org/10.1016/j.htct.2026.108075", "language": "en", "licence": "CC-BY", "licence_label": "CC BY", "licence_source": "journal", "licence_url": "https://creativecommons.org/licenses/by/4.0/", "metadata_licence": null, "native_subjects": [ [ "lcc", "RC633-647.5" ], [ "openalex", "2730|Inflammatory Biomarkers in Disease Prognosis" ] ], "openalex": "W7223153597", "pdf_url": null, "pmcid": null, "pmid": null, "published": "2026-10-23", "publisher": "Elsevier", "ris": "https://research.draconitic.com/paper/3vp01pmsvsycj.ris", "sources": [ { "first_seen": "2026-10-30T13:43:35Z", "native_id": "9863a026591c4309b93d161e640dde65", "source": "doaj", "url": "https://doi.org/10.1016/j.htct.2026.108075" } ], "subjects": [ { "field": "medicine", "origin": "openalex:2730|Inflammatory Biomarkers in Disease Prognosis", "subfield": "oncology" } ], "title": "ASSOCIATION BETWEEN NEUTROPHIL-PLATELET AGGREGATES, TUMOR STAGING AND NUTRITIONAL STATUS IN GASTRIC CANCER PATIENTS", "title_text": "ASSOCIATION BETWEEN NEUTROPHIL-PLATELET AGGREGATES, TUMOR STAGING AND NUTRITIONAL STATUS IN GASTRIC CANCER PATIENTS", "type": "peer-reviewed", "updated_at": "2026-10-30T13:43:35Z", "url": "https://research.draconitic.com/paper/3vp01pmsvsycj", "venue": "Hematology, Transfusion and Cell Therapy", "versions": [] }