Prognostic value of γ-glutamyl transpeptidase to albumin ratio combined with aspartate aminotransferase to lymphocyte ratio in patients with hepatocellular carcinoma after hepatectomy.
Prognostic value of γ-glutamyl transpeptidase to albumin ratio combined with aspartate aminotransferase to lymphocyte ratio in patients with hepatocellular carcinoma after hepatectomy.
复制标题
肝细胞癌后，γ-谷氨酰基转肽酶与白蛋白比的预后值与天冬氨酸氨基转移酶与淋巴细胞比例的淋巴细胞比率结合在一起。
DOI：
10.1097/md.0000000000023339
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发表时间：
2020-11-25
期刊：
影响因子：
1.6
通讯作者：
Bu Y
中科院分区：
文献类型：
--
作者：
Liu KJ;Lv YX;Niu YM;Bu Y
肝细胞癌是一种肝切除术后复发率高的恶性肿瘤。最近发现，术前炎症和肝功能储备指数可以预测肝细胞癌患者复发风险的增加和生存率的降低。本研究旨在评价γ-谷氨酰转肽酶/白蛋白比值(GAR)和天冬氨酸氨基转移酶/淋巴细胞比值(ALRI)单独和联合检测对肝细胞癌切除术后患者预后的预测作用。我们回顾了2011年1月至2016年11月在宁夏医科大学总医院接受根治性切除的206例肝细胞癌患者。用受试者工作特征(ROC)曲线分析确定GAR和ALRI的最佳临界值。采用皮尔逊卡方检验分析GAR、ALRI与临床病理特征的相关性。单变量和多变量分析用于确定这些因素对无病生存期(DFS)和总生存期(OS)的预测价值。生存率按Kaplan-Meier法计算，分组间差异比较采用对数等级统计法。经皮尔逊卡方检验，GAR和ALRI与性别、吸烟史、凝血酶原时间、肿瘤直径、T分期和早期肝内复发显著相关(P均 <； .05)。单因素分析显示，T分期、GAR、ALRI与肝切除后DFS、OS显著相关。多因素分析显示，GAR和ALRI与肝癌患者的DFS和OS独立相关。术前GAR >； 0.946或ALRI >； 18.734预测肝细胞癌切除后患者预后不良。此外，GAR和ALRI联合检测的预测范围比单独检测更敏感。我们的数据表明，肝细胞癌患者的临床病理特征与GAR或ALRI升高密切相关。较高的GAR和ALRI水平可以敏感和特异地预测肝切除术后肝细胞癌患者的不良预后。此外，联合使用GAR和ALRI可以提高这一预测的准确性。
Hepatocellular carcinoma (HCC) is a malignant tumor associated with a high recurrence rate after hepatectomy. Recently, preoperative inflammatory and liver function reserve indices were found to predict increased risk of recurrence and decreased survival in HCC patients. This study aims to evaluate the ability of the γ-glutamyl transpeptidase-to-albumin ratio (GAR) and aspartate aminotransferase-to-lymphocyte ratio (ALRI), individually and in combination, to predict the prognosis of HCC patients after hepatectomy. We retrospectively reviewed 206 HCC patients who underwent radical resection at the General Hospital of Ningxia Medical University from January 2011 to November 2016. Receiver operating characteristic (ROC) curve analysis was performed to determine the optimal cut-off value for GAR and ALRI. The Pearson Chi-Squared test was used to analyze the correlations between GAR, ALRI and clinicopathological characteristics. Univariate and multivariate analyses were used to determine the predictive value of these factors for disease-free survival (DFS) and overall survival (OS). Survival rates were drawn according to the Kaplan-Meier method and differences between subgroups were compared by the log-rank statistics. GAR and ALRI were significantly correlated with gender, history of smoking, prothrombin time, tumor diameter, T stage and early intrahepatic recurrence by the Pearson Chi-Squared test (all P < .05). Univariate analysis indicated that T stage, GAR and ALRI were significantly correlated with DFS and OS in HCC patients after hepatectomy. Multivariate analysis illustrated that GAR and ALRI were independently related to DFS and OS in HCC patients. Preoperative GAR > 0.946 or ALRI > 18.734 predicted poor prognosis in HCC patients after hepatectomy. Additionally, the predictive scope of GAR combined with ALRI was more sensitive than that of either individual measurement alone. Our data indicate that there is a close association between the clinicopathological characteristics in HCC patients and increased GAR or ALRI. Higher levels of GAR and ALRI could sensitively and specifically predict a poor prognosis in HCC patients after hepatectomy. Furthermore, combined usage of GAR and ALRI could improve the accuracy of this prediction.