Park Jae Woo, Kim Chul-Hwan, Ha Yong Chan, Kim Moon Young, Park Sung Min
Department of Oral and Maxillofacial Surgery, College of Dentistry, Dankook University, Cheonan, Korea.
J Korean Assoc Oral Maxillofac Surg. 2017 Oct;43(5):305-311. doi: 10.5125/jkaoms.2017.43.5.305. Epub 2017 Oct 26.
TNM staging, especially for lymph node metastasis, is the scoring system most widely used among prognostic factors for cancer survival. Several biomarkers have been studied as serologic markers, but their specificity is low and clinical applications are difficult. This study aimed to establish a scoring system for patients with oral squamous cell carcinoma (OSCC) using platelet (PLT) and mean platelet volume (MPV) levels measured postoperatively and to evaluate their significance as prognostic factors.
We studied 40 patients admitted to the Department of Oral and Maxillofacial Surgery of Dankook University Hospital who were diagnosed with primary OSCC histopathologically between May 2006 and May 2012. Clinical pathological information obtained from the medical records of each patient included age, sex, height, weight, tumor location, degree of differentiation, tumor diameter, lymph node metastasis, TNM stage, and other test values including white blood cell, MPV, PLT, C-reactive protein (CRP), and albumin obtained through a test conducted within 7 days before surgery. Count of platelet (COP)-MPV Score: Patients with both PLT and MPV values below the cut-off values were defined as score 0 (group A). Patients with at least one of the two higher than the cut-off value were defined as score 1 (group B).
Univariate analyses showed N-metastasis, COP-MPV (A vs B), PLT, platelet-lymphocyte ratio, and CRP were statistically significant prognostic factors. A multivariate Cox proportional hazards model showed N-metastasis (hazard ratio [HR] 6.227, =0.016) and COP-MPV (A vs B) (HR 18.992, =0.013) were independent prognostic factors with a significant effect on survival.
COP-MPV score is a simple and cost-effective test method and is considered a more effective prognostic factor than other considered factors in predicting the prognosis of OSCC patients.
TNM分期，尤其是淋巴结转移情况，是癌症生存预后因素中使用最广泛的评分系统。已有多种生物标志物作为血清学标志物进行研究，但其特异性较低，临床应用困难。本研究旨在利用术后测量的血小板（PLT）和平均血小板体积（MPV）水平，为口腔鳞状细胞癌（OSCC）患者建立一种评分系统，并评估其作为预后因素的意义。
我们研究了2006年5月至2012年5月期间在韩国檀国大学医院口腔颌面外科住院的40例经组织病理学诊断为原发性OSCC的患者。从每位患者的病历中获取的临床病理信息包括年龄、性别、身高、体重、肿瘤位置、分化程度、肿瘤直径、淋巴结转移情况、TNM分期，以及术前7天内进行的检查所获得的其他检查值，包括白细胞、MPV、PLT、C反应蛋白（CRP）和白蛋白。血小板计数（COP）-MPV评分：PLT和MPV值均低于临界值的患者定义为0分（A组）。两项指标中至少有一项高于临界值的患者定义为1分（B组）。
单因素分析显示，N转移、COP-MPV（A组与B组）、PLT、血小板-淋巴细胞比值和CRP是具有统计学意义的预后因素。多因素Cox比例风险模型显示，N转移（风险比[HR] 6.227，P = <0.016）和COP-MPV（A组与B组）（HR 18.992，P = <0.013）是对生存有显著影响的独立预后因素。
COP-MPV评分是一种简单且经济有效的检测方法，在预测OSCC患者预后方面，被认为是比其他考虑因素更有效的预后因素。
