Increased Platelet Distribution Width Predicts 3-Year Recurrence in Patients with Hepatocellular Carcinoma After Surgical Resection

Figures & data

Table 1 Baseline Characteristics of HCC Patients in PDW Group

Variables	PDW<17.1 (N=293)	PDW≥17.1 (N=178)	p value
Gender			0.507
Male	245	157
Female	39	30
Age(years)	53 (44–60)	54 (46–61)	0.700
AFP(ng/mL)	54.6 (6.1–1210.0)	48.5 (4.3–832.6)	0.351
ALB(U/L)	40.9 (38.3–43.7)	40.7 (38.1–43.8)	0.757
ALT(U/L)	38.4 (27.0–59.7)	41.4 (28.3–61.3)	0.199
CA 19-9(ng/mL)	22.2 (11.0–40.8)	24.6 (12.9–46.7)	0.549
CEA(ng/mL)	2.3 (1.6–3.4)	2.3 (1.5–3.5)	0.871
DBIL(μmol/L)	5.2 (3.7–6.5)	5.6 (4.4–7.4)	0.001**
HgB(g/L)	139 (128–150)	142 (132–151)	0.089
PLT Count(*10^9)	175 (130–219)	132 (92–181)	<0.001***
PT(s)	11.6 (11.1–12.2)	12 (11.3–12.6)	0.003*
RBC(*10^12)	4.54 (4.21–4.92)	4.49 (4.19–4.83)	0.478
TBIL(μmol/L)	12.5 (9.6–16.5)	13.9 (10.5–18.3)	0.002**
WBC(*10^9)	5.6 (4.5–6.9)	5.6 (4.2–6.9)	0.415
Tumor Size(cm)	5.5 (3.5–9.2)	5.3 (3.5–8.6)	0.959
Crea(μmol/L)	71 (61–78)	67 (58–75)	0.026*
PA(mg/L)	214 (174–252)	200 (166–243)	0.053
Blood Glucose(mmol/L)	4.9 (4.6–5.3)	4.9 (4.5–5.6)	0.720
HBsAg			0.515
Positive	233 (83.2)	156 (85.7)
Negative	47 (16.8)	26 (14.3)
Tumor Number			0.315
Single	240 (86.0)	164 (89.6)
Multiple	39 (14.0)	19 (10.4)
MVI			0.001**
M0	104 (35.5)	35 (19.7)
M1	114 (38.9)	81 (45.5)
M2	75 (25.6)	62 (34.8)
Child-Pugh Grade			0.686
A	269 (94.7)	175 (93.6)
B	15 (5.3)	12 (6.4)
Cirrhosis			0.433
Present	248 (94.3)	159 (92.4)
Absent	15 (5.7)	13 (7.6)

Notes: *p<0.05,**p<0.01,***p<0.001

Figure 1 The ROC curve of HCC recurrence diagnosed by PDW.

Figure 2 The correlation between PDW levels and disease free survival in patients with HCC. The cumulative recurrence was significantly higher in patients with PDW≥17.1 groups.

Table 2 The Univariate and Multivariate Analysis of Disease-Free Survival in HCC Patients

Variables	Univariate Analysis		Multivariate Analysis
	HR (95% CI)	p value	HR (95% CI)	p value
Gender(Male versus Female)	0.779(0.491–1.238)	0.291
Age(years)	1.003(0.989–1.016)	0.694
AFP(<20 versus 20–400, >400)	1.255(1.056–1.492)	0.010	1.274(1.095–1.482)	0.002
ALB(U/L)	1.005(0.986–1.009)	0.301
ALT(U/L)	1.000(0.998–1.001)	0.618
CA 19–9(ng/mL)	1.000(0.999–1.001)	0.492
CEA(ng/mL)	1.004(1.001–1.007)	0.008	1.005(1.002–1.008)	0.001
DBIL(μmol/L)	0.997(0.996–1.003)	0.583
HGB(g/L)	1.004(0.992–1.015)	0.535
PLT(*10^9)	1.001(0.999–1.003)	0.386
PT(s)	1.079(0.998–1.011)	0.112
RBC(*10^12)	0.939(0.768–1.147)	0.941
PDW (<17.1 versus ≥17.1)	1.300(0.972–1.738)	0.077	1.381(1.069–1.783)	0.014
TBIL(μmol/L)	1.004(0.993–1.014)	0.466
WBC(*10^9)	0.997(0.979–1.042)	0.112
Tumor Size(cm)	1.037(1.000–1.075)	0.048	1.045(1.016–1.074)	0.002
Crea(μmol/L)	1.003(0.996–1.010)	0.385
PA(mg/L)	0.998(0.997–1.000)	0.054
Blood Glucose(mmol/L)	0.975(0.927–1.025)	0.323
HBsAg(Positive versus Negative)	0.787(0.534–1.159)	0.225
Tumor Number(Single versus Multiple)	1.337(1.001–1.785)	0.049	1.441(1.120–1.854)	0.004
MVI(M0 versus M1, M2)	2.234(1.814–2.750)	<0.001	2.019(1.683–2.422)	<0.001
Child-Pugh Grade (A versus B)	1.228(0.568–2.654)	0.601
Cirrhosis (Present versus Absent)	1.118(0.986–1.267)	0.081
Capsule (complete versus incomplete)	0.928(0.797–1.018)	0.331

Figure 3 Nomogram predicting 3-year recurrence in HCC after surgery.

Figure 4 The bootstrapped calibration plot for the prediction of 3-year recurrence-free survival was shown. The blue line represents the ideal result; Red circles represent nomogram-predicted probabilities; “×” represent the bootstrap-corrected estimates; and error bars represent the 95% CIs of these estimates.