Platelet indices significantly correlate with liver fibrosis in HCV-infected patients

Autoři: Lin-Nan Shao aff001;  Shu-Ting Zhang aff001;  Ni Wang aff001;  Wei-Jian Yu aff001;  Mei Chen aff001;  Nan Xiao aff001;  Ying Duan aff001;  Ling-Zi Pan aff001;  Wen-Qian Song aff001;  Yue-Xin Xia aff001;  Li Zhang aff001;  Ning Qi aff001;  Ming Liu aff002;  Shi-Hang Zhou aff001
Působiště autorů: Dalian Blood Center, Zhongshan District, Dalian, Liaoning, China aff001;  Department of Cell Biology, Dalian Medical University, Dalian, Liaoning, China aff002
Vyšlo v časopise: PLoS ONE 15(1)
Kategorie: Research Article



A total of 241 patients with chronic HCV infection were recruited to investigate the association between liver fibrosis and PLT counts, as well as with MPV, PDW and P-LCR indices.


The determination of PLT indices was carried out using a Sysmex XT-1800i automated hematology analyzer. Serological tests for HA, LN, C-IV and PIIINP were performed in 210 patients. The liver stiffness was measured in 69 patients by transient elastography (FibroScan).


The analysis showed that the four serum fibrosis markers were negatively correlated with PLT counts, but positively correlated with the MPV, PDW and P-LCR values. Moreover, a similar pattern was found after analyzing the FibroScan measurements, which were negatively correlated with PLT counts, but positively correlated with MPV, PDW and P-LCR values. We subdivided the HCV-infected patients into mild and advanced fibrosis groups. The PLT counts were significantly decreased and the MPV, PDW and P-LCR values were significantly increased in the advanced fibrosis group when compared with the mild fibrosis group.


Our results demonstrate that not only the PLT counts but also the MPV, PDW and P-LCR indices significantly correlate with liver fibrosis in HCV-infected patients. Therefore, these indices may be useful laboratory measures for evaluating liver fibrosis progression.

Klíčová slova:

Blood counts – Collagens – Fibrosis – Hematology – Hepatitis C virus – Chronic liver disease – Liver fibrosis – Platelets


1. Irshad M, Mankotia DS, Irshad K. An insight into the diagnosis and pathogenesis of hepatitis C virus infection. World J Gastroenterol 2013; 19(44): 7896–909. doi: 10.3748/wjg.v19.i44.7896 24307784 PMCID: PMC3848138.

2. Heller T, Rehermann B. Acute hepatitis C: a multifaceted disease. Semin Liver Dis 2005; 25(1): 7–17. doi: 10.1055/s-2005-864778 15731994.

3. Oh S, Afdhal NH. Hepatic fbrosis: are any of the serum markers useful? Curr Gastroenterol Rep 2001;3(1):12–8. doi: 10.1007/s11894-001-0035-2 11177689.

4. Baranova A, Lal P, Birerdinc A, Younossi ZM. Non-invasive markers for hepatic fibrosis. BMC Gastroenterol 2011;11: 91. doi: 10.1186/1471-230X-11-91 21849046 PMCID: PMC3176189.

5. Gupta P, Guddattu V, Saravu K. Characterization of platelet count and platelet indices and their potential role to predict severity in malaria. Pathog Glob Health 2019;113(2):86–93. doi: 10.1080/20477724.2019.1600855 30967102 PMCID: PMC6493306.

6. Wu YY, Zhang X, Qin YY, Qin JQ, Lin FQ. Mean platelet volume/platelet count ratio in colorectal cancer: a retrospective clinical study. BMC Cancer 2019;19(1):314. doi: 10.1186/s12885-019-5504-9 30947696 PMCID: PMC6449942.

7. Wu M, Luan YY, Lu JF, Li H, Zhan HC, Chen YH, et al. Platelet count as a new biomarker for acute kidney injury induced by hemorrhagic shock. Platelets 2019; 27:1–9. doi: 10.1080/09537104.2019.1581921 30810451.

8. Yoneda M, Fujii H, Sumida Y, Hyogo H, Itoh Y, Ono M, et al. Platelet count for predicting fibrosis in nonalcoholic fatty liver disease. J Gastroenterol 2011; 46(11):1300–6. doi: 10.1007/s00535-011-0436-4 21750883.

9. Zhou K, Gao CF, Zhao YP, Liu HL, Zheng RD, Xian JC, et al. Simpler score of routine laboratory tests predicts liver fibrosis in patients with chronic hepatitis B. J Gastroenterol Hepatol 2010; 25(9):1569–77. doi: 10.1111/j.1440-1746.2010.06383.x 20796157.

10. Pohl A, Behling C, Oliver D, Kilani M, Monson P, Hassanein T. Serum Aminotransferase Levels and Platelet Counts as Predictors of Degree of Fibrosis in Chronic Hepatitis C Virus Infection. Am J Gastroenterol 2001; 96(11):3142–6. doi: 10.1111/j.1572-0241.2001.05268.x 11721762.

11. Purnak T, Olmez S, Torun S, Efe C, Sayilir A, Ozaslan E, et al. Mean platelet volume is increased in chronic hepatitis C patients with advanced fibrosis. Clin Res Hepatol Gastroenterol 2013; 37(1):41–6. doi: 10.1016/j.clinre.2012.03.035 22572524.

12. Zeng MD, Lu LG, Mao YM, Qiu DK, Li JQ, Wan MB, et al. Prediction of significant fibrosis in HBeAg-positive patients with chronic hepatitis B by a noninvasive model. Hepatology 2005;42(6):1437–45. doi: 10.1002/hep.20960 16317674.

13. Nitta Y, Kawabe N, Hashimoto S, Harata M, Komura N, Kobayashi K, et al. Liver stiffness measured by transient elastography correlates with fibrosis area in liver biopsy in patients with chronic hepatitis C. Hepatol Res 2009;39:675–84. doi: 10.1111/j.1872-034X.2009.00500.x 19261000

14. Kampstra P. Beanplot: A Boxplot Alternative for Visual Comparison of Distributions. J Stat Softw. 2008;28:1–9. doi: 10.18637/jss.v028.i07

15. Nagamine T, Ohtuka T, Takehara K, Arai T, Takagi H, Mori M. Thrombocytopenia associated with hepatitis C viral infection. J Hepatol 1996;24:135–40. doi: 10.1016/s0168-8278(96)80021-3 8907565.

16. Pawlotsky JM, Bouvier M, Fromont P, Deforges L, Duval J, Dhumeaux D, et al. Hepatitis C virus infection and autoimmune thrombocytopenic purpura. J Hepatol 1995;23(6):635–9. doi: 10.1016/0168-8278(95)80027-1 8750160.

17. Hernández F, Blanquer A, Linares M, López A, Tarín F, Cerveró A. Autoimmune thrombocytopenia associated with hepatitis C virus infection. Acta Haematol 1998;99(4):217–20. doi: 10.1159/000040842 9644300.

18. Matsumuro H, Moriyama M, Goto I, Tanaka N, Okubo H, Arakawa Y. Natural course of progression of liver fibrosis in Japanese patients with chronic liver disease type C-a study of 527 patients at one establishment. J Viral Hepat 2000;7(4):268–75. doi: 10.1046/j.1365-2893.2000.00235.x 10886535.

19. Aster RH. Pooling of platelets in the spleen: role in the pathogenesis of “hypersplenic” thrombocytopenia. J Clin Invest 1996;45:645–57. doi: 10.1172/JCI105380 5327481 PMCID: PMC292742.

20. Kawasaki T, Takeshita A, Souda K, Kobayashi Y, Kikuyama M, Suzuki F, et al. Serum thrombopoietin levels in patients with chronic hepatitis and liver cirrhosis. Am J Gastroenterol 1999;94(7):1918–22. doi: 10.1111/j.1572-0241.1999.01231.x 10406260.

21. Velázquez RF, Rodríguez M, Navascués CA, Linares A, Pérez R, Sotorríos NG, et al. Prospective analysis of risk factors for hepatocellular carcinoma in patients with liver cirrhosis. Hepatology 2003; 37(3): 520–7. doi: 10.1053/jhep.2003.50093 12601348.

22. Degos F, Christidis C, Ganne-Carrie N, Farmachidi JP, Degott C, Guettier C, et al. Hepatitis C virus related cirrhosis: time to occurrence of hepatocellular carcinoma and death. Gut 2000; 47(1): 131–6. doi: 10.1136/gut.47.1.131 10861275 PMCID: PMC1727946.

23. Taniguchi H, Iwasaki Y, Fujiwara A, Sakaguchi K, Moriya A, Yu PC, et al. Long-term monitoring of platelet count, as a non-invasive marker of hepatic fibrosis progression and/or regression in patients with chronic hepatitis C after interferon therapy. J Gastroenterol Hepatol 2006;21(1 Pt 2):281–7. doi: 10.1111/j.1440-1746.2006.04201.x 16460487.

24. Lv L, Li Y, Fan X, Xie Z, Liang H, Shen T. HCV coinfection aggravated the decrease of platelet counts, but not mean platelet volume in chronic HIV-infected patients. Sci Rep 2018; 8(1):17497. doi: 10.1038/s41598-018-35705-9 30504858 PMCID: PMC6269489.

25. Beyazit Y, Sayilir A, Torun S, Suvak B, Yesil Y, Purnak T, et al. Mean platelet volume as an indicator of disease severity in patients with acute pancreatitis. Clin Res Hepatol Gastroenterol 2012;36(2):162–8. doi: 10.1016/j.clinre.2011.10.003 22088974.

Článek vyšel v časopise


2020 Číslo 1
Nejčtenější tento týden