Keski Hakan
Department of Hematology, Health Sciences University Faculty of Medicine, Umraniye Training and Research Hospital, Istanbul, Turkiye.
North Clin Istanb. 2023 Jun 6;10(3):378-384. doi: 10.14744/nci.2023.92331. eCollection 2023.
Literature shows evidence of the use of mean platelet volume (MPV) as a biomarker in thromboembolic conditions. It is recommended that genetic testing be performed selectively for hereditary thrombophilia. It might be useful to determine the priority of patients for genetic testing of hereditary thrombophilia through appropriate methods. We aimed to investigate the predictive value of MPV for high-risk patients of hereditary thrombophilia.
The hematologic (MPV), biochemical (antithrombin III, protein S, protein C), molecular genetic test results (factor V Leiden [FVL], and prothrombin G20210A [PT]) obtained retrospectively from medical files of 263 patients categorized into high- versus low-risk for thrombophilia were statistically analyzed and the value of MPV in predicting high-risk patients was assessed by receiver operating characteristic (ROC) analysis.
The frequencies of high- versus low-risk patients were 45.2% and 54.8%, respectively. Significantly more high-risk patients (n=81) compared to low-risk patients had FVL (n=66) and PT mutations (n=80 vs. 34) (p<0.001). The MPV values in high-risk patients (mean=11.1 fl, range=7.8-13.6) were significantly higher than those in the low-risk patients (mean=8.6 fl, range=6-10.9) (p<0.001). The ROC curve analysis for MPV revealed a statistically significant area under the curve of 0.961 (95% confidence interval=0.931-0.981) at a cut-off point of 10.1 fl with a sensitivity of 89.1% and a specificity of 91.7% (p<0.001).
MPV might be used as an effective biomarker to screen and select patients for genetic thrombophilia testing. Large multicenter studies are needed for recommending the inclusion of MPV in future guidelines for hereditary thrombophilia.
文献表明平均血小板体积（MPV）可作为血栓栓塞性疾病的生物标志物。建议对遗传性血栓形成倾向进行选择性基因检测。通过适当方法确定遗传性血栓形成倾向基因检测患者的优先级可能会有所帮助。我们旨在研究MPV对遗传性血栓形成倾向高危患者的预测价值。
回顾性分析263例分为血栓形成倾向高危和低危的患者病历中获得的血液学指标（MPV）、生化指标（抗凝血酶III、蛋白S、蛋白C）、分子遗传学检测结果（因子V莱顿突变 [FVL] 和凝血酶原G20210A [PT]），并通过受试者工作特征（ROC）分析评估MPV在预测高危患者中的价值。
高危和低危患者的频率分别为45.2%和54.8%。与低危患者相比，高危患者（n = 81）中FVL（n = 66）和PT突变（n = 80对34）的比例显著更高（p < 0.001）。高危患者的MPV值（平均值 = 11.1 fl，范围 = 7.8 - 13.6）显著高于低危患者（平均值 = 8.6 fl，范围 = 6 - 10.9）（p < 0.001）。MPV的ROC曲线分析显示，在截断点为10.1 fl时，曲线下面积具有统计学意义，为0.961（95%置信区间 = 0.931 - 0.981），灵敏度为89.1%，特异性为91.7%（p < 0.001）。
MPV可作为一种有效的生物标志物，用于筛选和选择进行遗传性血栓形成倾向基因检测的患者。需要开展大型多中心研究，以建议将MPV纳入未来遗传性血栓形成倾向指南。
