Affiliation:
1. Department of MR Zhongshan City People's Hospital Zhongshan China
2. Department of Radiology The First Affiliated Hospital of Jinan University Guangzhou China
3. Department of Medical Imaging Center The second affiliated Hospital of Nanchang University Nanchang China
4. Department of Radiology The Seventh Affiliated Hospital Sun Yat‐Sen University Shenzhen China
5. Department of Radiology, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy Sun Yat‐sen University Cancer Center Guangzhou China
6. Department of CT Zhongshan City People's Hospital Zhongshan China
7. Department of Urology Zhongshan City People's Hospital Zhongshan China
Abstract
AbstractObjectivesThe association between platelet status and hepatocellular carcinoma (HCC) prognoses remains controversial. Herein, we aimed to clarify the prognostic value of multiple platelet‐related biomarkers, including platelet count, platelet/lymphocyte ratio (PLR), aspartate aminotransferase to platelet ratio index (APRI), and alkaline phosphatase‐to‐platelet count ratio index (APPRI) in HCC with microvascular invasion (MVI) after curative resection or liver transplantation.Materials and MethodsA retrospective review of 169 patients with solitary HCC and MVI who underwent resection or liver transplantation between January 2015 and December 2018 was conducted. Preoperative clinical, laboratory, pathologic, and imaging data were collected and analyzed. Overall survival (OS) and disease‐free survival (DFS) were defined as the clinical endpoints. Univariate and multivariate Cox proportional hazards regression analyses were conducted to investigate potential predictors of DFS and OS.ResultsMultivariate Cox regression analyses revealed that maximum tumor diameter, poor cell differentiation, and APPRI were independent predictors of DFS; while poor cell differentiation, APRI, APPRI, prothrombin time, and alpha‐fetoprotein were independent prognostic factors for OS. The 1‐, 3‐, and 5‐year DFS rates were 66.90%, 48.40%, and 37.40% for patients with APPRI ≤0.74 and 40.40%, 24.20%,and 24.20% for patients with APPRI>0.74. The corresponding rates of OS over 1, 3, and 5 years were 92.40%, 88.10% and 77.70%, and 72.30%, 38.20%, and 19.10%, respectively. The DFS and OS rates of patients whose APPRI was more than 0.74 were substantially lower than those of patients whose APPRI was less than or equal to 0.74 (p = 0.002 and p < 0.001, respectively).ConclusionElevated preoperative APPRI is a noninvasive, simple, and easily assessable parameter linked to poor prognosis in individuals with single HCC and MVI after resection or liver transplantation.
Funder
National Natural Science Foundation of China
Subject
Cancer Research,Radiology, Nuclear Medicine and imaging,Oncology