title: The Neutrophil-Platelet Score (NPS) Predicts Survival in Primary Operable Colorectal Cancer and a Variety of Common Cancers.
abstract: BACKGROUND
  Recent in-vitro studies have suggested that a critical checkpoint early in the inflammatory process involves the interaction between neutrophils and platelets. This confirms the importance of the innate immune system in the elaboration of the systemic inflammatory response. The aim of the present study was to examine whether a combination of the neutrophil and platelet counts were predictive of survival in patients with cancer.
  
  
  METHODS
  Patients with histologically proven colorectal cancer who underwent potentially curative resection at a single centre between March 1999 and May 2013 (n = 796) and patients with cancer from the Glasgow Inflammation Outcome Study, who had a blood sample taken between January 2000 and December 2007 (n = 9649) were included in the analysis.
  
  
  RESULTS
  In the colorectal cancer cohort, there were 173 cancer and 135 non-cancer deaths. In patients undergoing elective surgery, cancer-specific survival (CSS) at 5 years ranged from 97% in patients with TNM I disease and NPS = 0 to 57% in patients with TNM III disease and NPS = 2 (p = 0.019) and in patients undergoing elective surgery for node-negative colon cancer from 98% (TNM I, NPS = 0) to 65% (TNM II, NPS = 2) (p = 0.004). In those with a variety of common cancers there were 5218 cancer and 929 non-cancer deaths. On multivariate analysis, adjusting for age and sex and stratified by tumour site, incremental increase in the NPS was significantly associated with poorer CSS (p<0.001).
  
  
  CONCLUSIONS
  The neutrophil-platelet score predicted survival in a variety of common cancers and highlights the importance of the innate immune system in patients with cancer.
authors.affiliation: Academic Unit of Surgery, School of Medicine-University of Glasgow, Glasgow Royal Infirmary, Glasgow, United Kingdom.
authors.forename: David G
authors.initials: DG
authors.lastname: Watt
authors.affiliation: Academic Unit of Surgery, School of Medicine-University of Glasgow, Glasgow Royal Infirmary, Glasgow, United Kingdom.
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Proctor
authors.affiliation: Academic Unit of Surgery, School of Medicine-University of Glasgow, Glasgow Royal Infirmary, Glasgow, United Kingdom.
authors.forename: James H
authors.initials: JH
authors.lastname: Park
authors.affiliation: Academic Unit of Surgery, School of Medicine-University of Glasgow, Glasgow Royal Infirmary, Glasgow, United Kingdom.
authors.forename: Paul G
authors.initials: PG
authors.lastname: Horgan
authors.affiliation: Academic Unit of Surgery, School of Medicine-University of Glasgow, Glasgow Royal Infirmary, Glasgow, United Kingdom.
authors.forename: Donald C
authors.initials: DC
authors.lastname: McMillan
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001792:Blood Platelets / Q000276:immunology; D015331:Cohort Studies; D015179:Colorectal Neoplasms / Q000097:blood* / Q000401:mortality* / Q000601:surgery; D005260:Female; D006801:Humans; D007113:Immunity, Innate; D053208:Kaplan-Meier Estimate; D007958:Leukocyte Count; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009369:Neoplasms / Q000097:blood* / Q000276:immunology / Q000401:mortality*; D009504:Neutrophils / Q000276:immunology; D010976:Platelet Count; D011237:Predictive Value of Tests; D011379:Prognosis