Elevated platelet distribution width and diabetes may serve as preoperative predictors of microvascular invasion in primary hepatocellular carcinoma.

IF 2.8 3区 医学 Q3 ONCOLOGY Journal of Cancer Research and Clinical Oncology Pub Date : 2025-03-14 DOI:10.1007/s00432-025-06157-2
Ling Wang, Liu Jun, Jia Jian'an, Rao Chunmei, Jiang Yuhuan, Liu Peng, Li Huiming
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Abstract

Background and objective: Hepatocellular carcinoma (HCC) is one of the malignancies with increasing incidence globally, and microvascular invasion (MVI) is a crucial determinant of prognosis in patients. This study aimed to investigate platelet distribution width (PDW) and diabetes mellitus as indicators for predicting preoperative MVI in HCC, providing more accurate predictive tools for clinicians to guide treatment strategies and improve patient survival and quality of life.

Methods: A retrospective study was conducted, including 1357 patients who underwent hepatectomy for HCC between January 2008 and December 2014 at the Eastern Hepatobiliary Surgery Hospital in China. Clinical, pathological, and radiological data, including PDW and diabetes status, were collected. Univariate and multivariate logistic regression analyses were performed to identify risk factors for MVI and establish a predictive model. The predictive performance of the model was evaluated through nomograms and internal validation.

Results: Univariate analysis revealed significant associations between MVI and diabetes mellitus, presence of liver cirrhosis, prealbumin level, tumor diameter, number of tumors, HBV DNA viral load > 104, and PDW ≥ 17. Multivariate logistic regression analysis identified diabetes mellitus, liver cirrhosis, prealbumin level, tumor diameter, number of tumors, HBV DNA viral load > 104, and PDW ≥ 17 as independent risk factors for MVI. Based on these findings, a predictive model was established, demonstrating high predictive accuracy and stability in both the training and validation cohorts.

Conclusion: This study confirmed PDW and diabetes mellitus as reliable indicators for predicting preoperative MVI in HCC and established a corresponding predictive model. Future research should further explore the underlying mechanisms and enhance clinical validation to advance the field of HCC treatment.

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血小板分布宽度升高和糖尿病可能是原发性肝细胞癌微血管侵袭的术前预测因素。
背景与目的:肝细胞癌(HCC)是全球发病率越来越高的恶性肿瘤之一,微血管侵袭(MVI)是影响患者预后的重要因素。本研究旨在探讨血小板分布宽度(PDW)和糖尿病作为预测HCC术前MVI的指标,为临床医生指导治疗策略,提高患者生存率和生活质量提供更准确的预测工具。方法:回顾性研究,纳入2008年1月至2014年12月在中国东方肝胆外科医院因肝癌行肝切除术的1357例患者。收集临床、病理和放射学资料,包括PDW和糖尿病状况。采用单因素和多因素logistic回归分析确定MVI的危险因素并建立预测模型。通过模态图和内部验证来评估模型的预测性能。结果:单因素分析显示MVI与糖尿病、肝硬化、白蛋白前水平、肿瘤直径、肿瘤数量、HBV DNA病毒载量> 104和PDW≥17之间存在显著相关性。多因素logistic回归分析发现糖尿病、肝硬化、白蛋白前水平、肿瘤直径、肿瘤数量、HBV DNA病毒载量> 104、PDW≥17是MVI的独立危险因素。基于这些发现,建立了一个预测模型,在训练和验证队列中都显示出较高的预测准确性和稳定性。结论:本研究证实了PDW和糖尿病是预测HCC术前MVI的可靠指标,并建立了相应的预测模型。未来的研究应进一步探索其潜在机制,加强临床验证,以推动HCC治疗领域的发展。
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来源期刊
CiteScore
4.00
自引率
2.80%
发文量
577
审稿时长
2 months
期刊介绍: The "Journal of Cancer Research and Clinical Oncology" publishes significant and up-to-date articles within the fields of experimental and clinical oncology. The journal, which is chiefly devoted to Original papers, also includes Reviews as well as Editorials and Guest editorials on current, controversial topics. The section Letters to the editors provides a forum for a rapid exchange of comments and information concerning previously published papers and topics of current interest. Meeting reports provide current information on the latest results presented at important congresses. The following fields are covered: carcinogenesis - etiology, mechanisms; molecular biology; recent developments in tumor therapy; general diagnosis; laboratory diagnosis; diagnostic and experimental pathology; oncologic surgery; and epidemiology.
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