Published online Jan 27, 2018. doi: 10.4254/wjh.v10.i1.82
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
To provide a simple surrogate marker predictive of liver cirrhosis (LC).
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.
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%.
The MPV/PLT ratio, which can be determined simply from the complete blood count, may be a simple surrogate marker predicting LC.
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.