Background: Platelets (PLT) have a role in the pathogenesis, progression, and prognosis of hepatocellular carcinoma (HCC) and could represent a readily measurable laboratory parameter to enhance the comprehensive evaluation of HCC patients. Methods: The PubMed, Web of Science, and Scopus databases were searched with a focus on survival as well as patient and tumor-specific characteristics in correlation to reported PLT counts. Survival outcomes were analyzed with both common-effect and random-effects models. The hazard ratio (HR) and its 95% confidence interval (CI) from analyzed trials were incorporated. Studies that did not provide survival data but focused on platelet count correlation with HCC characteristics were reviewed. Results: In total, 26 studies, including a total of 9403 patients, met our criteria. The results showed that thrombocytopenia in HCC patients was associated with poor overall survival (common-effect HR = 1.15, 95% CI: 1.06–1.25; random-effect HR = 1.30, 95% CI: 1.05–1.63). Moreover, three studies reveal significant correlations between PLT indices and tumor characteristics such as size, foci number, and etiology of HCC development. Conclusion: Our meta-analysis confirmed that PLT count could act as a prognostic marker in HCC, especially with a PLT count cut off <100 × 103/mm3. Further prospective studies focusing on the role of PLT in clearly defined subgroups are necessary.
背景：血小板在肝细胞癌的发病机制、进展及预后中具有重要作用，可作为易于测量的实验室参数，以增强对肝细胞癌患者的综合评估。方法：检索PubMed、Web of Science和Scopus数据库，重点关注生存率以及患者和肿瘤特异性特征与报告的血小板计数的相关性。采用固定效应模型和随机效应模型分析生存结果，并纳入分析试验的风险比及其95%置信区间。对未提供生存数据但关注血小板计数与肝细胞癌特征相关性的研究进行了综述。结果：共有26项研究符合我们的标准，总计纳入9403例患者。结果显示，肝细胞癌患者的血小板减少与较差的总生存期相关（固定效应HR=1.15，95% CI：1.06-1.25；随机效应HR=1.30，95% CI：1.05-1.63）。此外，三项研究揭示了血小板指数与肿瘤特征（如大小、病灶数量及肝细胞癌发展的病因）之间存在显著相关性。结论：我们的荟萃分析证实，血小板计数可作为肝细胞癌的预后标志物，尤其是当血小板计数临界值设定为<100×10³/mm³时。未来有必要针对血小板在明确定义的亚组中的作用开展进一步前瞻性研究。
肿瘤(癌症)患者之家