Zhang Zhaohui, Zhang Yi, Wang Wei, Hua Yunpeng, Liu Linyun, Shen Shunli, Peng Baogang
Department of Hepatic Surgery, First Affiliated Hospital, Sun Yat-Sen University, Guangzhou, China.
Department of Medical Ultrasonics, First Affiliated Hospital, Sun Yat-Sen University, Guangzhou, China.
J Surg Res. 2017 Apr;210:99-107. doi: 10.1016/j.jss.2016.11.002. Epub 2016 Nov 11.
Recently, increasing studies have revealed the association of inflammatory parameters, such as preoperative platelet count, and the prognosis of hepatocellular carcinoma (HCC). However, the link between the platelet count and the prognosis of patients with HCC after hepatic resection is still controversial.
We searched PubMed, Web of Science, EMBASE, and CBM for relevant trials and analyzed outcomes with random-effects model. The hazard ratio (HR) and its 95% confidence interval (CI) were calculated.
In total, 31 studies, including a total of 10,730 patients, met our criteria. The results showed that thrombocytopenia in HCC patients was associated with poor overall survival (HR = 1.47, 95% CI: 1.21-1.78), disease-free survival (HR = 1.36, 95% CI: 1.08-1.72), and a high risk of cancer recurrence (HR = 1.41, 95% CI: 1.22-1.62), but a low risk of extrahepatic metastasis (HR = 0.55, 95% CI: 0.47-0.63).
The meta-analysis revealed that preoperative platelet count could act as a significant biomarker in the prognosis of HCC, especially a platelet count of <100 × 10/mm. Additional high-quality trials are needed, considering the low-quality studies analyzed.
最近，越来越多的研究揭示了炎症参数（如术前血小板计数）与肝细胞癌（HCC）预后之间的关联。然而，血小板计数与肝切除术后HCC患者预后之间的联系仍存在争议。
我们在PubMed、科学网、EMBASE和中国生物医学文献数据库中检索相关试验，并采用随机效应模型分析结果。计算风险比（HR）及其95%置信区间（CI）。
共有31项研究，包括总共10730例患者，符合我们的标准。结果显示，HCC患者血小板减少与总体生存率低（HR = 1.47，95%CI：1.21 - 1.78）、无病生存率低（HR = 1.36，95%CI：1.08 - 1.72）以及癌症复发风险高（HR = 1.41，95%CI：1.22 - 1.62）相关，但肝外转移风险低（HR = 0.55，95%CI：0.47 - 0.63）。
荟萃分析表明，术前血小板计数可作为HCC预后的重要生物标志物，尤其是血小板计数<100×10⁹/L。考虑到所分析研究质量较低，还需要更多高质量试验。
