Preoperative PDW levels predict pulmonary metastasis in patients with hepatocellular carcinoma

Abstract

Background In hepatocellular carcinoma (HCC), pulmonary metastasis (PM) after hepatectomy is associated with poor clinical outcomes. The crucial phases of tumour cell proliferation, angiogenesis, and metastasis all entail platelet activation. In HCC, platelet distribution width (PDW) suggests platelet size changes and predicts a worse prognosis. The aim of this study was to assess the association between PDW and PMs in HCC patients receiving hepatectomy. Material/methods From January 2013 to December 2015, a cohort of patients who underwent hepatectomy for HCC at the Harbin Medical University Cancer Hospital in China were retrospectively evaluated. The relationship between PDW levels and clinical and demographic parameters was examined. To investigate the relationships between predicted factors and PM, a competing risk model was used. From January 2016 to December 2018, a validation cohort of 109 patients from the First Affiliated Hospital of Harbin Medical University was studied independently. Results In the primary cohort, 19 out of 214 patients had postoperative PMs. In HCC patients with PM, PDW levels were lower than in those without PM. There was a significant difference in the cumulative incidence of 2-year PM between the high-PDW and low-PDW groups after controlling for competing risk events (death prior to the development of PM) (p < 0.001). In addition, PDW was also found to be an independent predictor for PM in a multivariable competing risk analysis. The results were externally validated in another cohort. Conclusions In HCC, preoperative PDW is significantly associated with PM. PDW could be a biomarker for post-operative PM in HCC patients.

Genetic Analysis of Platelet-Related Genes in Hepatocellular Carcinoma Reveals a Novel Prognostic Signature and Determines PRKCD as the Potential Molecular Bridge

“…Generally, the ultrasound examination and serum alpha-fetoprotein (AFP) levels are widely utilized for the early screening of high-risk populations, and the suspected patients subsequently obtain a clinical or definitive diagnosis via the CT/MRI enhanced scanning or liver biopsy. In recent years, several commonly used blood routine and biochemistry indexes have also attracted much attention from researchers in addition to the classic serum oncology biomarkers, which have the potential to serve as prospective indicators for prognosis assessment and risk stratification of patients with HCC independently or synergistically [ 27 – 29 ], and platelet is one of the representatives [ 11 , 30 – 32 ]. Studies have demonstrated that abnormal platelet counts (including thrombocytopenia and thrombocytosis) are closely related to the poor OS of patients with HCC [ 30 , 33 ].…”

“…The liver is a substantial organ with a dual blood supply system, and this anatomical characteristic also makes it necessary to explore the potential function of platelets in liver diseases, especially in HCC. In current studies, clinical explorations about platelets in HCC mainly concentrate on the significance of the variation of platelet counts or morphology as well as the platelet-related ratio in prognostic prediction [ 9 – 11 ]. While from the perspective of clinical findings combined with molecular changes, whether there are corresponding abnormal changes in platelet-related genes in the development of HCC remains unclear.…”

Genetic Analysis of Platelet-related Genes in Hepatocellular Carcinoma Reveals a Novel Prognostic Signature and Determines PRKCD as the Potential Molecular Bridge

“…Studies have demonstrated that abnormal platelet counts (including thrombocytopenia and thrombocytosis) are closely related to the poor OS of patients with HCC (26, 29). Additionally, aberrant changes in morphology or functional status of platelet have also been discovered to be connected with tumor metastasis and patients' adverse outcomes (11,27). Actually, the intimate connection between platelets and tumor progression has been widely recognized, numerous fundamental research has proved that platelets take an essential part in mediating cancer proliferation, angiogenesis, invasion and metastasis, as well as immune escape (4).…”

“…Generally, the ultrasound examination and serum alpha-fetoprotein (AFP) levels are widely utilized for the early screening of high-risk populations, and the suspected patients subsequently obtain a clinical or de nitive diagnosis via the CT/MRI enhanced scanning or liver biopsy. In recent years, several commonly used blood routine and biochemistry indexes have also attracted much attention from researchers in addition to the classic serum oncology biomarkers, which have the potential to serve as prospective indicators for prognosis assessment and risk strati cation of patients with HCC independently or synergistically (23)(24)(25), and platelet is one of the representatives (11,(26)(27)(28). Studies have demonstrated that abnormal platelet counts (including thrombocytopenia and thrombocytosis) are closely related to the poor OS of patients with HCC (26, 29).…”

“…The liver is a substantial organ with a dual blood supply system, and this anatomical characteristic also makes it necessary to explore the potential function of platelets in liver diseases, especially in HCC. In current studies, clinical explorations about platelets in HCC mainly concentrate on the signi cance of the variation of platelet counts or morphology as well as the platelet-related ratio in prognostic prediction (9)(10)(11). While from the perspective of clinical ndings combined with molecular changes, whether there are corresponding abnormal changes in platelet-related genes in the development of HCC remains unclear.…”