Prognostic Value of Gamma-Glutamyl Transpeptidase to Lymphocyte Count Ratio in Patients With Single Tumor Size ≤ 5 cm Hepatocellular Carcinoma After Radical Resection

Liao, Minjun; Qin, Wanying; Liao, Yan; Yao, Renzhi; Yu, Junxiong; Liao, Weijia

doi:10.3389/fonc.2019.00347

Cited by 13 publications

(15 citation statements)

References 40 publications

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“…The specific principle of follow-up adopted in this study was the same as our previous study. 20 The general methods were as follows: within the first 2 years after the operation, the blood routine, liver and kidney function, and abdominal ultrasonography were examined every 2 months, and chest X-ray film was taken every 6 months; after 2 years, the time interval of chest X-ray film remained unchanged, whereas the time interval of the other routine examinations was 3-6 months. If the reexamination results were abnormal, CT contrast-enhanced scanning or MRI examination should be performed to confirm tumor progression.…”

Section: Follow-upmentioning

confidence: 99%

“…19 In addition, in our previous study, we found that GLR has a better prediction ability in HCC patients with single tumor size (TS) <5 cm. 20 However, whether there is a similar result in AFP-negative HCC patients, and whether there is potential significance in the diagnosis and postoperative monitoring of HCC, there are no relevant researches reported yet. This study intended to focus on the application value of GLR in AFP-negative HCC, so as to provide possible assistance for the clinical diagnosis and treatment of AFP-negative HCC.…”

Section: Introductionmentioning

confidence: 99%

“…The specific diagnosis criteria, surgical indications, and radical hepatectomy criteria of the patients were described in detail in our previous study. 20 Radical resection was defined as all patients who underwent radical resection of HCC. The specific objectives were as follows: complete removal of all tumor nodules, and no residual tumor was found on the cutting edge according to histological examinations.…”

Section: Introductionmentioning

confidence: 99%

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The Significance of Gamma-Glutamyl Transpeptidase to Lymphocyte Count Ratio in the Early Postoperative Recurrence Monitoring and Prognosis Prediction of AFP-Negative Hepatocellular Carcinoma

Li¹,

Xu²,

Liao³

et al. 2021

JHC

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Background: Currently, there is still a lack of effective biomarkers for the recurrence monitoring and survival prognosis assessment of hepatocellular carcinoma (HCC) patients with alpha-fetoprotein (AFP)-negative (≤20 ng/mL) after radical resection. Methods: The clinicopathological data of 606 patients (303 in the AFP-negative group and 303 in the AFP-positive group) who underwent radical resection of HCC were analyzed retrospectively. Results: The gamma-glutamyl transpeptidase to lymphocyte count ratio (GLR) of patients in the AFP-negative group was lower than that in the AFP-positive group (p <0.001). The GLR level of the early-recurrence group was higher than that of the non-early-recurrence group (p =0.003). GLR had fair accuracy in predicting the early-recurrence of HCC patients [c-index=0.654 (95% CI=0.606-0.702); AUC=0.681 (95% CI=0.625-0.733)]. Univariate analysis showed that patients with tumor size <5 cm, no microvascular invasion, single tumor, no metastasis, BCLC stage 0-A, no recurrence, and GLR ≤45.0 had longer disease-free survival (DFS) and overall survival (OS) among AFP-negative HCC patients. In addition, multivariate Cox proportional hazards regression analysis showed that tumor size <5 cm (p =0.003), no recurrence (p <0.001), and GLR <45.0 (p <0.001) were independent predictors of longer OS. Conclusion: GLR may be a potential indicator for early recurrence monitoring and prognosis evaluation in HCC patients with AFP-negative after radical resection.

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Section: Follow-upmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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The Significance of Gamma-Glutamyl Transpeptidase to Lymphocyte Count Ratio in the Early Postoperative Recurrence Monitoring and Prognosis Prediction of AFP-Negative Hepatocellular Carcinoma

Li¹,

Xu²,

Liao³

et al. 2021

JHC

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“…Alkaline phosphatase (ALP) and gamma-glutamyl transpeptidase (GGT) are the representative enzymes in serum, as well as the parameters for liver function. Previous studies have reported that ALP, GGT and lymphocyte count were independent prognostic predictors for liver cancer [3][4][5]; and ALP to lymphocyte count ratio or GGT to lymphocyte count ratio could serve as prognostic factors as well [5,6]. It was found that, the normal references of serum ALP and GGT level were roughly equal in clinical, and a complementary effect was speculated between these two factors; meanwhile, the limitation of a single factor for predicting HCC prognosis should be considered.…”

Section: Introductionmentioning

confidence: 96%

AGLR is a Novel Index for the Prognosis of Hepatocellular Carcinoma Patients: A Retrospective Study

Yan

Wei

Yao

et al. 2020

Preprint

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Background: Most hepatocellular carcinoma (HCC) patients’ liver function indexes are abnormal. We aimed to investigate the relationship between (alkaline phosphatase + gamma-glutamyl transpeptidase) / lymphocyte ratio (AGLR) and the progression as well as the prognosis of HCC. Methods: A total of 495 HCC patients undergoing radical hepatectomy were retrospectively analyzed. We randomly divided these patients into the training cohort (n = 248) and the validation cohort (n = 247). In the training cohort, receiver operating characteristic (ROC) curve was used to determine the optimal cut-off value of AGLR for predicting postoperative survival of HCC patients, and the predictive value of AGLR was evaluated by concordance index (C-index). Further analysis of clinical and biochemical data of patients and the correlation analysis between AGLR and other clinicopathological factors were finished. Univariate and multivariate analyses were performed to identify prognostic factors for HCC patients. Survival curves were analyzed using the Kaplan-Meier method.Results: According to the ROC curve analysis, the optimal predictive cut-off value of AGLR was 90. The C-index of AGLR was 0.637 in the training cohort and 0.654 in the validation cohort, respectively. Based on this value, the HCC patients were divided into the low-AGLR group (AGLR ≤ 90) and the high-AGLR group (AGLR > 90). Preoperative AGLR level was positively correlated with α-fetoprotein (AFP), tumor size, tumor-node-metastasis (TNM) stage, and microvascular invasion (MVI) (all p < 0.05). In the training and validation cohorts, patients with AGLR > 90 had significantly shorter OS than patients with AGLR ≤ 90 (p < 0.001). Univariate and multivariate analyses of the training cohort (HR, 1.79; 95% CI, 1.21-2.69; p < 0.001) and validation cohort (HR, 1.82; 95% CI, 1.35-2.57; p < 0.001) had identified AGLR as an independent prognostic factor. A new prognostic scoring model was established based on the independent predictors determined in multivariate analysis.Conclusions: The elevated preoperative AGLR level indicated poor prognosis for patients with HCC; the novel prognostic scoring model had favorable predictive capability for postoperative prognosis of HCC patients, which may bring convenience for clinical management.

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“…Alkaline phosphatase (ALP) and gamma-glutamyl transpeptidase (GGT) are the representative enzymes in serum, as well as the parameters for liver function. Previous studies have reported that ALP, GGT and lymphocyte count were independent prognostic predictors for liver cancer [ 3 – 5 ]; and ALP to lymphocyte count ratio or GGT to lymphocyte count ratio could serve as prognostic factors as well [ 5 , 6 ]. It was found that, the normal references of serum ALP and GGT level were roughly equal in clinical, and a complementary effect was speculated between these two factors; meanwhile, the limitation of a single factor for predicting HCC prognosis should be considered.…”

Section: Introductionmentioning

confidence: 99%

AGLR is a novel index for the prognosis of hepatocellular carcinoma patients: a retrospective study

et al. 2021

Self Cite

View full text Add to dashboard Cite

Background Most hepatocellular carcinoma (HCC) patients’ liver function indexes are abnormal. We aimed to investigate the relationship between (alkaline phosphatase + gamma-glutamyl transpeptidase)/lymphocyte ratio (AGLR) and the progression as well as the prognosis of HCC. Methods A total of 495 HCC patients undergoing radical hepatectomy were retrospectively analyzed. We randomly divided these patients into the training cohort (n = 248) and the validation cohort (n = 247). In the training cohort, receiver operating characteristic (ROC) curve was used to determine the optimal cut-off value of AGLR for predicting postoperative survival of HCC patients, and the predictive value of AGLR was evaluated by concordance index (C-index). Further analysis of clinical and biochemical data of patients and the correlation analysis between AGLR and other clinicopathological factors were finished. Univariate and multivariate analyses were performed to identify prognostic factors for HCC patients. Survival curves were analyzed using the Kaplan–Meier method. Results According to the ROC curve analysis, the optimal predictive cut-off value of AGLR was 90. The C-index of AGLR was 0.637 in the training cohort and 0.654 in the validation cohort, respectively. Based on this value, the HCC patients were divided into the low-AGLR group (AGLR ≤ 90) and the high-AGLR group (AGLR > 90). Preoperative AGLR level was positively correlated with alpha-fetoprotein (AFP), tumor size, tumor-node-metastasis (TNM) stage, and microvascular invasion (MVI) (all p < 0.05). In the training and validation cohorts, patients with AGLR > 90 had significantly shorter OS than patients with AGLR ≤ 90 (p < 0.001). Univariate and multivariate analyses of the training cohort (HR, 1.79; 95% CI 1.21–2.69; p < 0.001) and validation cohort (HR, 1.82; 95% CI 1.35–2.57; p < 0.001) had identified AGLR as an independent prognostic factor. A new prognostic scoring model was established based on the independent predictors determined in multivariate analysis. Conclusions The elevated preoperative AGLR level indicated poor prognosis for patients with HCC; the novel prognostic scoring model had favorable predictive capability for postoperative prognosis of HCC patients, which may bring convenience for clinical management.

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Prognostic Value of Gamma-Glutamyl Transpeptidase to Lymphocyte Count Ratio in Patients With Single Tumor Size ≤ 5 cm Hepatocellular Carcinoma After Radical Resection

Cited by 13 publications

References 40 publications

The Significance of Gamma-Glutamyl Transpeptidase to Lymphocyte Count Ratio in the Early Postoperative Recurrence Monitoring and Prognosis Prediction of AFP-Negative Hepatocellular Carcinoma

The Significance of Gamma-Glutamyl Transpeptidase to Lymphocyte Count Ratio in the Early Postoperative Recurrence Monitoring and Prognosis Prediction of AFP-Negative Hepatocellular Carcinoma

AGLR is a Novel Index for the Prognosis of Hepatocellular Carcinoma Patients: A Retrospective Study

AGLR is a novel index for the prognosis of hepatocellular carcinoma patients: a retrospective study

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