Background
Platelet–albumin–bilirubin (PALBI) has been demonstrated to be superior to conventional Child–Pugh (C-P) grade in evaluating liver function and prognosis of HCC patients. However, both thrombocytosis and thrombocytopenia are unfavorable for HCC survival. The aim of this study was to preliminarily investigate the prognostic value of PALBI in HCC patients with thrombocytopenia and excluding thrombocytopenia.
Methods
In this retrospective cohort study, we reviewed 465 cases of HCC patients who underwent radical surgery. PALBI grade was calculated based on preoperative serological examinations. The primary outcomes were overall survival (OS) and recurrence-free survival (RFS), which were assessed by Kaplan–Meier method and Cox regression. The prognostic performances of PALBI and other models were estimated by using the concordance index (C-index).
Results
During a median follow-up time of 28 months, 31.6% (147/465) of patients died and 33.5% (156/465) experienced recurrence. Multivariate analyses revealed that both thrombocytosis and thrombocytopenia were independently associated with poor OS and RFS compared with normal platelet count (PLT) in HCC patients. Stratified analysis further revealed that PALBI was a significant predictor for HCC survival in patients excluding thrombocytopenia but not in patients with thrombocytopenia. In particular, in HCC patients excluding thrombocytopenia, the combination of tumor size with PALBI (C-index = 0.730, 95% CI: 0.674–0.786) may be superior to the classical Barcelona Clinic Liver Cancer (BCLC) and Cancer of Liver Italian Program (CLIP) staging systems in predicting survival.
Conclusion
In conclusion, PALBI grade, in particular the combination with tumor size, is an effective model for discriminating survival in HCC patients excluding thrombocytopenia but not in thrombocytopenic HCC patients.
Spectrum-locked high-power diode lasers are extremely sought after in many fields. Here, we establish the volume Bragg grating external-cavity diode laser model and investigate the impact of facet reflectivity on the output spectrum. The simulation results emphasize that optimizing reflectivity can realize better spectrum-locking and side-mode suppression ratio. To prove the feasibility, we built a diode laser array with 20 single emitters. Three different facet reflectivity are prepared, 0.1%, 0.5%, and 0.8%. As a result, the output spectrums of the array are improved obviously with the decrease in reflectivity. In the case of 0.1%, the side-mode is well suppressed under injection current up to 16 A, and the calculated current-spectrum shift is around 0.07 nm A−1. After beam combining and fiber coupling, an output power of 243.4 W and a brightness of about 11.2 MW cm−2-str is attained.
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