ASSOCIATION BETWEEN NEUTROPHIL-PLATELET AGGREGATES, TUMOR STAGING AND NUTRITIONAL STATUS IN GASTRIC CANCER PATIENTS
- 1Universidade Estadual de Campinas (UNICAMP), Campinas, Brazil
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.
Related
- Neutrophil-to-Lymphocyte and Platelet-to-Lymphocyte Ratios in Patients with Pterygium: A Retrospective CaseControl Study
- Neutrophil-to-prognostic nutritional index ratio and short-term mortality in heart failure: an exploratory association without demonstrated superiority over PNI, NLR, or SII
- Associations of neutrophil-to-lymphocyte and platelet-to-lymphocyte ratios with amputation risk in patients with diabetic foot disease: a systematic review and meta-analysis
- Association of pretransfusion platelet count with mortality in patients with sepsis-associated acute kidney injury
- Association of preoperative systemic immune-inflammation index and geriatric nutritional risk index with prolonged postoperative length of stay in older patients with hip fracture : A retrospective cohort study
BibTeX
@article{oliveira2026association,
title = {{ASSOCIATION BETWEEN NEUTROPHIL-PLATELET AGGREGATES, TUMOR STAGING AND NUTRITIONAL STATUS IN GASTRIC CANCER PATIENTS}},
author = {Jose OLIVEIRA and Renata CONTRICIANI and Leo KIM and Larissa CARRILHO and Sandra BRANBILLA and Barbara CIPRIANO and Bruna ROBISON and Fabiana DA SILVA and Nicole NOVAIS and Fabíola ZARPELÃO and Juliana PEZZUTTI and Ananda SILVA and Luiz LOPES and Nelson ANDREOLLO and Maria MENDES and José CARVALHEIRA and Fernanda ORSI},
journal = {Hematology, Transfusion and Cell Therapy},
year = {2026},
month = oct,
doi = {10.1016/j.htct.2026.108075},
url = {https://doi.org/10.1016/j.htct.2026.108075},
note = {CC BY},
}
RIS
TY - JOUR
TI - ASSOCIATION BETWEEN NEUTROPHIL-PLATELET AGGREGATES, TUMOR STAGING AND NUTRITIONAL STATUS IN GASTRIC CANCER PATIENTS
AU - Jose OLIVEIRA
AU - Renata CONTRICIANI
AU - Leo KIM
AU - Larissa CARRILHO
AU - Sandra BRANBILLA
AU - Barbara CIPRIANO
AU - Bruna ROBISON
AU - Fabiana DA SILVA
AU - Nicole NOVAIS
AU - Fabíola ZARPELÃO
AU - Juliana PEZZUTTI
AU - Ananda SILVA
AU - Luiz LOPES
AU - Nelson ANDREOLLO
AU - Maria MENDES
AU - José CARVALHEIRA
AU - Fernanda ORSI
PY - 2026
DA - 2026/10/23
JO - Hematology, Transfusion and Cell Therapy
DO - 10.1016/j.htct.2026.108075
UR - https://doi.org/10.1016/j.htct.2026.108075
AB - 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.
SN - 2531-1379
SN - 2531-1387
ER -