平均血小板容积对肝细胞癌TACE术后疗效判断的临床价值

The clinical value of mean platelet volume in predicting the therapeutic effect of TACE for HCC

目的探讨肝细胞癌患者的平均血小板容积在TACE术后疗效评价中的价值。方法收集2012年1月—2016年6月接受TACE治疗的肝细胞癌(HCC)患者的临床资料,主要包括初次TACE术前、术后及随访过程中每次TACE术前、术后平均血小板容积(MPV),并记录肿瘤首次发生进展的时间(TTP)(参照m RECIST标准)。将初次TACE术前MPV值按中位数分为低MPV组与高MPV组,并比较两组TTP。结果共随访263例患者,HCC患者初次TACE术前MPV值(9.45±1.24)fL与初次术后MPV值(9.01±1.11)fL差异有统计学意义(t=4.344,P<0.05);HCC病灶首次出现进展时MPV值(9.38±1.16)fL与初次TACE术后MPV值(9.01±1.11)fL差异也有统计学意义(t=3.498,P<0.05)。以初次TACE术前MPV值的中位数(9.3 fL)为界值,将初次TACE术前MPV值分为低MPV组、高MPV组,高MPV组首次肿瘤进展时间与低MPV组差异存在统计学意义(P<0.05)。所有资料采用Cox回归分析显示BCLC分期B、C期、初次术前MPV是HCC TACE术后肿瘤病灶进展的独立风险预测因素。结论 HCC患者术前及术后MPV值的变化在TACE术后疗效的评估方面有一定临床意义,且初次术前MPV值可能对TACE术后HCC进展时间起到预测作用。

Objective To explore the potential clinical value of mean platelet volume（MPV） in predicting the curative effect of TACE for hepatocellular carcinoma（HCC）. Methods The clinical data of 263 HCC patients, who were treated with TACE at authors＇ hospital during the period from January 2012 to June 2016, were collected. The MPV data before initial TACE, before and after each repeated TACE were recorded. The time of tumor progression（TTP; referring to m RECIST standard）, was documented. Based on the MPV determined before initial TACE, the patients were divided into low-MPV group and high-MPV group, and the TTP between the two groups was compared. Results A total of 263 patients were enrolled in this study. In HCC patients, the MPV determined before initial TACE was（9.45±1.24） fL, while the MPV determined after initial TACE was（9.01±1.11） fL, the difference between the two was statistically significant（t =4.344, P〈0.05）. The MPV determined at the time when HCC lesion first developed progression was（9.38±1.16） fL, which was significantly different with the MPV of（9.01±1.11） fL that was obtained after initial TACE（t=3.498, P〈0.05）. Taking the median value of MPV determined before initial TACE（9.3 fL） as the cutoff value, the patients were divided into the low-MPV group and the high-MPV group according to patient＇s MPV determined before initial TACE. Statistically significant difference in the time when HCC lesion first developed progression existed between the low-MPV group and the high-MPV group（P〈0.05）.COX regression analysis showed that BCLC stage B and C, MPV value before initial TACE were the independent risk predictors of tumor progression. Conclusion The pre-TACE and post-TACE MPV values in HCC patients treated with TACE has certain clinical significance in evaluating the curative effect of TACE.Moreover, MPV value before initial TACE has some value in predicting the time of HCC progression after TACE.