Department of Nursing, Dongyang University, Gyeongbuk, Republic of Korea.
College of Medicine, Kyung Hee University, Seoul, Republic of Korea.
Medicine (Baltimore). 2022 Sep 9;101(36):e30504. doi: 10.1097/MD.0000000000030504.
This study aimed to evaluate the prognostic potential of mean platelet volume (MPV) in gastric cancer (GC) patients. Patients with stage I-III GC who underwent gastrectomy were enrolled in this study. Cox regression analysis was performed to evaluate the determinants of overall survival (OS) and disease-free survival (DFS). The discriminative capacity of the model was determined using the Harrell concordance index (C-index). The net benefit of the model was validated using decision curve analysis (DCA). Data from 401 patients were analyzed. Multivariate Cox regression analysis revealed that age, stage, serum albumin level (ALB), perineural invasion (PNI) and MPV were determinants of both OS and DFS. The MPV model consisted of 5 covariates (age, stage, ALB, PNI, and MPV level), and the baseline model constituted the same covariates as the MPV model, except for the MPV level. C-indices for OS and DFS were higher in the MPV model than in the baseline model. When the models were validated using DCA, the MPV model showed a greater net benefit than the baseline model for nearly all the threshold probabilities. Age, stage, ALB, PNI, and MPV are prognostic factors for OS and DFS. The discriminative capacities for OS and DFS in the MPV model were higher than those in the baseline model, thus implying the clinical significance of the MPV level as a determinant of survival in GC.
本研究旨在评估平均血小板体积(MPV)在胃癌(GC)患者中的预后潜力。纳入了接受胃切除术的 I-III 期 GC 患者。采用 Cox 回归分析评估总生存(OS)和无病生存(DFS)的决定因素。采用 Harrell 一致性指数(C-index)评估模型的判别能力。使用决策曲线分析(DCA)验证模型的净获益。对 401 名患者的数据进行了分析。多变量 Cox 回归分析显示,年龄、分期、血清白蛋白水平(ALB)、神经周围侵犯(PNI)和 MPV 是 OS 和 DFS 的决定因素。MPV 模型包含 5 个协变量(年龄、分期、ALB、PNI 和 MPV 水平),而基线模型包含与 MPV 模型相同的协变量,除了 MPV 水平。MPV 模型的 OS 和 DFS 的 C 指数高于基线模型。当使用 DCA 验证模型时,对于几乎所有的阈值概率,MPV 模型的净获益均高于基线模型。年龄、分期、ALB、PNI 和 MPV 是 OS 和 DFS 的预后因素。MPV 模型对 OS 和 DFS 的判别能力高于基线模型,这表明 MPV 水平作为 GC 患者生存的决定因素具有临床意义。