USR PUBLISHER

Background: Cervical cancer remains a major cause of illness and death among women in low- and middle-income countries. Malignancy can disturb haemostasis through tumour-associated inflammation, platelet activation, endothelial injury, treatment effects and activation of coagulation. Platelet indices are generated during routine automated blood counts and may provide useful information about platelet size and heterogeneity, while prothrombin time and activated partial thromboplastin time assess selected components of plasma coagulation. Objective: To compare mean platelet volume, platelet distribution width, platelet-large cell ratio, prothrombin time and activated partial thromboplastin time between women with cervical cancer and apparently healthy women in Owerri, Nigeria, and to examine the relationship between prothrombin time and activated partial thromboplastin time among the patients. Methods: This hospital-based comparative cross-sectional study enrolled 50 adult women, comprising 25 patients with histologically confirmed cervical cancer and 25 age-matched apparently healthy controls. Venous blood was collected into dipotassium ethylenediaminetetraacetic acid tubes for platelet indices and 3.2% trisodium citrate tubes for coagulation testing. Mean platelet volume, platelet distribution width and platelet-large cell ratio were obtained using an automated haematology analyser. Prothrombin time and activated partial thromboplastin time were determined from platelet-poor plasma by clot-based methods. Group means were compared with the independent-samples t test, and the relationship between prothrombin time and activated partial thromboplastin time was assessed using Pearson correlation. Statistical significance was set at p < 0.05. Results: Mean platelet volume was lower in the cervical cancer group than in controls (8.61 ± 1.06 versus 10.06 ± 0.91 fL; p < 0.001). Platelet distribution width was also lower (11.72 ± 1.90% versus 14.18 ± 1.50%; p < 0.001), as was platelet-large cell ratio (17.88 ± 2.80% versus 21.12 ± 4.36%; p = 0.003). Prothrombin time did not differ significantly between patients and controls (14.70 ± 1.91 versus 14.31 ± 1.29 seconds; p = 0.400), and activated partial thromboplastin time was likewise similar (34.68 ± 1.81 versus 33.81 ± 2.10 seconds; p = 0.124). Prothrombin time showed a very weak, non-significant positive correlation with activated partial thromboplastin time among patients (r = 0.061; p = 0.772). Conclusion: Women with cervical cancer in this study had lower platelet size and heterogeneity indices, whereas routine clotting times were not significantly altered. The results support further investigation of platelet indices as inexpensive adjunctive markers, but they do not justify using these indices alone to infer platelet activation, thrombosis risk or disease severity. Larger studies that account for tumour stage, treatment exposure, platelet count, inflammation and nutritional status are required.