Elevated platelet distribution width predicts poor prognosis in hepatocellular carcinoma
Elevated platelet distribution width predicts poor prognosis in hepatocellular carcinoma
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血小板分布宽度升高预示肝细胞癌预后不良
DOI：
10.3233/cbm-182076
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发表时间：
2019-01-01
影响因子：
3.1
通讯作者：
Chen, Wei
中科院分区：
文献类型：
--
作者：
Zuo, Xiaomin;Kong, Weihao;Chen, Wei
背景：已有研究表明，血小板在多种肿瘤的生长、侵袭和血管生成中起重要作用。然而，血小板指数在肝细胞癌（HCC）的预后作用尚未探讨。本研究的目的是探讨血小板指数与HCC预后的关系。方法：回顾性分析2009年1月至2015年12月期间共260例HCC患者。通过受试者工作特征曲线（ROC）确定最佳血小板分布宽度（PDW）临界值。评估PDW与临床病理特征的关系。采用Kaplan-Meier法和考克斯回归模型分析PDW对预后的影响。结果：PDW水平升高与门脉高压、血管侵犯和Child-Pugh分级显著相关。生存曲线显示高PDW水平患者的预后比低PDW水平患者差（P < 0.001）。多因素考克斯回归分析显示PDW是影响肝癌患者预后的独立因素（危险比：4.460，95%可信区间：2.308-8.619，P < 0.001）。结论：PDW升高可能是预测肝癌预后的一个新指标，但该结论有待进一步研究证实。
BACKGROUND: Previous studies have demonstrated that platelets play an important role in growth, invasion, and angiogenesis of a variety of tumors. Nevertheless, the prognostic role of platelet indices in hepatocellular carcinoma (HCC) has not been explored. The aim of this study was to explore the association between platelet indices and prognosis in HCC.METHOD: A total of 260 patients with HCC between January 2009 and December 2015 were retrospectively analyzed. The optimal platelet distribution width (PDW) cutoff value is identified by the receiver operating characteristic curve (ROC) curve. The relationship between PDW and clinicopathological features was assessed. The prognostic effects of PDW were assessed by using the Kaplan-Meier method and Cox regression model.RESULT: Elevated PDW level was significantly associated with portal hypertension, vascular invasion, and Child-Pugh grade. In addition, survival curve indicates that patients with high PDW levels have a worse prognosis than patients with low PDW levels (P < 0.001). Multivariate Cox regression analysis identified PDW as an independent factor of prognosis in HCC patients (hazard ratio: 4.460, 95% confidence interval: 2.308-8.619, P < 0.001).CONCLUSION: Elevated PDW may be a novel marker for predicting the prognosis of HCC, but further research is needed to validate our conclusions.