Association between platelet count and hepatocellular carcinoma overall survival: a large retrospective cohort study
Objectives To explore the non-linear relationship between platelet count (PLT) and hepatocellular carcinoma (HCC) overall survival (OS).Setting The study was done in Sun Yat-sen University Cancer Center (SYSUCC) from January 2007 to May 2012, a total of 5005 consecutive participants at SYSUCC were r...
Saved in:
| Main Authors: | , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
BMJ Publishing Group
2020-11-01
|
| Series: | BMJ Open |
| Online Access: | https://bmjopen.bmj.com/content/10/11/e038172.full |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1850218560645758976 |
|---|---|
| author | Yan Zhang Xiong Chen Jingnan Liu Linbin Lu Zhimin Su Peichan Zheng Zhixian Wu Huimin He Shan Lin |
| author_facet | Yan Zhang Xiong Chen Jingnan Liu Linbin Lu Zhimin Su Peichan Zheng Zhixian Wu Huimin He Shan Lin |
| author_sort | Yan Zhang |
| collection | DOAJ |
| description | Objectives To explore the non-linear relationship between platelet count (PLT) and hepatocellular carcinoma (HCC) overall survival (OS).Setting The study was done in Sun Yat-sen University Cancer Center (SYSUCC) from January 2007 to May 2012, a total of 5005 consecutive participants at SYSUCC were retrospectively reviewed, and 979 patients with Barcelona clinic liver cancer (BCLC) stage B were selected for the final analysis.Participants A total of 979 newly diagnosed patients with HCC with BCLC stage B were identified for the secondary analysis. Eight cases were excluded for missing data of PLT.Main outcome measures Cox proportional hazard regression models were used to calculate multivariable-adjusted HRs and 95% CIs for HCC. The non-linear relationship was estimated through a restricted cubic spline regression, and a two-piecewise Cox proportional hazards model was further performed to calculate the threshold effect. We used multiple imputation to deal with the missing data.Results In the multivariate analysis, Log PLT was associated with a 91% risk increase in death (HR 1.91; 1.28 to 2.85) with adjustment for gender, Child-Pugh class, age × diameter of main tumour, both lobe with lesions × number of the intrahepatic lesions, alpha-fetoprotein (<25, ≥25) and lactic dehydrogenase (<245, ≥245). We also found a U-shape relationship between PLT and HCC OS at the inflexion point of 67.6×109/L. The HR was 0.12 (95% CI 0.03 to 0.52) for Log PLT≤10.83 and 3.07 (CI 1.91 to 4.92) for Log PLT>10.83 after adjusting for potential confounders. The core results were consistent with those from the sensitivity analysis. Besides, a significantly higher hazard risk was found in the patients with age <55, both lobes with lesions, tumour diameter >50, haemoglobin ≥120 and C reactive protein >10.Conclusion PLT was nonlinearly associated with HCC OS. |
| format | Article |
| id | doaj-art-e625f2efb1964fdfaff2135cbdce217a |
| institution | OA Journals |
| issn | 2044-6055 |
| language | English |
| publishDate | 2020-11-01 |
| publisher | BMJ Publishing Group |
| record_format | Article |
| series | BMJ Open |
| spelling | doaj-art-e625f2efb1964fdfaff2135cbdce217a2025-08-20T02:07:41ZengBMJ Publishing GroupBMJ Open2044-60552020-11-01101110.1136/bmjopen-2020-038172Association between platelet count and hepatocellular carcinoma overall survival: a large retrospective cohort studyYan Zhang0Xiong Chen1Jingnan Liu2Linbin Lu3Zhimin Su4Peichan Zheng5Zhixian Wu6Huimin He7Shan Lin81 State Key Laboratory of Reproductive Medicine, Nanjing Medical University, Nanjing, Jiangsu, ChinaDepartment of Otolaryngology-Head and Neck Surgery, Zhongnan Hospital of Wuhan University, Wuhan, ChinaDepartment of Oncology, 900th Hospital of PLA, Fuzhou, ChinaDepartment of Oncology, 900th Hospital of PLA, Fuzhou, ChinaDepartment of Medical Oncology, Xiamen Branch, Zhongshan Hospital, Fudan University, Shanghai, ChinaFujian Center for Safety Evaluation of New Drug, Fujian Medical University, Fuzhou, ChinaDepartment of Hepatobiliary Disease, 900th Hospital of PLA, Fuzhou, ChinaDepartment of Oncology, 900th Hospital of PLA, Fuzhou, ChinaDepartment of Ophthalmology, University of California San Francisco, San Francisco, California, USAObjectives To explore the non-linear relationship between platelet count (PLT) and hepatocellular carcinoma (HCC) overall survival (OS).Setting The study was done in Sun Yat-sen University Cancer Center (SYSUCC) from January 2007 to May 2012, a total of 5005 consecutive participants at SYSUCC were retrospectively reviewed, and 979 patients with Barcelona clinic liver cancer (BCLC) stage B were selected for the final analysis.Participants A total of 979 newly diagnosed patients with HCC with BCLC stage B were identified for the secondary analysis. Eight cases were excluded for missing data of PLT.Main outcome measures Cox proportional hazard regression models were used to calculate multivariable-adjusted HRs and 95% CIs for HCC. The non-linear relationship was estimated through a restricted cubic spline regression, and a two-piecewise Cox proportional hazards model was further performed to calculate the threshold effect. We used multiple imputation to deal with the missing data.Results In the multivariate analysis, Log PLT was associated with a 91% risk increase in death (HR 1.91; 1.28 to 2.85) with adjustment for gender, Child-Pugh class, age × diameter of main tumour, both lobe with lesions × number of the intrahepatic lesions, alpha-fetoprotein (<25, ≥25) and lactic dehydrogenase (<245, ≥245). We also found a U-shape relationship between PLT and HCC OS at the inflexion point of 67.6×109/L. The HR was 0.12 (95% CI 0.03 to 0.52) for Log PLT≤10.83 and 3.07 (CI 1.91 to 4.92) for Log PLT>10.83 after adjusting for potential confounders. The core results were consistent with those from the sensitivity analysis. Besides, a significantly higher hazard risk was found in the patients with age <55, both lobes with lesions, tumour diameter >50, haemoglobin ≥120 and C reactive protein >10.Conclusion PLT was nonlinearly associated with HCC OS.https://bmjopen.bmj.com/content/10/11/e038172.full |
| spellingShingle | Yan Zhang Xiong Chen Jingnan Liu Linbin Lu Zhimin Su Peichan Zheng Zhixian Wu Huimin He Shan Lin Association between platelet count and hepatocellular carcinoma overall survival: a large retrospective cohort study BMJ Open |
| title | Association between platelet count and hepatocellular carcinoma overall survival: a large retrospective cohort study |
| title_full | Association between platelet count and hepatocellular carcinoma overall survival: a large retrospective cohort study |
| title_fullStr | Association between platelet count and hepatocellular carcinoma overall survival: a large retrospective cohort study |
| title_full_unstemmed | Association between platelet count and hepatocellular carcinoma overall survival: a large retrospective cohort study |
| title_short | Association between platelet count and hepatocellular carcinoma overall survival: a large retrospective cohort study |
| title_sort | association between platelet count and hepatocellular carcinoma overall survival a large retrospective cohort study |
| url | https://bmjopen.bmj.com/content/10/11/e038172.full |
| work_keys_str_mv | AT yanzhang associationbetweenplateletcountandhepatocellularcarcinomaoverallsurvivalalargeretrospectivecohortstudy AT xiongchen associationbetweenplateletcountandhepatocellularcarcinomaoverallsurvivalalargeretrospectivecohortstudy AT jingnanliu associationbetweenplateletcountandhepatocellularcarcinomaoverallsurvivalalargeretrospectivecohortstudy AT linbinlu associationbetweenplateletcountandhepatocellularcarcinomaoverallsurvivalalargeretrospectivecohortstudy AT zhiminsu associationbetweenplateletcountandhepatocellularcarcinomaoverallsurvivalalargeretrospectivecohortstudy AT peichanzheng associationbetweenplateletcountandhepatocellularcarcinomaoverallsurvivalalargeretrospectivecohortstudy AT zhixianwu associationbetweenplateletcountandhepatocellularcarcinomaoverallsurvivalalargeretrospectivecohortstudy AT huiminhe associationbetweenplateletcountandhepatocellularcarcinomaoverallsurvivalalargeretrospectivecohortstudy AT shanlin associationbetweenplateletcountandhepatocellularcarcinomaoverallsurvivalalargeretrospectivecohortstudy |