血小板平均体积降低是肝移植后肝细胞癌复发的风险指标。
Lower mean platelet volume is a risk indicator of hepatocellular carcinoma recurrence following liver transplantation.
机构信息
Division of Hepatobiliary and Pancreatic Surgery, Department of Surgery, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310003, China.
Key Laboratory of Combined Multi-Organ Transplantation, Ministry of Public Health, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310003, China.
出版信息
Hepatobiliary Pancreat Dis Int. 2019 Jun;18(3):223-227. doi: 10.1016/j.hbpd.2019.04.009. Epub 2019 Apr 24.
BACKGROUND
Lower mean platelet volume (MPV) is an indicator of platelet activity in the setting of tumor development. This study was to assess the relationship between preoperative MPV and survival outcomes of patients with hepatocellular carcinoma (HCC) following liver transplantation (LT).
METHODS
The demographic and clinical characteristics of 304 HCC patients following LT were retrieved from an LT database. All the patients were divided into the normal and lower MPV groups according to the median MPV. The factors were first analyzed using a Kaplan-Meier survival analysis, then the factors with P < 0.10 were selected for multivariate Cox regression analysis and were used to define the independent risk factors for poor prognosis.
RESULTS
The 1-, 3-, and 5-year tumor free survival was 95.34%, 74.67% and 69.29% in the normal MPV group, respectively, and 95.40%, 59.97% and 42.94% in the lower MPV group, respectively (P < 0.01). No significant difference was observed in post-LT complications between the normal and lower MPV groups. Portal vein tumor thrombosis (PVTT) [hazard ratio (HR = 2.24; 95% confidence interval: 1.46-3.43; P < 0.01) and lower MPV (HR = 1.58; 95% confidence interval: 1.05-2.36; P = 0.03) were identified as independent prognostic risk factors for recipient survival.
CONCLUSION
Preoperative lower MPV is a risk indicator of HCC patients survival outcomes after LT.
背景
在肿瘤发展的情况下，较低的平均血小板体积（MPV）是血小板活性的指标。本研究旨在评估肝移植（LT）后肝癌（HCC）患者术前 MPV 与生存结局之间的关系。
方法
从 LT 数据库中检索了 304 例 LT 后 HCC 患者的人口统计学和临床特征。根据中位数 MPV 将所有患者分为正常 MPV 组和低 MPV 组。首先使用 Kaplan-Meier 生存分析对这些因素进行分析，然后选择 P<0.10 的因素进行多变量 Cox 回归分析，并用于定义预后不良的独立危险因素。
结果
正常 MPV 组的 1、3 和 5 年无肿瘤生存率分别为 95.34%、74.67%和 69.29%，低 MPV 组分别为 95.40%、59.97%和 42.94%（P<0.01）。正常 MPV 组和低 MPV 组之间在 LT 后并发症方面无显著差异。门静脉癌栓形成（PVTT）[风险比（HR）=2.24；95%置信区间：1.46-3.43；P<0.01]和低 MPV（HR=1.58；95%置信区间：1.05-2.36；P=0.03）被确定为受体生存的独立预后危险因素。
结论
术前低 MPV 是 LT 后 HCC 患者生存结局的风险指标。
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