MMP9 and cancer: Previous studies have shown that neutrophils release matrix metalloproteinases (MMP-8, MMP-9) and cytokines that promote tumor angiogenesis, basement membrane degradation, and cancer cell invasion and metastasis.[19] Platelets, by shielding circulating tumor cells from shear forces and immune attacks, enhance tumor cell survival and metastatic potential.[20] Elevated NLR and PLR further suggest an exacerbated immunosuppressive state, facilitating tumor growth and metastasis.