Prognostic utility of gamma-glutamyl transpeptidase to platelet ratio in patients with solitary hepatitis B virus-related hepatocellular carcinoma after hepatectomy.

IF 2.5 4区 医学 Q2 GASTROENTEROLOGY & HEPATOLOGY
Cheng-Kun Yang, Zhong-Liu Wei, Xiao-Qiang Shen, Yu-Xuan Jia, Qiong-Yuan Wu, Yong-Guang Wei, Hao Su, Wei Qin, Xi-Wen Liao, Guang-Zhi Zhu, Tao Peng
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引用次数: 0

Abstract

Background: The prognostic impact of preoperative gamma-glutamyl transpeptidase to platelet ratio (GPR) levels in patients with solitary hepatitis B virus (HBV)-related hepatocellular carcinoma (HCC) following radical resection has not been established.

Aim: To examine the clinical utility of GPR for prognosis prediction in solitary HBV-related HCC patients.

Methods: A total of 1167 solitary HBV-related HCC patients were retrospectively analyzed. GPR levels were compared with 908 non-HCC individuals. Overall survival (OS) and recurrence-free survival (RFS) were evaluated, and cox proportional hazard model analyses were performed to identify independent risk factors. Differences in characteristics were adjusted by propensity score matching (PSM). Subgroup and stratified survival analyses for HCC risks were performed, and a linear trend of the hazard ratio (HR) according to GPR levels was constructed.

Results: GPR levels of patients with solitary HBV-related HCC were higher than those with hepatic hemangiomas, chronic hepatitis B and healthy control (adjusted P < 0.05). Variable bias was diminished after the PSM balance test. The low GPR group had improved OS (P < 0.001) and RFS (P < 0.001) in the PSM analysis and when combined with other variables. Multivariate cox analyses suggested that low GPR levels were associated with a better OS (HR = 0.5, 95%CI: 0.36-0.7, P < 0.001) and RFS (HR = 0.57, 95%CI: 0.44-0.73, P < 0.001). This same trend was confirmed in subgroup analyses. Prognostic nomograms were constructed and the calibration curves showed that GPR had good survival prediction. Moreover, stratified survival analyses found that GPR > 0.6 was associated with a worse OS and higher recurrence rate (P for trend < 0.001).

Conclusion: Preoperative GPR can serve as a noninvasive indicator to predict the prognosis of patients with solitary HBV-related HCC.

γ -谷氨酰转肽酶与血小板比值在孤立性乙型肝炎病毒相关肝癌患者肝切除术后的预后价值
背景:单纯性乙型肝炎病毒(HBV)相关肝细胞癌(HCC)根治性切除术后术前γ -谷氨酰转肽酶与血小板比率(GPR)水平对预后的影响尚未确定。目的:探讨GPR在孤立性hbv相关HCC患者预后预测中的临床应用价值。方法:回顾性分析1167例孤立性hbv相关HCC患者。比较908例非hcc患者的GPR水平。评估总生存期(OS)和无复发生存期(RFS),并进行cox比例风险模型分析以确定独立危险因素。特征差异通过倾向评分匹配(PSM)进行调整。对HCC风险进行亚组和分层生存分析,并根据GPR水平构建风险比(HR)的线性趋势。结果:孤立性hbv相关HCC患者GPR水平高于肝血管瘤、慢性乙型肝炎及健康对照组(经校正P < 0.05)。PSM平衡测试后,可变偏倚减少。低GPR组在PSM分析和结合其他变量时,OS (P < 0.001)和RFS (P < 0.001)均有改善。多因素cox分析显示,低GPR水平与较好的OS (HR = 0.5, 95%CI: 0.36-0.7, P < 0.001)和RFS (HR = 0.57, 95%CI: 0.44-0.73, P < 0.001)相关。在亚组分析中也证实了同样的趋势。构建了预后图,校正曲线显示GPR具有良好的生存预测能力。此外,分层生存分析发现GPR >.6与更差的OS和更高的复发率相关(趋势P < 0.001)。结论:术前GPR可作为预测孤立性hbv相关HCC患者预后的无创指标。
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来源期刊
World Journal of Gastrointestinal Oncology
World Journal of Gastrointestinal Oncology Medicine-Gastroenterology
CiteScore
4.20
自引率
3.30%
发文量
1082
期刊介绍: The World Journal of Gastrointestinal Oncology (WJGO) is a leading academic journal devoted to reporting the latest, cutting-edge research progress and findings of basic research and clinical practice in the field of gastrointestinal oncology.
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