Prognostic value of platelet volume indices in patients with resectable esophageal squa-mous cell carcinoma
Objective To evaluate the prognostic value of platelet volume indices(PVI)in patients with resectable esophage-al 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).Com-pared 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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