目的 探讨平均血小板体积(MPV)与血小板计数(PLT)比值(MPV/PLT)预测小肝癌患者并发微血管浸润(MVI)的临床价值.方法 回顾性分析153例小肝癌患者临床资料,并根据肝癌患者术后是否并发MVI将其分为MVI组(70例),非MVI组(83例).所有肝癌患者入院后均检测MPV、PLT,并计算MPV/PLT.分析比较MVI组、非MVI组MPV/PLT值差异,采用受试者工作特性曲线(ROC)分析MPV/PLT对肝癌患者并发MVI的预测价值,采用多因素Logistic回归分析影响肝癌患者并发MVI的相关因素.结果 与非MVI组比较,MVI组患者MPV水平更高、PLT水平更低(P<0.05).MVI组患者MPV/PLT水平明显高于非MVI组(P<0.05).经ROC曲线结果显示,MPV/PLT曲线下面积、截断值、敏感度、特异度分别为0.825、0.060、82.5%、89.6%,均高于MPV、PLT单项的敏感度、特异度(P<0.05).单因素分析结果显示,MVI组与非MVI组患者AFP水平、肿瘤直径、分化程度、MPV/PLT水平具有明显差异(P<0.05).多因素logistics回归分析结果显示:低分化程度、肿瘤直径>3 cm、AFP>200 ng/ml、MPV/PLT>0.060均为肝癌患者并发MVI的危险因素(P<0.05).结论 MPV/PLT水平在小肝癌并发微血管浸润患者中明显升高,是影响小肝癌患者并发MVI的相关因素,有望作为预测小肝癌患者并发MVI的有效生物标志物.
Objective To investigate the clinical value of mean platelet volume(MPV)to platelet count(PLT)ratio(MPV/PLT)in predicting microvascular infiltration(MVI)in patients with small liver cancer.Methods The clinical data of 153 patients with small liver cancer were retrospectively analyzed.According to whether patients complicated with MVI after oper-ation,they were divided into MVI group(70 cases)and non MVI group(83 cases).MPV and PLT were detected in all patients with liver cancer after admission,and MPV/PLT was calculated.The differences of MPV/PLT between MVI group and non MVI group were compared.The predictive value of MPV/PLT for MVI in patients with liver cancer was analyzed by receiver operating characteristic curve(ROC).The related factors for MVI in patients with liver cancer were analyzed by multivariate logistic regres-sion.Results Compared with the non-MVI group,the MPV level in the MVI group was higher,and PLT level was lower(P<0.05).The level of MPV/PLT in MVI group was significantly higher than that in non MVI group(P<0.05).The ROC curve showed that the area,cut-off value,sensitivity and specificity under MPV/PLT curve were 0.825,0.060,82.5%and 89.6%,re-spectively,which were higher than those of MPV and PLT(P<0.05).Univariate analysis showed that there were significant differences in AFP level,tumor diameter,degree of differentiation and MPV/PLT level between MVI group and non MVI group(P<0.05).Multivariate logistic regression analysis showed that the low differentiation,tumor diameter>3 cm,AFP>200 ng/ml and MPV/PLT>0.060 were the risk factors of MVI in patients with liver cancer(P<0.05).Conclusion The level of MPV/PLT is significantly increased in patients with small liver cancer complicated with microvascular infiltration,which is a related fac-tor affecting the complications of MVI in patients with small liver cancer,and is expected to be an effective biomarker for predic-ting the complications of MVI in patients with small liver cancer.