Shen Xueqin, Niu Xiaoping
Department of Clinical Nutrition, Yijishan Hospital of Wannan Medical College, Wuhu, People's Republic of China.
Department of Gastroenterology, Yijishan Hospital of Wannan Medical College, Wuhu, People's Republic of China.
J Hepatocell Carcinoma. 2024 Oct 27;11:2077-2085. doi: 10.2147/JHC.S478186. eCollection 2024.
The close association between inflammation and the clinical outcomes of hepatocellular carcinoma (HCC) has been extensively documented. This study aims to analyze the association between a novel inflammatory indicator, the gamma-glutamyl transpeptidase to neutrophil ratio (GNR), and HCC prognosis following curative resection.
A cohort of 204 eligible HCC cases were included. Based on an optimal cut-off value determined utilizing the X-tile software, patients were categorized into low- and high-GNR groups. The overall survival (OS) and recurrence-free survival (RFS) rates were assessed using the Kaplan-Meier analysis method with Log rank tests. Multivariate Cox proportional hazard regression was used to investigate the independent association between GNR and HCC prognosis. Restricted cubic splines were used to explore the nonlinear relationship between GNR and the risk of death or recurrence.
The low GNR group exhibited significantly higher 3-year OS and RFS rates than the high GNR group. Multivariate Cox analysis indicated that a high GNR level was independently associated with poor OS and RFS. A linear correlation between GNR and the risk of death, as well as a nonlinear inverted "U" shape correlation between GNR and the risk of recurrence, were observed.
The findings provide evidence supporting the independent association of GNR with HCC prognosis. These results offer promise for enhancing prognosis assessments and guiding active monitoring strategies for patients with HCC post-curative resection.
炎症与肝细胞癌（HCC）临床结局之间的密切关联已有大量文献记载。本研究旨在分析一种新型炎症指标——γ-谷氨酰转肽酶与中性粒细胞比值（GNR）与根治性切除术后HCC预后的相关性。
纳入204例符合条件的HCC病例。根据使用X-tile软件确定的最佳临界值，将患者分为低GNR组和高GNR组。采用Kaplan-Meier分析法和Log rank检验评估总生存期（OS）和无复发生存期（RFS）率。多因素Cox比例风险回归用于研究GNR与HCC预后的独立相关性。采用受限立方样条来探讨GNR与死亡或复发风险之间的非线性关系。
低GNR组的3年OS和RFS率显著高于高GNR组。多因素Cox分析表明，高GNR水平与较差的OS和RFS独立相关。观察到GNR与死亡风险之间存在线性相关性，以及GNR与复发风险之间存在非线性倒“U”形相关性。
研究结果为支持GNR与HCC预后的独立相关性提供了证据。这些结果为改善预后评估和指导HCC根治性切除术后患者的主动监测策略带来了希望。
