HCC and its microenvironment

Thrombocytopenia has been reported to be a surrogate for cirrhosis, but the HCC phenotypes associated with and without cirrhosis are not well studied. To compare characteristics of HCC patients with and without associated thrombocytosis.

Records were examined of a cohort of 668 biopsy-proven and randomly presenting unresectable HCC patients, who were dichotomized for presence (platelets <125 x 109/L) or absence (platelets 125-400 x 109/L) of thrombocytopenia.

Patients with normal platelets had larger tumors, more tumor nodules and longer survival than in the thrombocytopenia group. They also had more normal total plasma bilirubin, albumin and prothrombin times, yet had higher GGTP, ALKP and AFP levels.

Thrombocytopenia in association with HCC occurs in patients with smaller tumor sizes, worse liver function and poorer survival, supporting the importance of host factors and liver micro-environment in HCC patients and the likelihood of two pathways for HCC development.