Department of Hepatobiliary Oncology, Sun Yat-sen University Cancer Center, China.
State Key Laboratory of Oncology in South China, China.
Dis Markers. 2020 Jul 10;2020:4269460. doi: 10.1155/2020/4269460. eCollection 2020.
Gamma-glutamyltransferase (GGT) is involved in tumor development and progression, but its prognostic value in -fetoprotein- (AFP-) negative (AFP < 25 ng/mL) hepatocellular carcinoma (HCC) patients remains unknown.
A large cohort of 678 patients with AFP-negative HCC following curative resection who had complete data were enrolled in this study. The optimal cutoff value for the preoperative level of GGT was determined by the X-tile program. Independent prognostic factors for overall survival (OS) and disease-free survival (DFS) were also identified.
The optimal cutoff values for the preoperative levels of GGT were 37.2 U/L and 102.8 U/L, which were used to divide all patients into three subgroups (group 1, GGT < 37.2 U/L ( = 211, 31.1%); group 2, GGT ≥ 37.2 and <102.8 U/L ( = 320, 47.2%); group 3, GGT ≥ 102.8 U/L ( = 147, 21.7%)), with distinct OS times (58.5 vs. 53.5 vs. 44.4 months, < 0.001) and DFS times (47.9 vs. 40.3 vs. 30.1 months, < 0.001). Elevated preoperative GGT levels were associated with an unfavorable tumor burden (larger tumor size, multiple tumors, and microvascular invasion) and were selected as independent predictors of a worse OS (group 2 vs. group 1, HR: 1.73 (1.13-2.65), = 0.011; group 3 vs. group 1, HR: 3.28 (2.10-5.13), < 0.001) and DFS (group 2 vs. group 1, HR: 1.52 (1.13-2.05), = 0.006; group 3 vs. group 1, HR: 2.11 (1.49-2.98), < 0.001) in multivariable analysis.
Elevated preoperative GGT levels are associated with an unfavorable tumor burden and serve as an independent prognostic marker for worse outcomes in AFP-negative HCC patients following resection.
γ-谷氨酰转移酶（GGT）参与肿瘤的发生和发展，但在甲胎蛋白（AFP）阴性（AFP<25ng/ml）的肝细胞癌（HCC）患者中，其预后价值尚不清楚。
本研究纳入了 678 例接受根治性切除术的 AFP 阴性 HCC 患者，这些患者均有完整的数据。通过 X-tile 程序确定术前 GGT 水平的最佳截断值。还确定了总生存（OS）和无病生存（DFS）的独立预后因素。
术前 GGT 水平的最佳截断值为 37.2U/L 和 102.8U/L，以此将所有患者分为三组（组 1，GGT<37.2U/L（n=211，31.1%）；组 2，GGT≥37.2 且<102.8U/L（n=320，47.2%）；组 3，GGT≥102.8U/L（n=147，21.7%）），三组 OS 时间（58.5 vs. 53.5 vs. 44.4 个月，<0.001）和 DFS 时间（47.9 vs. 40.3 vs. 30.1 个月，<0.001）均有明显差异。术前升高的 GGT 水平与不良肿瘤负荷（更大的肿瘤大小、多个肿瘤和微血管侵犯）相关，并被选为 OS 不良的独立预测因素（组 2 与组 1 相比，HR：1.73（1.13-2.65），=0.011；组 3 与组 1 相比，HR：3.28（2.10-5.13），<0.001）和 DFS（组 2 与组 1 相比，HR：1.52（1.13-2.05），=0.006；组 3 与组 1 相比，HR：2.11（1.49-2.98），<0.001）。
术前升高的 GGT 水平与不良肿瘤负荷相关，并作为 AFP 阴性 HCC 患者术后生存不良的独立预后标志物。
