Retrospective Study
Copyright ©The Author(s) 2018. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Hepatol. Jan 27, 2018; 10(1): 82-87
Published online Jan 27, 2018. doi: 10.4254/wjh.v10.i1.82
Ratio of mean platelet volume to platelet count is a potential surrogate marker predicting liver cirrhosis
Hiroya Iida, Masaki Kaibori, Kosuke Matsui, Morihiko Ishizaki, Masanori Kon
Hiroya Iida, Masaki Kaibori, Kosuke Matsui, Morihiko Ishizaki, Masanori Kon, Department of Surgery, Kansai Medical University, Osaka 573-1010, Japan
Author contributions: Iida H designed the research and performed the surgical interventions; Kaibori M performed the surgical interventions and contributed to the statistical assessment; Matsui K and Ishizaki M performed the surgical interventions; Kon M performed the surgical interventions and conferred on the final agreement for publication.
Institutional review board statement: The study was reviewed and approved by the Kansai Medical University Institutional Review Board.
Informed consent statement: Since this research was retrospective observation research using medical record information, the authors only gave the patient the opportunity to opt out. Therefore, there is no informed consent statement signed by the patients.
Conflict-of-interest statement: None of the authors have any conflicts of interest or financial disclosures.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Hiroya Iida, MD, Department of Surgery, Kansai Medical University, 2-5-1 Shinmachi Hirakata, Osaka 573-1010, Japan. hiroya0001@mac.com
Telephone: +81-72-8040101 Fax: +81-72-8042578
Received: March 26, 2017
Peer-review started: March 28, 2017
First decision: June 30, 2017
Revised: November 10, 2017
Accepted: December 4, 2017
Article in press: December 7, 2017
Published online: January 27, 2018
Abstract
AIM

To provide a simple surrogate marker predictive of liver cirrhosis (LC).

METHODS

Specimens from 302 patients who underwent resection for hepatocellular carcinoma between January 2006 and December 2012 were retrospectively analyzed. Based on pathologic findings, patients were divided into groups based on whether or not they had LC. Parameters associated with hepatic functional reserve were compared in these two groups using Mann-Whitney U-test for univariate analysis. Factors differing significantly in univariate analyses were entered into multivariate logistic regression analysis.

RESULTS

There were significant differences between the LC group (n = 100) and non-LC group (n = 202) in prothrombin activity, concentrations of alanine aminotransferase, aspartate aminotransferase, total bilirubin, albumin, cholinesterase, type IV collagen, hyaluronic acid, indocyanine green retention rate at 15 min, maximal removal rate of technitium-99m diethylene triamine penta-acetic acid-galactosyl human serum albumin and ratio of mean platelet volume to platelet count (MPV/PLT). Multivariate analysis showed that prothrombin activity, concentrations of alanine aminotransferase, aspartate aminotransferase, total bilirubin and hyaluronic acid, and MPV/PLT ratio were factors independently predictive of LC. The area under the curve value for MPV/PLT was 0.78, with a 0.8 cutoff value having a sensitivity of 65% and a specificity of 78%.

CONCLUSION

The MPV/PLT ratio, which can be determined simply from the complete blood count, may be a simple surrogate marker predicting LC.

Keywords: Mean platelet volume, Platelet count, Liver cirrhosis, Hepatic functional reserve, Liver fibrosis

Core tip: Although liver biopsy is considered the gold standard in the diagnosis of liver fibrosis and cirrhosis, liver biopsy is an invasive procedure, with attendant morbidity. Less invasive procedures are needed in the diagnosis of liver cirrhosis. Multivariate analysis showed that the mean platelet volume to platelet count ratio was independently predictive of liver cirrhosis. This ratio, which can be determined from a routine complete blood count, may be a simple surrogate marker predicting liver cirrhosis.