目的:血小板计数升高可能反映肿瘤和炎症状态,与细胞因子驱动的血小板过度生产。这项研究的目的是评估高血小板计数的预后效用在接受根治性肝手术治疗肝内胆管癌(ICC)的患者中。
方法:国际,多机构队列用于确定接受ICC根治性肝切除术的患者(2000-2020).高血小板计数被定义为血小板>300*109/L。术前血小板计数,癌症特异性生存率(CSS),并检查总生存期(OS)。
结果:在825例接受ICC根治性切除术的患者中,139的血小板计数高,与多灶性疾病相关,淋巴结转移,差到未分化等级,和微血管入侵。血小板计数高的患者5年表现较差(35.8%vs.46.7%,p=0.009)CSS和OS(24.8%vs.39.8%,p<0.001),相对于血小板计数低的患者。在控制相关临床病理因素后,高血小板计数仍然是CSS(HR=1.46,95%CI1.02-2.09)和OS(HR=1.59,95%CI1.14-2.22)的不良独立预测因子.
结论:高血小板计数与较差的肿瘤特征和较差的长期CSS和OS相关。血小板计数代表了一个容易获得的实验室值,可以在术前改善接受ICC根治性肝切除术的患者的风险分层。
OBJECTIVE: An elevated platelet count may reflect neoplastic and inflammatory states, with cytokine-driven overproduction of platelets. The objective of this study was to evaluate the prognostic utility of high platelet count among patients undergoing curative-intent liver surgery for intrahepatic cholangiocarcinoma (ICC).
METHODS: An international, multi-institutional cohort was used to identify patients undergoing curative-intent liver resection for ICC (2000-2020). A high platelet count was defined as platelets >300 *109/L. The relationship between preoperative platelet count, cancer-specific survival (CSS), and overall survival (OS) was examined.
RESULTS: Among 825 patients undergoing curative-intent resection for ICC, 139 had a high platelet count, which correlated with multifocal disease, lymph nodes metastasis, poor to undifferentiated grade, and microvascular invasion. Patients with high platelet counts had worse 5-year (35.8% vs. 46.7%, p = 0.009) CSS and OS (24.8% vs. 39.8%, p < 0.001), relative to patients with a low platelet count. After controlling for relevant clinicopathologic factors, high platelet count remained an adverse independent predictor of CSS (HR = 1.46, 95% CI 1.02-2.09) and OS (HR = 1.59, 95% CI 1.14-2.22).
CONCLUSIONS: High platelet count was associated with worse tumor characteristics and poor long-term CSS and OS. Platelet count represents a readily-available laboratory value that may preoperatively improve risk-stratification of patients undergoing curative-intent liver resection for ICC.