Department of Nutritional Carcinogenesis, IRCCS S. de Bellis National Institute for Digestive Diseases, Castellana Grotte, Italy.
Oncology. 2013;85(3):153-9. doi: 10.1159/000354416. Epub 2013 Aug 29.
Thrombocytopenia is a cirrhosis surrogate which is associated with hepatocellular carcinoma (HCC) development.
To compare the clinical characteristics of HCC in the presence and absence of thrombocytopenia.
The baseline clinical data of a large cohort of randomly presenting, biopsy-proven HCC patients was examined for phenotypic patterns, after organizing the data by tumor size and subdivision into tumor size terciles.
Small tumor size tercile I patients had the lowest platelet counts. Patients with higher platelets within each size tercile had the lowest bilirubin and prothrombin time and higher γ-glutamyl transpeptidase (GGTP) and alkaline phosphatase (ALKP) levels. When patients with similar platelet and bilirubin levels were compared, α-fetoprotein, GGTP, and ALKP were significantly increased in patients with larger tumors and in the presence of portal vein thrombus. Large tumor size tercile III patients without thrombocytopenia had larger tumors, higher GGTP and ALKP, and lower bilirubin levels than did patients with thrombocytopenia.
Thrombocytopenia occurred in 40.7% of patients with smaller tumors but only in 11.3% of patients with larger tumors. Patients without thrombocytopenia had elevated GGTP and ALKP and lower bilirubin levels, regardless of tumor size, but they also had larger tumors within the large tumor tercile.
血小板减少症是肝硬化的替代指标，与肝细胞癌（HCC）的发展相关。
比较伴有和不伴有血小板减少症的 HCC 的临床特征。
对大量随机出现、经活检证实的 HCC 患者的基线临床数据进行检查，根据肿瘤大小进行分组，并进一步分为肿瘤大小三分位数，以观察表型模式。
小肿瘤大小三分位数 I 患者的血小板计数最低。在每个大小三分位数内血小板较高的患者，胆红素和凝血酶原时间较低，γ-谷氨酰转肽酶（GGTP）和碱性磷酸酶（ALKP）水平较高。当比较具有相似血小板和胆红素水平的患者时，较大肿瘤和门静脉血栓形成患者的甲胎蛋白、GGTP 和 ALKP 显著增加。无血小板减少症的大肿瘤大小三分位数 III 患者的肿瘤较大，GGTP 和 ALKP 较高，胆红素水平较低，而血小板减少症患者的肿瘤较小。
血小板减少症发生在较小肿瘤患者中的比例为 40.7%，而在较大肿瘤患者中仅为 11.3%。无论肿瘤大小如何，无血小板减少症的患者的 GGTP 和 ALKP 水平升高，胆红素水平降低，但在大肿瘤三分位数内的肿瘤也更大。
