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Prognostic value of platelet volume indices in patients with resectable esophageal squamous cell carcinoma |
YUE Xiang1, HUANG Hao2, WANG Wen3, TIAN Mang1 |
1. Department of Cardiothoracic Urology, the 987th Hospital of PLA Joint Logistics Support Force, Baoji 721000, China; 2. Department of Cardiothoracic Surgery, General Hospital of PLA Central Theater Command, Wuhan 430064, China; 3. School of Medicine of Yan’an University, Yan’an 716000, China |
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Abstract Objective To evaluate the prognostic value of platelet volume indices (PVI) in patients with resectable esophageal squamous cell carcinoma (ESCC). Methods Clinical data of 210 patients with ESCC who underwent surgery from March 2013 to June 2023 were retrospectively analyzed, and the cut-off values of PVI were obtained from the receiver operating characteristic curve (ROC), and the Kaplan-Meier method and COX model were used to analyze the effect of PVI index on the prognosis of ESCC patients. Results During a 5-year follow-up, 125 patients (59.52%) died, with a median OS of 15.0 months (range of 3-60 months). Compared with the survival group, platelet count (PLT) in the death group[250.50 (205.0, 300.50) vs. 212.50 (179.50, 278.50), Z=-2.801, P=0.005], platelet distribution width (PDW) in the death group[12.90 (11.80, 15.80) FL vs. 11.30 (10.40, 14.95) FL, Z=-2.665, P=0.008]increased (P<0.05), PDW/PLT[12.90 (11.80, 15.80) vs. 11.30 (10.20, 15.05), Z=-6.719, P<0.001]significantly increased, and the mean platelet volume (MPV) /PLT significantly decreased[0.04 (0.03, 0.04) vs. 0.05 (0.04, 0.06), Z=-10.847, P<0.001]. The receiver operating characteristic curve showed that PLT, PDW, MPV/PLT and PDW/PLT could all be used to predict the mortality risk of patients with resectable ESCC, P<0.05, but the clinical value of PLT and PDW was not high[area under the curve (AUC)<0.7]; when MPV/PLT≥0.043 or PDW/ PLT≥60.230,the AUC values were 0.771 and 0.802, respectively, and when the two were combined, the AUC values for predicting mortality risk increased to 0.929.Compared with patients with MPV/PLT>0.043 and PDW/PLT≤60.230, the overall survival (OS) of ESCC patients with MPV/PLT≤0.043(Log-Rank=34.502,P<0.001) and PDW/PLT>60.230(Log-Rank=172.056,P<0.001) was shorter. The COX multivariate model analysis showed that PDW/PLT>60.230 and MPV/PLT>0.043 were independently associated with postoperative mortality in ESCC patients (P<0.05). Conclusions PVI is a potential prognostic indicator for resectable ESCC patients after surgery, especially the clinical prognostic value of combined detection of MPV/PLT and PDW/PLT is more ideal.
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Received: 20 May 2024
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