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F0 was defined as no fibrosis ( n = 22), F1 as chronic hepatitis with fibrous portal expansion ( n = 67), F2 as chronic hepatitis with bridging fibrosis ( n = 62), F3 as chronic hepatitis with bridging fibrosis and architectural distortion ( n = 51), and F4 as LC with tendency toward nodular formation throughout the whole area. All patients were assessed pathologically by stage of fibrosis in nontumor liver tissue using the new Inuyama classification. This retrospective study assessed samples obtained from 302 patients who underwent liver resection for hepatocellular carcinoma (HCC) between January 2006 and December 2012. This study was, therefore, designed to determine whether liver fibrosis and LC are associated with the MPV/PLT ratio or not. These findings suggested that the ratio of MPV to PLT may correlate strongly with the degree of liver fibrosis. Increased MPV, as well as decreased platelet count (PLT), were found to reflect a greater degree of fibrosis. Several studies have reported that liver cirrhosis (LC) and fibrosis are related to MPV. In contrast, abnormally low MPV values are indicative of thrombocytopenia because of impaired platelet production, as observed in patients with aplastic anemia. MPV may also be higher in patients with pre-eclampsia and those recovering from transient bone marrow hypoplasia. Moreover, MPV is higher when there is destruction of platelets, as observed in patients with inflammatory bowel disease, immune thrombocytopenic purpura, myeloproliferative diseases and Bernard-Soulier syndrome. Because average platelet size is directly proportional to the numbers of platelets produced, MPV is indicative of platelet production in bone marrow. Normal MPV ranges from 7.5 fL to 11.5 fL. Mean platelet volume (MPV) is a machine-calculated measurement of average platelet size, usually included in complete blood count testing.