Pang Qing, Gong Xuankun, Pan Hongtao, Wang Yong, Hu Xiaosi, Liu Huichun, Jin Hao
Department of General Surgery, Anhui No.2 Provincial People's Hospital, Hefei, 230041, Anhui, China.
Department of Hepatobiliary Surgery, The First Affiliated Hospital of Bengbu Medical College, Bengbu, 233000, Anhui, China.
Heliyon. 2024 Mar 18;10(6):e28173. doi: 10.1016/j.heliyon.2024.e28173. eCollection 2024 Mar 30.
Vascular invasion (VI) indicates highly invasive tumor biological behavior and is a major determining factor of poor survival and high risk of metastasis in hepatocellular carcinoma (HCC). Epidemiological evidence of the association between pretherapeutic platelet count (PLT) and the risk of VI and extrahepatic metastasis in HCC remains controversial.
A systematic retrieval was executed in databases of PubMed, Embase, and Web of Science until Dec 2022. Effect size and 95% confidence interval (CI) were extracted or estimated to synthetically investigate the effects of pretherapeutic PLT on VI and extrahepatic metastasis. Meta-analyses were performed by using a random or a fixed effects model.
Finally, the current meta-analysis included 15 studies with a total of 12,378 HCC patients. It was shown that, patients with a higher pretherapeutic level of PLT had a significantly increased risk of VI (11 studies,8,759 patients; OR = 1.44, 95%CI: 1.02-2.02) and extrahepatic metastasis (6 studies,8, 951 patients; OR = 2.51, 95% CI: 2.19-2.88) in comparison with patients with a lower PLT. Funnel plots and Begg's tests indicated that there were no significant publication biases.
This meta-analysis shows that pretherapeutic elevated PLT is associated with an increased risk of VI and extrahepatic metastasis in HCC.
血管侵犯（VI）提示肿瘤具有高度侵袭性的生物学行为，是肝细胞癌（HCC）患者生存率低和转移风险高的主要决定因素。治疗前血小板计数（PLT）与HCC患者VI及肝外转移风险之间关联的流行病学证据仍存在争议。
截至2022年12月，在PubMed、Embase和Web of Science数据库中进行系统检索。提取或估计效应量及95%置信区间（CI），以综合研究治疗前PLT对VI和肝外转移的影响。采用随机或固定效应模型进行荟萃分析。
最终，本荟萃分析纳入15项研究，共12378例HCC患者。结果显示，与PLT水平较低的患者相比，治疗前PLT水平较高的患者发生VI（11项研究，8759例患者；OR = 1.44，95%CI：1.02 - 2.02）和肝外转移（6项研究，8951例患者；OR = 2.51，95%CI：2.19 - 2.88）的风险显著增加。漏斗图和Begg检验表明无显著的发表偏倚。
本荟萃分析表明，治疗前PLT升高与HCC患者VI和肝外转移风险增加相关。
