Decreased platelet distribution width predicts a worse prognosis in patients undergoing surgical resection for hepatocellular carcinoma

Article type: Research Article

Authors: Yue, Chen-Xi^{a; 1} | Liu, Yu-Xi^{a; 1} | Yun, Zhi-Yuan^a | Li, Na^a | Zhao, Chang-Jiu^{b; *} | Wang, Rui-Tao^{a; *}

Affiliations: [a] Department of Internal Medicine, Harbin Medical University Cancer Hospital, Harbin Medical University, Harbin, Heilongjiang, China | [b] Department of Nuclear Medicine, The First Affiliated Hospital, Harbin Medical University, Harbin, Heilongjiang, China

Correspondence: [*] Corresponding authors: Chang-Jiu Zhao, Department of Nuclear Medicine, The First Affiliated Hospital, Harbin Medical University, NO. 23 Post Street, Nangang District, Harbin, Heilongjiang 150001, China. Tel./Fax: +86 451 53603622; Email: changjiu_zhao@126.com; Rui-Tao Wang, Department of Internal Medicine, Harbin Medical University Cancer Hospital, Harbin Medical University, NO. 150 Haping ST, Nangang District, Harbin, Heilongjiang 150081, China. Tel.: +86 451 86298352; Fax: +86 451 86298353; Email: ruitaowang@126.com.

Note: [1] Chen-Xi Yue and Yu-Xi Liu contributed equally to this work.

Abstract: BACKGROUND: Hepatocellular carcinoma (HCC) is the sixth most common malignant tumor and second most common cause of tumor-related deaths worldwide. Activated platelets play a prominent role in tumor. Platelet distribution width (PDW) indicates platelets activation and is altered in malignancies. The aim of this study was to explore the prognostic value of PDW for overall survival (OS) in HCC patients. METHODS: We retrospectively reviewed 273 HCC patients at a single institution from 2010 to 2014. The relationship between PDW and clinicopathological characteristics was analyzed. Kaplan-Meier curves and multivariate Cox regression analyses were used to evaluate the relationship of PDW with OS. RESULTS: Low PDW levels were observed in 127 (46.5%) out of 273 patients. A significant correlation was found between PDW and liver cirrhosis. Median follow-up was 36 months, survival curves revealed that the patients with increased PDW had significantly shorter survival time than those with normal PDW (p= 0.001). Cox regression analysis demonstrated that PDW was an independent prognostic factor for overall survival (hazard ratio, 2.464; 95% confidence interval [CI], 1.402–4.330, p= 0.001). CONCLUSION: PDW is significantly associated with OS in HCC. This result suggests activated platelet may affect clinical outcome and warrant continued investigation.

Keywords: Hepatocellular carcinoma, platelet distribution width, prognosis

DOI: 10.3233/CBM-190474

Journal: Cancer Biomarkers, vol. 26, no. 3, pp. 361-366, 2019