Thrombocytosis and Hepatocellular Carcinoma

Background Thrombocytopenia has been reported to be both a risk factor for hepatocellular carcinoma (HCC) development as well as a prognostic factor. Many HCCs also occur in presence of normal platelets. Aim To examine a cohort of HCC patients with associated thrombocytosis. Methods Records were examined of a cohort of 634 biopsy-proven and randomly presenting HCC patients without thrombocytopenia. Results In the total cohort, 52 patients were identified with thrombocytosis (platelet levels >400 x10(9)/L) and compared with 582 patients with normal platelet values. The average tumor sizes were 13.1 versus 8.8 cm (p < 0.0001), and their total average bilirubin levels were 0.9 versus 1.5 (p = 0.02), comparing thrombocytosis patients versus normal platelet count HCC patients. These differences were even more pronounced in patients with HCC sizes >5 cm. Thrombocytosis patients were younger and had less cirrhosis, but similar percent with hepatitis B or C or alcohol consumption. Conclusion Thrombocytosis in association with HCC occurs in patients with larger tumor sizes and better liver function.