Comparison of the prognostic value of platelet-based prognostic models in patients with malignant hepatic tumors after TACE therapy

Du, Qian Cheng; Hu, Chen Liang; Wang, Yan Yan; Zhou, Ying

doi:10.1590/s0102-865020190070000010

Qian Cheng Du

Master, Department of General Surgery, Shanghai Fourth People's Hospital Affiliated to Tongji University School of Medicine, Shanghai, China. Intellectual, scientific, conception and design of the study; acquisition, analysis and interpretation of data; technical procedures; statistical analysis; manuscript preparation, final approval

* Contributed equally to this work.

http://orcid.org/0000-0002-0154-2210

Chen Liang Hu

Master, Department of Hepatopancreatobiliary Surgery, the Affiliated Hospital of Qinghai University, Xining, China. Intellectual, scientific, conception and design of the study; acquisition, analysis and interpretation of data; technical procedures; statistical analysis; manuscript preparation, final approval

* Contributed equally to this work.

http://orcid.org/0000-0002-4231-2411

Yan Yan Wang

Master, Department of Hematology, Affiliated Fuyang Hospital of Anhui Medical University, Fuyang, China. Intellectual, scientific, conception and design of the study; acquisition, analysis and interpretation of data; technical procedures; statistical analysis; manuscript preparation, final approval

* Contributed equally to this work.

http://orcid.org/0000-0002-1136-6521

Ying Zhou Correspondence: Ying Zhou Department of Hepatopancreatobiliary Surgery The Affiliated Hospital, Qinghai University Xining 810000 China Phone: +86 971 6230701 17697227511@163.com

Full Professor, Department of Hepatopancreatobiliary Surgery, the Affiliated Hospital of Qinghai University and Qinghai Province Key Laboratory of Hydatid Disease Research, Qinghai University, Xining, China. Acquisition, analysis and interpretation of data; technical procedures; critical revision; manuscript preparation, final approval

http://orcid.org/0000-0003-4553-4367

Correspondence: Ying Zhou Department of Hepatopancreatobiliary Surgery The Affiliated Hospital, Qinghai University Xining 810000 China Phone: +86 971 6230701 17697227511@163.com

Conflict of interest: none

*
Contributed equally to this work.

Master, Department of General Surgery, Shanghai Fourth People's Hospital Affiliated to Tongji University School of Medicine, Shanghai, China. Intellectual, scientific, conception and design of the study; acquisition, analysis and interpretation of data; technical procedures; statistical analysis; manuscript preparation, final approval

Master, Department of Hepatopancreatobiliary Surgery, the Affiliated Hospital of Qinghai University, Xining, China. Intellectual, scientific, conception and design of the study; acquisition, analysis and interpretation of data; technical procedures; statistical analysis; manuscript preparation, final approval

Master, Department of Hematology, Affiliated Fuyang Hospital of Anhui Medical University, Fuyang, China. Intellectual, scientific, conception and design of the study; acquisition, analysis and interpretation of data; technical procedures; statistical analysis; manuscript preparation, final approval

Full Professor, Department of Hepatopancreatobiliary Surgery, the Affiliated Hospital of Qinghai University and Qinghai Province Key Laboratory of Hydatid Disease Research, Qinghai University, Xining, China. Acquisition, analysis and interpretation of data; technical procedures; critical revision; manuscript preparation, final approval

Index	Formulas
Pohl score	$1 : AAR > 1 and PLT < 150 \times 10^{9} /L or else, the score = 0$
AARP	$1 : AAR > 1 or PLT < 150 \times 10^{9} /L or else, the score = 0$
API	$\begin{matrix} Age (years): < 30 = 0; 30 - 39 = 1; 40 - 49 = 2; 50 - 59 = 3; 60 - 69 = 4; \geq 70 = 5. PLT: \geq 225 = 0; 200 - 224 \\ = 1; 175 - 199 = 2; 150 - 174 = 3; 125 - 149 = 4; < 125 = 5 API is the sum of age and platelet scores and \\ therefore varied from 0-10 \end{matrix}$
CDS	$\begin{array}{c} PLT: > 340 = 0; 280 - 339 = 1; 220 - 279 = 2; 160 - 219 = 3; 100 - 159 = 4; 40 - 99 = 5; < 40 = 6 ALT/AST \\ ratio: > 1.7 = 0; 1.2 - 1.7 = 1; 0.6 - 1.19 = 2; < 0.6 = 3 INR: < 1.1 = 0; 1.1 - 1.4 = 1; > 1.4 = 2 CDS is the sum \\ of the above \end{array}$
APRI	$[AST (/ULN) \times {100] /PLT (10}^{9} /L)$
FIB-4	$[age (years) \times AST (U/L)] / [PLT(109/L) \times {ALT(U/L)}^{1/2}]$
FibroQ	$10 \times (Age \times AST \times PT INR / ALT \times PLT)$
Lok index	$Log odds = - 5.56 - 0.0089 \times PLT (10^{9} /L) + 1.26 \times AAR + 5.27 \times INR, lok index = \exp (\log odds) / [1 + \exp (\log odds)]$
GUCI	$AST \times INR \times 100 /PLT (10^{9} /L)$
APGA	$\begin{array}{l} Log (index) = 1.44 + 0.1490 \times log [GGT (U / L)] + 0.3308 \times \log [AST (U / L)] - 0.5846 \times \log [PLT (10^{9} / L)] + 0.1148 \times \log \\ [AFP (ng / mL) + 1] \end{array}$
PAPAS	$\begin{array}{l} \log (index + 1) = 0.025 + 0.0031 [age (years)] + 0.1483 \times \log [ALP (U / L)] + 0.004 \times \log [AST (U / L)] + 0.0908 \times \log \\ [AFP (ng / mL) + 1] - 0.028 \times \log [PLT (10^{9} / L)] \end{array}$
King's score	$Age \times AST \times {INR/PLT(10}^{9} /L)$
GPR	${GGT/PLT(10}^{9} /L)$
S-index	$1000 \times GGT/[PLT(109/L) \times {ALB}^{2}]$
PSR	${PLT(10}^{9} /L)/spleen diameter (mm)$
P2/MS	${PLT}^{2} {(10}^{9} /L)/(monocyte fraction \times segmented neutrophil fraction)$
Forns index	$7.811 - 3.131 \times {ln[PLT(10}^{9} /L)] + 0.781 \times ln(GGT) +3.467 \times ln(age) - 0.014 \times (cholesterol)$

Variable	Total	Survival status		P value
Variable	Total	Survival	Death	P value
Sex				0.681
man	67	37	30
women	25	15	10
Hepatitis				0.208
Yes	53	27	26
No	39	25	14
Ascites				0.442
Yes	9	4	5
No	83	48	35
Cirrhosis				0.256
Yes	49	25	24
No	43	27	16
Child-Pugh classification				0.195
A	75	40	35
B	17	12	5
Polycythemia				0.578
Yes	3	1	2
No	89	51	38
Number of tumors
single	53	35	18	0.032
multiple	39	17	22
Vascular cancer embolus				0.025
Yes	16	5	11
No	76	47	29
Age (year)	57±9	55±9	58±10	0.240
Diameter of spleen (mm)	107.25 (77-194.1)	107.25 (83.90-194.1)	106.45 (77-175.3)	0.795
AFP (ng/ml)	461.94 (0.83-2000)	238.64 (0.83-2000)	728.20 (1.76-2000)	0.130
ALB (g/L)	36.09±5.62	37.60±5.77	35.50±5.52	0.356
TCH (mmol/L)	3.62(1.84-8.10)	3.59 (1.94-7.42)	3.89 (1.84-8.10)	0.503
ALT (U/L)	45 (7-169)	44.5 (14.4-169)	45.5 (7-120.7)	0.925
AST (U/L)	53 (13-438)	51 (13-438)	58 (16-188)	0.262
ALP (U/L)	145.50 (63-1854.5)	141.5 (67.1-908)	149.85 (63-1854.5)	0.584
GGT (U/L)	153.65 (12-1257)	153.15 (19-1257)	152 (12-622.1)	0.598
APTT (s)	33.38±6.45	32.42±6.70	34.53±5.94	0.119
PT (s)	12.9 (9.9-17.70)	12.8 (9.9-17.7)	13.45 (11-17.4)	0.464
INR	1.08 (0.83-1.50)	1.07 (0.83-1.5)	1.12 (0.92-1.48)	0.419

Variable	Total	Survival status		P value
Variable	Total	Survival	Death	P value
AARP				0.447
negative	12	8	4
positive	80	44	36
Pohl score				0.035
negative	55	36	19
positive	37	16	21
PLT ×109/L	136.50(37-447)	149 (38-447)	115.50 (37-322)	0.085
API	7(1-10)	6 (2-10)	8 (1-10)	0.074
CDS	6(3-10)	6 (3-10)	7 (3-9)	0.006
APRI	1.16(0.16-16.47)	0.975 (0.22-16.47)	1.596 (0.16-6.6)	0.032
King's score	27.59(3.68-305.10)	23.27 (4.92-305.10)	34.45 (3.68-225.60)	0.015
Lok index	0.63(0.09-0.99)	0.56 (0.09-0.97)	0.75 (0.19-0.99)	0.015
P2/MS	49.88(1.05-521.57)	60.56 (1.05-521.57)	34.14 (1.98-399.04)	0.196
PAPAS	3.83±1.26	3.61±1.12	4.10±1.39	0.064
PSR	1.29(0.30-4.04)	1.37 (0.30-4.04)	0.99 (0.39-3.40)	0.139
S-index	0.84(0.06-10.9)	0.812 (0.10-10.9)	0.892 (0.06-4.54)	0.501
FIB-4	3.29(0.87-26.59)	2.867 (0.91-24.50)	4.905 (0.87-26.59)	0.010
FibroQ	5.66(1.25-45.83)	4.82 1.25-45.83)	7.79 (1.35-45.12)	0.008
GUCI	48.96(6.23-663.26)	39.21 (8.06-663.26)	62.48 (6.23-300.80)	0.033
GPR	1.08(0.05-13.66)	1.07 (0.16-13.66)	1.065 (0.05-5.2)	0.671
APGA	22.76(4.39-68.33)	22.12 (6.68-65.83)	26.06 (4.39-68.33)	0.097
Forn index	10.21±1.91	9.95±1.88	10.53±1.94	0.151

Variable	AUC	95% CI	Cut-off value	P-value
PLT	0.605	0.498-0.705	114×10⁹	0.08
API	0.608	0.500-0.708	4	0.07
CDS	0.665	0.559-0.760	6	0.003
APRI	0.632	0.525-0.730	1.36	0.029
King's score	0.648	0.542-0.745	31.31	0.013
Lok index	0.647	0.540-0.744	0.75	0.013
P2/MS	0.579	0.472-0.681	42.46	0.19
PAPAS	0.607	0.500-0.707	4.36	0.07
PSR	0.590	0.482-0.691	1.04	0.14
S-index	0.541	0.434-0.645	0.64	0.5
FIB-4	0.658	0.552-0.754	5.64	0.008
FibroQ	0.661	0.555-0.756	7.06	0.006
GUCI	0.630	0.523-0.728	60.21	0.03
GPR	0.526	0.419-0.631	0.87	0.7
APGA	0.602	0.494-0.702	32.03	0.09
Forn index	0.602	0.494-0.702	10.57	0.10

Variable	P value
Sex (male/female)	0.396
Age (≤52Y/>52Y)	0.112
Cirrhosis	0.049
HBV (Yes/No)	0.171
Ascites (Yes/No)	0.337
Polycythemia (Yes/No)	0.573
Number of tumors (single/multiple)	0.040
Vascular cancer embolus (Yes/No)	<0.001
AFP(≤8.54ng/ml/>8.54ng/ml)	0.038
ALT(≤98U/L/>98U/L)	0.316
AST(≤38U/L/>38U/L)	0.058
ALP(≤146U/L/>146U/L)	0.016
GGT(≤177U/L/>177U/L)	0.415
ALB(≤40g/L/>40g/L)	0.105
PT(≤13.3s/>13.3s)	0.107
APTT(≤28.1s/>28.1s)	0.001
INR(≤1.11/>1.11)	0.131
Diameter of spleen(≤ 95.3mm/>95.3mm)	0.082
PLT×10⁹(≤114/>114)	0.132
APGA(≤32.03/>32.03)	0.049
API(≤4/>4)	0.148
APRI(≤1.36/>1.36)	0.004
CDS(≤6/>6)	0.088
FIB-4(≤5.64/>5.64)	0.005
FibroQ (≤7.06/>7.06)	0.024
Forn index(≤10.57/>10.57)	0.162
GPR(≤0.87/>0.87)	0.056
GUCI(≤60.21/>60.21)	0.008
King's score(≤31.31/>31.31)	0.002
Lok index(≤0.75/>0.75)	0.009
P2/MS(≤42.46/>42.46)	0.126
PAPAS(≤4.36/>4.36)	0.028
PSR(≤1.04/>1.04)	0.193
S-index(≤0.64/>0.64)	0.200
Pohl score(negative/positive)	0.166
AARP(negative/positive)	0.914

Variable	OR	95%CI	P
Cirrhosis	1.272	0.558-2.901	0.568
Number of tumors	0.52	0.258-1.048	0.067
Vascular cancer embolus	0.219	0.084-0.570	0.002
AFP	0.513	0.176-1.496	0.221
ALP	0.406	0.179-0.922	0.031
APTT	0.088	0.021-0.371	0.001
APGA	3.213	1.089-9.477	0.034
APRI	0.558	0.094-3.297	0.52
FIB-4	0.500	0.104-2.414	0.388
FibroQ	2.037	0.440-9.431	0.363
GUCI	1.472	0.245-8.833	0.672
King's score	0.460	0.116-1.824	0.269
Lok index	0.666	0.278-1.591	0.360
PAPAS	0.923	0.344-2.481	0.874

[1] Correspondence: Ying Zhou Department of Hepatopancreatobiliary Surgery The Affiliated Hospital, Qinghai University Xining 810000 China Phone: +86 971 6230701 17697227511@163.com

Brasil

Brasil

Comparison of the prognostic value of platelet-based prognostic models in patients with malignant hepatic tumors after TACE therapy¹ 1 Research performed at Department of Hepatopancreatobiliary Surgery, The Affiliated Hospital, Qinghai University, Xining, China.

Abstract

Purpose:

Methods:

Results:

Conclusion:

Brasil

Brasil

Comparison of the prognostic value of platelet-based prognostic models in patients with malignant hepatic tumors after TACE therapy1 1 Research performed at Department of Hepatopancreatobiliary Surgery, The Affiliated Hospital, Qinghai University, Xining, China.

Abstract

Purpose:

Methods:

Results:

Conclusion:

Comparison of the prognostic value of platelet-based prognostic models in patients with malignant hepatic tumors after TACE therapy¹ 1 Research performed at Department of Hepatopancreatobiliary Surgery, The Affiliated Hospital, Qinghai University, Xining, China.