Department of Liver Surgery & Liver Transplantation Center, West China Hospital, Sichuan University, Chengdu, Sichuan Province, China.
Department of Ultrasound, West China Hospital, Sichuan University, Chengdu, Sichuan Province, China.
PLoS One. 2019 Jul 3;14(7):e0219219. doi: 10.1371/journal.pone.0219219. eCollection 2019.
Posthepatectomy liver failure (PHLF) is the most leading cause of mortality following hepatectomy in patients with hepatocellular carcinoma (HCC). Platelet count was reported to be a simple but useful indicator of liver cirrhosis and function of spleen. Spleen stiffness (SS) was used to evaluate the morphological change of spleen and was reported to be related to liver cirrhosis and portal hypertension. However, the predictive value of platelet to spleen stiffness ratio (PSR) on PHLF remains unknown. A retrospective study was performed to analyze 158 patients with HCC following hepatectomy from August 2015 to February 2016. Univariate and multivariate analyses were performed to evaluate the value of each risk factor for predicting PHLF. The predictive efficiency of the risk factors was evaluated by receiver operating characteristic (ROC) curve. PHLF occured in 23 (14.6%) patients. PSR (P<0.001, odds ratio (OR) = 0.622, 95% confidence interval (CI) 0.4930.784), hepatic inflow occlusion (HIO) (P = 0.003, OR = 1.044, 95% CI 1.0151.075) and major hepatectomy (P = 0.019, OR = 5.967, 95% CI 1.346~26.443) were demonstrated to be the independent predictive factors for development of PHLF in a multivariate analysis. Results of the present study suggested PSR is a novel and non-invasive model for predicting PHLF in patients with HCC.
术后肝衰竭（PHLF）是肝细胞癌（HCC）患者肝切除术后死亡的主要原因。血小板计数被报道为一种简单但有用的肝硬化和脾脏功能的指标。脾脏硬度（SS）用于评估脾脏的形态变化，据报道与肝硬化和门静脉高压有关。然而，血小板与脾脏硬度比值（PSR）对 PHLF 的预测价值尚不清楚。本回顾性研究分析了 2015 年 8 月至 2016 年 2 月接受肝切除术的 158 例 HCC 患者。进行单因素和多因素分析，以评估每个危险因素预测 PHLF 的价值。通过接收者操作特征（ROC）曲线评估危险因素的预测效率。23 例（14.6%）患者发生 PHLF。PSR（P<0.001，比值比（OR）=0.622，95%置信区间（CI）0.4930.784）、肝入肝阻断（HIO）（P=0.003，OR=1.044，95%CI 1.0151.075）和大范围肝切除术（P=0.019，OR=5.967，95%CI 1.346~26.443）在多因素分析中被证明是 PHLF 发生的独立预测因素。本研究结果表明，PSR 是预测 HCC 患者 PHLF 的一种新的非侵入性模型。
