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Preoperative alkaline phosphatase‐to‐platelet count ratio as a prognostic factor for hepatocellular carcinoma with microvascular invasion
OBJECTIVES: The 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 p...
Autores principales: | , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
John Wiley and Sons Inc.
2023
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10524001/ https://www.ncbi.nlm.nih.gov/pubmed/37492981 http://dx.doi.org/10.1002/cam4.6368 |
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author | Zhang, Yongxin Zhang, Bin Gong, Lianggeng Xiong, Liangxia Xiao, Xuehong Bu, Chao Liang, Zhiying Li, Liangcai Tang, Binghang Lu, Yangbai |
author_facet | Zhang, Yongxin Zhang, Bin Gong, Lianggeng Xiong, Liangxia Xiao, Xuehong Bu, Chao Liang, Zhiying Li, Liangcai Tang, Binghang Lu, Yangbai |
author_sort | Zhang, Yongxin |
collection | PubMed |
description | OBJECTIVES: The 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 METHODS: A 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. RESULTS: Multivariate 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). CONCLUSION: Elevated 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. |
format | Online Article Text |
id | pubmed-10524001 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | John Wiley and Sons Inc. |
record_format | MEDLINE/PubMed |
spelling | pubmed-105240012023-09-28 Preoperative alkaline phosphatase‐to‐platelet count ratio as a prognostic factor for hepatocellular carcinoma with microvascular invasion Zhang, Yongxin Zhang, Bin Gong, Lianggeng Xiong, Liangxia Xiao, Xuehong Bu, Chao Liang, Zhiying Li, Liangcai Tang, Binghang Lu, Yangbai Cancer Med RESEARCH ARTICLES OBJECTIVES: The 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 METHODS: A 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. RESULTS: Multivariate 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). CONCLUSION: Elevated 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. John Wiley and Sons Inc. 2023-07-26 /pmc/articles/PMC10524001/ /pubmed/37492981 http://dx.doi.org/10.1002/cam4.6368 Text en © 2023 The Authors. Cancer Medicine published by John Wiley & Sons Ltd. https://creativecommons.org/licenses/by/4.0/This is an open access article under the terms of the http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | RESEARCH ARTICLES Zhang, Yongxin Zhang, Bin Gong, Lianggeng Xiong, Liangxia Xiao, Xuehong Bu, Chao Liang, Zhiying Li, Liangcai Tang, Binghang Lu, Yangbai Preoperative alkaline phosphatase‐to‐platelet count ratio as a prognostic factor for hepatocellular carcinoma with microvascular invasion |
title | Preoperative alkaline phosphatase‐to‐platelet count ratio as a prognostic factor for hepatocellular carcinoma with microvascular invasion |
title_full | Preoperative alkaline phosphatase‐to‐platelet count ratio as a prognostic factor for hepatocellular carcinoma with microvascular invasion |
title_fullStr | Preoperative alkaline phosphatase‐to‐platelet count ratio as a prognostic factor for hepatocellular carcinoma with microvascular invasion |
title_full_unstemmed | Preoperative alkaline phosphatase‐to‐platelet count ratio as a prognostic factor for hepatocellular carcinoma with microvascular invasion |
title_short | Preoperative alkaline phosphatase‐to‐platelet count ratio as a prognostic factor for hepatocellular carcinoma with microvascular invasion |
title_sort | preoperative alkaline phosphatase‐to‐platelet count ratio as a prognostic factor for hepatocellular carcinoma with microvascular invasion |
topic | RESEARCH ARTICLES |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10524001/ https://www.ncbi.nlm.nih.gov/pubmed/37492981 http://dx.doi.org/10.1002/cam4.6368 |
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