Prognostic value of platelet-related parameters in intrahepatic cholangiocarcinoma patients undergoing radical resection

doi:10.3877/cma.j.issn.2095-3232.2024.03.009

Abstract

Abstract:

Objective

To investigate the prognostic value of platelet-related parameters in patients with intrahepatic cholangiocarcinoma (ICC) undergoing radical resection.

Methods

Clinical data of63 patients with ICC who underwent radical resection in No.909 Hospital from January 1, 2016 to December 31, 2019 were retrospectively analyzed. Among them, 41 patients were male and 22 female, aged from 39 to 65 years, with a median age of 52 years. The informed consents of all patients were obtained and the local ethical committee approval was received. Prognostic factors of ICC patients were identified by univariate and multivariate Cox regression models. Survival analysis of ICC patients with different platelet-related parameters was conducted by using Kaplan-Meier method and Log-rank test. Receiver operating characteristic (ROC) curve was drawn to evaluate the predictive efficiency of Plt, platelet distribution width (PDW) and mean platelet volume (MPV) on disease-free survival (DFS) and overall survival (OS).

Results

Univariate and multivariate Cox analyses showed that Plt≥185×10⁹/L, PDW≥16.5%, MPV≤9.25 fl and hilar invasion were the independent risk factors for DFS in ICC patients (HR=2.384, 2.546, 2.853, 3.933; P<0.05). Plt≥185×10⁹/L, PDW≥16.5%, MPV≤9.25 fl, hilar invasion and vascular invasion were the independent risk factors for OS (HR=3.100, 2.617, 3.313, 3.708, 3.685; P<0.05). Survival analysis showed that the postoperative 3-year DFS rates of patients with Plt≥185×10⁹/L, PDW≥16.5% and MPV≤9.25 fl were respectively 18.74%, 19.54%, 23.54%, and 89.34%, 78.21%, 85.45% in the control group (χ²=41.500, 29.545, 19.973; P<0.05). The postoperative 3-year OS of patients with Plt≥185×10⁹/L,PDW≥16.5% and MPV≤9.25 fl were respectively 19.53%, 18.64%, 20.43%, and 91.53%, 77.64%, 87.94% in the control group (χ²=41.352, 30.128, 19.909; P<0.05). ROC curve analysis revealed that the area under the ROC curve of Plt for predicting postoperative 3-year OS was 0.942, 0.968 for the sensitivity and 0.744 for the specificity, and 0.843, 0.742, 0.875 for PDW, and 0.886, 0.781, 0.935 for MPV, respectively.

Conclusions

Preoperative platelet-related parameters including Plt, PDW and MPV are the independent prognostic factors for ICC patients undergoing radical resection, which possess a great predictive value for survival and prognosis of ICC patients.

Key words: Intrahepatic cholangiocarcinoma, Liver neoplasms, Platelet count (Plt), Platelet distribution width (PDW), Platelet volume ratio (PCT), Mean platelet volume (MPV)

Junhao Huang, Zongjie Chen, Tiansong Hu. Prognostic value of platelet-related parameters in intrahepatic cholangiocarcinoma patients undergoing radical resection[J]. Chinese Journal of Hepatic Surgery(Electronic Edition), 2024, 13(03): 308-312.

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参数	DFS			OS
参数	HR	95%CI	P值	HR	95%CI	P值
Plt（≥185×10⁹/L / <185×10⁹/L）	4.358	2.534～7.875	<0.001	4.826	2.460～7.934	<0.001
PDW（≥16.5% / <16.5%）	3.032	2.109～7.902	<0.001	3.111	2.143～7.087	<0.001
PCT（≥0.16% / <0.16%）	3.730	2.017～8.705	<0.001	3.571	1.981～8.022	0.001
MPV（≤9.25 fl / >9.25 fl）	4.634	2.646～8.971	<0.001	4.940	2.714～8.347	<0.001
MPV/Plt（≤0.05 / >0.05）	5.880	2.263～9.715	<0.001	5.349	2.190～9.866	<0.001
肝门侵犯（是/否）	5.249	2.519～11.697	<0.001	5.290	2.464～11.357	<0.001
淋巴结转移（是/否）	3.926	1.910～8.067	<0.001	3.957	1.927～8.126	<0.001
胆管侵犯（是/否）	2.541	1.254～5.150	0.010	2.585	1.276～5.239	0.008

参数	DFS			OS
参数	HR	95%CI	P值	HR	95%CI	P值
Plt（≥185×10⁹/L / <185×10⁹/L）	4.358	2.534～7.875	<0.001	4.826	2.460～7.934	<0.001
PDW（≥16.5% / <16.5%）	3.032	2.109～7.902	<0.001	3.111	2.143～7.087	<0.001
PCT（≥0.16% / <0.16%）	3.730	2.017～8.705	<0.001	3.571	1.981～8.022	0.001
MPV（≤9.25 fl / >9.25 fl）	4.634	2.646～8.971	<0.001	4.940	2.714～8.347	<0.001
MPV/Plt（≤0.05 / >0.05）	5.880	2.263～9.715	<0.001	5.349	2.190～9.866	<0.001
肝门侵犯（是/否）	5.249	2.519～11.697	<0.001	5.290	2.464～11.357	<0.001
淋巴结转移（是/否）	3.926	1.910～8.067	<0.001	3.957	1.927～8.126	<0.001
胆管侵犯（是/否）	2.541	1.254～5.150	0.010	2.585	1.276～5.239	0.008

参数	DFS			OS
参数	HR	95%CI	P值	HR	95%CI	P值
Plt≥185×10⁹/L	2.384	1.861～4.181	0.011	3.100	1.830～7.586	0.012
PDW≥16.5%	2.546	1.501～4.770	0.028	2.617	1.520～5.025	0.026
MPV≤9.25 fl	2.853	1.933～6.251	0.030	3.313	1.021～6.651	0.047
肝门侵犯	3.933	1.700～5.335	0.003	3.708	1.636～5.589	0.008
血管侵犯	1.696	0.784～3.667	0.179	3.685	1.763～6.723	0.007

参数	DFS			OS
参数	HR	95%CI	P值	HR	95%CI	P值
Plt≥185×10⁹/L	2.384	1.861～4.181	0.011	3.100	1.830～7.586	0.012
PDW≥16.5%	2.546	1.501～4.770	0.028	2.617	1.520～5.025	0.026
MPV≤9.25 fl	2.853	1.933～6.251	0.030	3.313	1.021～6.651	0.047
肝门侵犯	3.933	1.700～5.335	0.003	3.708	1.636～5.589	0.008
血管侵犯	1.696	0.784～3.667	0.179	3.685	1.763～6.723	0.007

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