Thrombocytosis: A paraneoplastic syndrome in patients with hepatocellular carcinoma

• Published in: World journal of gastroenterology : WJG Vol. 10; no. 17; pp. 2472 - 2477
• Main Author: Hwang, Shinn-Jang
• Format: Journal Article
• Language: English
• Published: United States Taipei Municipal Yang-Ming Hospital, Taipei,Taiwan, China%Division of Gastroenterology, Department of Medicine, Taipei Veterans General Hospital and National Yang-Ming University School of Medicine, Taiwan, China%Department of Pathology, Taipei Veterans General Hospital and National Yang-Ming University School of Medicine,Taiwan, China%Department of Radiology, Taipei Veterans General Hospital and National Yang-Ming University School of Medicine,Taiwan, China%Department of Surgery, Taipei Veterans General Hospital and National Yang-Ming University School of Medicine, Taiwan, China%Central Laboratory, Shin Kong Wu Ho-Su Memorial Hospital, Taiwan, China 01.09.2004; Department of Family Medicine, Taipei Veterans General Hospital and National Yang-Ming University School of Medicine, Taiwan, China; Division of Gastroenterology, Department of Medicine, Taipei Veterans General Hospital and National Yang-Ming University School of Medicine, Taiwan, China; Baishideng Publishing Group Inc
• Subjects: Adolescent; Adult; Aged; Aged, 80 and over; alpha-Fetoproteins - metabolism; Carcinoma, Hepatocellular - blood; Carcinoma, Hepatocellular - complications; Cross-Sectional Studies; Female; Humans; Liver Cancer; Liver Cirrhosis - blood; Liver Cirrhosis - complications; Liver Neoplasms - blood; Liver Neoplasms - complications; Male; Middle Aged; Paraneoplastic Syndromes - blood; Paraneoplastic Syndromes - complications; Platelet Count; Retrospective Studies; Thrombocytosis - blood; Thrombocytosis - etiology; Thrombopoietin - blood
• ISSN: 1007-9327; 2219-2840
• DOI: 10.3748/wjg.v10.i17.2472

Hepatocellular carcinoma (HCC) patients manifest a variety of paraneoplastic syndromes. Thrombocytosis was reported in children with hepatoblastoma. The aims of this study were to evaluate the prevalence and clinical significance of thrombocytosis in HCC patients and its relationships with serum thrombopoietin (TPO). We retrospectively reviewed clinical, biochemical and image data of 1,154 HCC patients. In addition, we measured platelet count and serum TPO in HCC patients with and without thrombocytosis, in patients with cirrhosis, chronic hepatitis and healthy subjects in a cross-sectional study. Thirty-one (2.7%) of 1,154 HCC patients had thrombocytosis (platelet count > or = 400 K/mm3). HCC patients with thrombocytosis were significantly younger, had a higher serum alpha-fetoprotein, higher rate of main portal vein thrombosis, larger tumor volume, shorter survival, and were less likely to receive therapy than HCC patients without thrombocytosis. Multivariate logistic regression analyses showed that tumor volumes > or = 30% and serum alpha-fetoprotein > or = 140,000 ng/mL could significantly predict thrombocytosis. HCC patients with thrombocytosis had a significantly higher mean serum TPO than those without, as well as patients with cirrhosis, chronic hepatitis and healthy subjects. Platelet count and serum TPO dropped significantly after tumor resection in HCC patients with thrombocytosis and re-elevated after tumor recurred. Furthermore, the expression of TPO mRNA was found to be more in tumor tissues than in non-tumor tissues of liver in an HCC patient with thrombocytosis. Thrombocytosis is a paraneoplastic syndrome of HCC patients due to the overproduction of TPO by HCC. It is frequently associated with a large tumor volume and high serum alpha-fetoprotein.