Carr Brian I, Guerra Vito
Hepatogastroenterology. 2013 Sep;60(126):1433-7. doi: 10.5754/hge121028.
BACKGROUND/AIMS: Thrombocytopenia has been reported to be a surrogate for cirrhosis, but the HCC phenotypes associated with and without cirrhosis are not well studied. To compare characteristics of HCC patients with and without associated thrombocytosis.
Records were examined of a cohort of 668 biopsy-proven and randomly presenting unresectable HCC patients, who were dichotomized for presence (platelets <125 x 109/L) or absence (platelets 125-400 x 109/L) of thrombocytopenia.
Patients with normal platelets had larger tumors, more tumor nodules and longer survival than in the thrombocytopenia group. They also had more normal total plasma bilirubin, albumin and prothrombin times, yet had higher GGTP, ALKP and AFP levels.
Thrombocytopenia in association with HCC occurs in patients with smaller tumor sizes, worse liver function and poorer survival, supporting the importance of host factors and liver micro-environment in HCC patients and the likelihood of two pathways for HCC development.
背景/目的：据报道，血小板减少是肝硬化的替代指标，但与有或无肝硬化相关的肝癌表型尚未得到充分研究。为了比较伴有和不伴有血小板增多症的肝癌患者的特征。
对一组668例经活检证实且随机就诊的不可切除肝癌患者的记录进行了检查，根据是否存在血小板减少（血小板<125×10⁹/L）将患者分为两组。
血小板正常的患者比血小板减少组的患者肿瘤更大、肿瘤结节更多、生存期更长。他们的总血浆胆红素、白蛋白和凝血酶原时间也更正常，但谷氨酰转肽酶、碱性磷酸酶和甲胎蛋白水平更高。
与肝癌相关的血小板减少发生在肿瘤较小、肝功能较差和生存期较短的患者中，这支持了宿主因素和肝脏微环境在肝癌患者中的重要性以及肝癌发展的两种途径的可能性。
