Preoperative PDW levels predict pulmonary metastasis in patients with hepatocellular carcinoma.
Preoperative PDW levels predict pulmonary metastasis in patients with hepatocellular carcinoma.
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DOI：
10.1186/s12885-022-09754-3
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发表时间：
2022-06-21
期刊：
影响因子：
3.8
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中科院分区：
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--
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在肝细胞癌中，肝切除术后肺转移(PM)与不良的临床预后有关。肿瘤细胞增殖、血管生成和转移的关键阶段都需要激活血小板。在肝细胞癌中，血小板分布宽度(PDW)预示着血小板大小的改变，并预示着更差的预后。本研究的目的是评估接受肝切除术的肝细胞癌患者的PDW和PMS之间的关系。对2013年1月至2015年12月在哈尔滨医科大学中国肿瘤医院接受肝切除术的肝癌患者进行回顾性分析。研究PDW水平与临床和人口学参数之间的关系。为了研究预测因素与PM之间的关系，使用了竞争风险模型。于2016年1月至2018年12月，对哈尔滨医科大学附属第一医院109例患者进行了自主研究。在最初的队列中，214名患者中有19名术后发生PMS。在有PM的肝癌患者中，PDW水平低于无PM的患者在控制了竞争性风险事件(发生PM前死亡)后，高PDW组和低PDW组的2年PM累积发生率有显著差异(p <； 0.001)。此外，在多变量竞争风险分析中，PDW也被发现是PM的独立预测因子。结果在另一个队列中得到了外部验证。在肝细胞癌中，术前PDW与PM显著相关PDW可作为肝细胞癌患者术后PM的生物标志物。
In hepatocellular carcinoma (HCC), pulmonary metastasis (PM) after hepatectomy is associated with poor clinical outcomes. The crucial phases of tumour cell proliferation, angiogenesis, and metastasis all entail platelet activation. In HCC, platelet distribution width (PDW) suggests platelet size changes and predicts a worse prognosis. The aim of this study was to assess the association between PDW and PMs in HCC patients receiving hepatectomy. From January 2013 to December 2015, a cohort of patients who underwent hepatectomy for HCC at the Harbin Medical University Cancer Hospital in China were retrospectively evaluated. The relationship between PDW levels and clinical and demographic parameters was examined. To investigate the relationships between predicted factors and PM, a competing risk model was used. From January 2016 to December 2018, a validation cohort of 109 patients from the First Affiliated Hospital of Harbin Medical University was studied independently. In the primary cohort, 19 out of 214 patients had postoperative PMs. In HCC patients with PM, PDW levels were lower than in those without PM. There was a significant difference in the cumulative incidence of 2-year PM between the high-PDW and low-PDW groups after controlling for competing risk events (death prior to the development of PM) (p < 0.001). In addition, PDW was also found to be an independent predictor for PM in a multivariable competing risk analysis. The results were externally validated in another cohort. In HCC, preoperative PDW is significantly associated with PM. PDW could be a biomarker for post-operative PM in HCC patients.
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