术前MPV/PLT预测肝癌消融术后早期复发的效能  

Efficacy of preoperative mean platelet volume/platelet count ratio in predicting early recurrence after ablation for hepatocellular carcinoma

作　　者：隋永博[1] 周立芳[1] 陈金玲 张重阳[1] 王宇 张家驹 SUI Yongbo;ZHOU Lifang;CHEN Jinling;ZHANG Chongyang;WANG YU;ZHANG Jiaju(Department of 1 Hepatobiliary Surgery,Cangzhou Integrated Traditional Chinese and Western Medicine Hospital,Cangzhou 061000,China)

机构地区：[1]河北省沧州中西医结合医院肝胆外一科,河北沧州061000

出　　处：《青岛大学学报(医学版)》2024年第6期907-911,共5页Journal of Qingdao University(Medical Sciences)

基　　金：河北省医学科学研究课题计划项目(20232146)。

摘　　要：目的探讨肝细胞癌(简称肝癌)病人术前平均血小板体积/血小板计数(MPV/PLT)比值对其消融术后早期复发的预测效能。方法选取2020年2月—2022年2月在河北省沧州中西医结合医院接受肝癌消融术治疗的87例病人作为研究对象,术前采血检测并计算所有病人的MPV/PLT比值。随访1年,根据肝癌消融术后是否早期复发分为复发组(观察组,20例)和未复发组(对照组,67例)。采用受试者工作特征(ROC)曲线下面积(AUC)评估术前MPV/PLT比值对肝癌消融术后早期复发的预测效能;采用多因素Logistic回归分析影响肝癌消融术后早期复发的相关因素。结果观察组BCLC肝癌分期、病灶数量、肿瘤长径、术前MPV和MPV/PLT比值均明显高于对照组,而PLT则明显低于对照组(t=3.668~10.902,χ^(2)=7.414~11.344,P<0.05)。二分类多因素Logistic逐步回归分析显示,BCLC肝癌分期B/C期、多个病灶、肿瘤长径≥3 cm和术前MPV/PLT比值≥0.049均是影响肝癌消融术后早期复发的风险因素(OR=2.442~3.751,95%CI=(1.365~1.809)~(4.372~7.777),P<0.05)。术前的MPV、PLT及MPV/PLT比值预测肝癌消融术后早期复发的AUC分别为0.851、0.736和0.928。结论术前MPV/PLT比值升高是肝癌消融术后早期复发的危险因素,其对评估肝癌消融术后病人的预后有一定预测效能。Objective To investigate the efficacy of preoperative mean platelet volume/platelet count(MPV/PLT)ratio in predicting early recurrence after ablation in patients with hepatocellular carcinoma(HCC).Methods A total of 87 patients who received ablation therapy for HCC in Cangzhou Integrated Traditional Chinese and Western Medical Hospital from February 2020 to February 2022 were enrolled as subjects.Blood samples were collected before surgery and MPV/PLT ratio was calculated for all patients.The patients were followed up for 1 year,and then according to the presence or absence of the early recurrence of HCC after ablation,the patients were divided into recurrence group(observation group with 20 patients)and non-recurrence group(control group with 67 patients).The receiver operating characteristic(ROC)curve and the area under the ROC curve(AUC)were used to evaluate the efficacy of preoperative MPV/PLT ratio in predicting early recurrence of HCC after ablation,and the multivariate Logistic regression analysis was used to investigate the influencing factors for the early recurrence of HCC after ablation.Results Compared with the control group,the observation group had significantly higher BCLC stage,number of lesions,tumor diameter,preoperative MPV,and preoperative MPV/PLT ratio and a significantly lower PLT level(t=3.668-10.902,χ^(2)=7.414-11.344,P<0.05).The binary Logistic stepwise regression analysis showed that BCLC stage B/C HCC,multiple lesions,a tumor diameter of≥3 cm,and a preoperative MPV/PLT ratio of≥0.049 were all risk factors for early recurrence of HCC after ablation(OR=2.442-3.751,95%CI=1.365-1.809 to 4.372-7.777,P<0.05).Preoperative MPV,PLT,and MPV/PLT ratio had an AUC of 0.851,0.736,and 0.928,respectively,in predicting the early recurrence of HCC after ablation.Conclusion An increase in preoperative MPV/PLT ratio is a risk factor for the early recurrence of HCC after ablation,with a certain efficacy in predicting the prognosis of patients after HCC ablation.

关 键 词：癌 肝细胞 射频消融术 平均血小板体积 血小板计数 肿瘤复发 局部 预测 

分 类 号：R730.261[医药卫生—肿瘤] R446.11[医药卫生—临床医学]