Wang Wan-Li, Zheng Xing-Long, Zhang Zhi-Yong, Zhou Ying, Hao Jie, Tang Gang, Li Ou, Xiang Jun-Xi, Wu Zheng, Wang Bo
Department of Hepatobiliary Surgery, First Affiliated Hospital, Health Science Center, Xi'an Jiaotong University, Xi'an Department of General Surgery, Bazhong Central Hospital, Bazhong, People's Republic of China.
Medicine (Baltimore). 2016 Jul;95(27):e4087. doi: 10.1097/MD.0000000000004087.
Liver fibrosis and cirrhosis is associated with the prognosis of patients with hepatocellular carcinoma (HCC) after treatment. The γ-glutamyl transpeptidase to platelet ratio (GPR) is reported to predict significant liver fibrosis and cirrhosis. The aim of this study was to investigate the predictive value of preoperative GPR on the recurrence and survival of patients with HCC who underwent curative hepatectomy.A retrospective review of demographics, medical records, and prognosis of patients with hepatitis B virus (HBV)-related HCC was performed. Overall survival (OS) and disease-free survival (DFS) were evaluated using Kaplan-Meier method, and the log-rank test was used to analyze differences in recurrence and survival. Univariate and multivariate analyses were used for significance of prognostic factor.A total of 357 patients with HBV-related HCC were included in this analysis. The preoperative GPR was associated with recurrence and survival rates, independent of HCC progression or tumor marker levels, in a multivariate analysis. OS was higher in patients with a GPR <0.84 versus ≥084 (5-year survival rates 58.6% vs. 38.5%; P < 0.001). DFS was also worse in patients with a GPR ≥0.84 than in those with GPR <0.84 (5-year recurrence rates 42.8% vs. 22.8%; P < 0.001).GPR score of ≥0.84 represents a major risk factor for the poor prognosis for HBV-related HCC after hepatic resection, and GPR served as an independent predictive factor for HBV-related HCC OS.
肝纤维化和肝硬化与肝细胞癌(HCC)患者治疗后的预后相关。据报道,γ-谷氨酰转肽酶与血小板比值(GPR)可预测显著的肝纤维化和肝硬化。本研究的目的是探讨术前GPR对接受根治性肝切除术的HCC患者复发和生存的预测价值。
对乙型肝炎病毒(HBV)相关HCC患者的人口统计学、病历和预后进行了回顾性分析。采用Kaplan-Meier法评估总生存期(OS)和无病生存期(DFS),并使用对数秩检验分析复发和生存的差异。采用单因素和多因素分析来确定预后因素的显著性。
本分析共纳入357例HBV相关HCC患者。在多因素分析中,术前GPR与复发率和生存率相关,独立于HCC进展或肿瘤标志物水平。GPR<0.84的患者OS高于GPR≥0.84的患者(5年生存率分别为58.6%和38.5%;P<0.001)。GPR≥0.84的患者DFS也比GPR<0.84的患者差(5年复发率分别为42.8%和22.8%;P<0.001)。
GPR评分≥0.84是HBV相关HCC肝切除术后预后不良的主要危险因素,GPR是HBV相关HCC OS的独立预测因素。