Preoperative gamma-glutamyltransferase to lymphocyte ratio predicts long-term outcomes in intrahepatic cholangiocarcinoma patients following hepatic resection

doi:10.3748/wjg.v26.i13.1501

Advanced Search

BPG is committed to discovery and dissemination of knowledge

Home / Archive / Volume 26, Issue 13

This Article

Academic Content and Language Evaluation of This Article

CrossCheck and Google Search of This Article

Academic Rules and Norms of This Article

Supplementary Materials of This Article

Citation of this article

Corresponding Author of This Article

Research Domain of This Article

Article-Type of This Article

Open-Access Policy of This Article

Times Cited Counts in Google of This Article

Number of Hits and Downloads for This Article

Total Article Views (7353)

All Articles published online

The chart showing PDF series, WORD series, HTML series, Figures (1-2) series, Tables (1-4) series.

Item

Count

PDF

343

WORD

270

HTML

3184

Figures (1-2)

433

Tables (1-4)

333

Sum=4563

Publishing Process of This Article

The chart showing Browse series, Download series.

Item

Count

Browse

875

Download

1915

Sum=2790

Apr 7, 2020 (publication date) through Feb 17, 2025

Times Cited of This Article

Times Cited (12)

Journal Information of This Article

Publication Name

World Journal of Gastroenterology

ISSN

1007-9327

Publisher of This Article

Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA

Retrospective Study

World J Gastroenterol. Apr 7, 2020; 26(13): 1501-1512
Published online Apr 7, 2020. doi: 10.3748/wjg.v26.i13.1501

Table 1 Correlation between gamma-glutamyltransferase to lymphocyte ratio and clinicopathological characteristics in intrahepatic cholangiocarcinoma

Variables	Derivation		P value	Validation		P value
Variables	GLR ≤ 33.7	GLR > 33.7	P value	GLR ≤ 33.7	GLR > 33.7	P value
Total patients	107	157		97	166
Age, yr	57.96 (11.48)	57.80 (10.35)	0.902	56.97 (10.69)	56.48 (10.56)	0.716
Male gender, n (%)	42 (39.3)	85 (54.1)	0.024^a	38 (39.2)	89 (53.6)	0.030^a
HBsAg, n (%)	36 (33.6)	37 (23.6)	0.073	31 (32.3)	47 (28.5)	0.575
Hepatolithiasis, n (%)	14 (13.1)	27 (17.2)	0.396	15 (15.5)	32 (19.3)	0.511
Child-Pugh grade B, n (%)	3 (2.8)	8 (5.1)	0.533	2 (2.1)	11 (6.6)	0.141
Ascites, n (%)	6 (5.6)	21 (13.4)	0.061	4 (4.1)	19 (11.4)	0.068
CA-199 < 22, n (%)	38 (36.5)	42 (27.5)	0.005^a	29 (31.2)	40 (24.2)	0.043^a
Tumor size, cm	5.14 (2.29)	6.51 (2.78)	< 0.001^a	5.40 (2.22)	6.36 (2.97)	0.007^a
Solitary tumor, n (%)	89 (83.2)	102 (65.0)	0.001^a	67 (69.1)	113 (68.1)	0.895
Well tumor differentiation, n (%)	6 (5.6)	4 (2.5)	0.331	5 (5.2)	7 (4.2)	0.767
Macrovascular invasion, n (%)	17 (15.9)	45 (28.7)	0.011^a	8 (8.2)	53 (31.9)	< 0.001^a
Microvascular invasion, n (%)	6 (5.6)	23 (14.6)	0.026^a	7 (7.2)	17 (10.2)	0.514
Liver capsule invasion, n (%)	67 (62.6)	107 (68.2)	0.362	64 (66.0)	97 (58.4)	0.248
Node-positive, n (%)	16 (15.0)	48 (30.6)	0.005^a	18 (18.6)	47 (28.3)	0.107
Perineural invasion, n (%)	9 (8.4)	27 (17.2)	0.044^a	8 (8.2)	35 (21.1)	0.009^a
Cirrhosis, n (%)	27 (25.2)	53 (33.8)	0.174	19 (19.6)	46 (27.7)	0.182
TNM stage, n (%)			0.002^a			0.107
IA	23 (21.5)	12 (7.6)		13 (13.4)	15 (9.0)
IB	6 (5.6)	12 (7.6)		6 (6.2)	13 (7.8)
II	6 (5.6)	13 (8.3)		10 (10.3)	26 (15.7)
IIIA	55 (51.4)	72 (45.9)		50 (51.5)	64 (38.6)
IIIB	17 (15.9)	48 (30.6)		18 (18.6)	48 (28.9)
BCLC stage, n (%)			< 0.001^a			< 0.001^a
0	6 (5.6)	9 (5.7)		3 (3.1)	5 (3.0)
A	44 (41.1)	25 (15.9)		34 (35.1)	38 (22.9)
B	40 (37.4)	78 (49.7)		52 (53.6)	70 (42.2)
C	17 (15.9)	45 (28.7)		8 (8.2)	53 (31.9)

^aP < 0.05. HBV: Hepatitis B virus; CA-199: Carbohydrate antigen-199; TNM: Tumor-node-metastasis; BCLC: BARCELONA Clinic Liver Cancer; GLR: Gamma-glutamyltransferase to lymphocyte ratio; ICC: Intrahepatic cholangiocarcinoma; HR: Hazard ratio; CI: Confidence interval.

Table 2 Univariate analysis in the derivation cohort

Variables	Overall survival			Recurrence-free survival
Variables	HR	95%CI	P value	HR	95%CI	P value
Age	1.002	0.987-1.017	0.819	0.998	0.985-1.011	0.763
Gender, F/M	0.752	0.546-1.035	0.080^a	0.846	0.633-1.132	0.262
HBsAg	1.210	0.853-1.717	0.285	1.274	0.924-1.756	0.139
Hepatolithiasis	1.593	1.061-2.393	0.025^a	1.176	0.785-1.761	0.433
Child-Pugh grade, A /B	0.614	0.323-1.167	0.136	0.732	0.381-1.367	0.317
Ascites	1.639	1.011-2.658	0.045^a	1.532	0.988-2.376	0.056^a
CA-199 (≥ 22/< 22)	0.953	0.926-0.981	0.001^a	1.546	1.259-1.899	< 0.001^a
Tumor size	1.075	1.012-1.141	0.019^a	1.123	1.063-1.187	< 0.001^a
Tumor number, Multiple/Single	1.655	1.172-2.328	0.004^a	1.893	1.388-2.582	< 0.001^a
Tumor differentiation, Moderate-Poor/Well	1.891	0.699-5.115	0.209	3.277	1.045-10.274	0.042^a
Macrovascular invasion	1.371	0.953-1.972	0.089^a	1.277	0.913-1.787	0.153
Microvascular invasion	1.619	1.029-2.548	0.037^a	1.983	1.306-3.012	0.001^a
Liver capsule invasion	0.815	0.586-1.134	0.225	1.140	0.833-1.561	0.412
Node-positive	2.846	2.030-3.989	< 0.001^a	2.484	1.810-3.409	< 0.001^a
Perineural invasion	1.737	1.129-2.673	0.012^a	1.245	0.821-1.887	0.302
Cirrhosis	1.526	1.094-2.130	0.013^a	1.182	0.863-1.617	0.297
TNM stage, III/I-II	1.067	0.745-1.529	0.722	1.431	1.010-2.028	0.044^a
BCLC, B-C/0-A	1.295	0.906-1.850	0.156	1.607	1.150-2.246	0.005^a
NLR, > 2.62/≤ 2.62	1.701	1.221-2.371	0.002^a	1.422	1.057-1.912	0.020^a
PLR, > 103/≤ 103	1.366	0.983-1.897	0.063^a	1.360	1.009-1.833	0.043^a
GLR, > 33.7/≤ 33.7	2.316	1.617-3.316	< 0.001^a	1.931	1.413-2.639	< 0.001^a

^aP < 0.10. M: male; F: Female; HBV: Hepatitis B virus; CA-199: Carbohydrate antigen-199; TNM: Tumor-node-metastasis; BCLC: Barcelona Clinic Liver Cancer; NLR: Neutrophil to lymphocyte ratio; PLR: Platelet to lymphocyte ratio; GLR: Gamma-glutamyltransferase to lymphocyte ratio; HR: Hazard ratio; CI: Confidence interval.

Table 3 Univariate analysis in the validation cohort

Variables	Overall survival			Recurrence-free survival
Variables	HR	95%CI	P value	HR	95%CI	P value
Age	0.996	0.981-1.011	0.594	0.990	0.976-1.004	0.148
Gender, F/M	0.907	0.667-1.233	0.534	0.920	0.695-1.218	0.560
HBsAg	1.004	0.717-1.405	0.982	1.110	0.819-1.505	0.500
Hepatolithiasis	1.092	0.744-1.602	0.654	0.799	0.551-1.158	0.236
Child-Pugh grade, A /B	0.852	0.435-1.671	0.642	0.751	0.418-1.350	0.339
Ascites	1.440	0.871-2.382	0.155	1.580	1.004-2.487	0.048^a
CA-199, ≥ 22/< 22	1.744	1.390-2.188	< 0.001^a	1.402	1.140-1.722	0.001^a
Tumor size	1.054	0.997-1.115	0.064^a	1.084	1.030-1.141	0.002^a
Tumor number, Multiple/Single	1.845	1.344-2.531	< 0.001^a	1.874	1.397-2.513	< 0.001^a
Tumor differentiation, Moderate-Poor/Well	13.449	1.881-96.150	0.010	6.053	1.930-18.982	0.002^a
Macrovascular invasion	1.050	0.730-1.511	0.792	1.009	0.718-1.418	0.959
Microvascular invasion	1.995	1.228-3.242	0.005^a	2.023	1.290-3.172	0.002^a
Liver capsule invasion	1.553	1.118-2.159	0.009^a	1.280	0.955-1.716	0.099^a
Node-positive	2.009	1.438-2.808	< 0.001^a	1.525	1.115-2.085	0.008^a
Perineural invasion	1.366	0.906-2.059	0.136	1.262	0.867-1.838	0.225
Cirrhosis	0.984	0.686-1.412	0.932	1.054	0.762-1.459	0.749
TNM stage, III/I-II	1.774	1.242-2.533	0.002^a	1.413	1.035-1.929	0.029
BCLC, B-C/0-A	1.619	1.136-2.308	0.008^a	1.849	1.335-2.562	< 0.001^a
NLR, > 2.62/≤ 2.62	1.649	1.202-2.261	0.002^a	1.635	1.226-2.180	0.001^a
PLR, > 103/≤ 103	1.417	1.036-1.938	0.029^a	1.065	0.803-1.414	0.661
GLR, > 33.7/≤ 33.7	1.826	1.300-2.565	0.001^a	1.780	1.315-2.408	< 0.001^a

^aP < 0.10. M: Male; F: Female; HBV: Hepatitis B virus; CA-199: Carbohydrate antigen-199; TNM: Tumor-node-metastasis; BCLC: Barcelona Clinic Liver Cancer; NLR: Neutrophil to lymphocyte ratio; PLR: Platelet to lymphocyte ratio; GLR: Gamma-glutamyltransferase to lymphocyte ratio; HR: Hazard ratio; CI: Confidence interval.

Table 4 Multivariate analysis of prognostic factors for overall survival and recurrence-free survival

OS	Derivation cohort (n = 264)			Validation cohort (n = 263)
OS	HR	95%CI	P value	HR	95%CI	P value
Gender, F/M	0.847	0.58-1.216	0.367	-
Hepatolithiasis	1.073	0.677-1.699	0.765	-
Child-Pugh grade, A /B	0.775	0.38-1.583	0.485	-
Ascites	0.758	0.428-1.339	0.340	0.640	0.376-1.090	0.100
CA-199, ≥ 22/< 22	1.731	1.331-2.252	< 0.001^a	1.612	1.252-2.075	< 0.001^a
Tumor size	1.053	0.967-1.146	0.234	0.931	0.857-1.011	0.088
Tumor number, Multiple/Single	1.662	1.086-2.543	0.019^a	1.677	1.189-2.366	0.003^a
Tumor differentiation, Moderate-Poor/Well	-			7.927	1.083-58.02	0.042^a
Macrovascular invasion	1.199	0.781-1.843	0.407	-
Microvascular invasion	1.082	0.635-1.842	0.773	1.349	0.801-2.274	0.261
Liver capsule invasion	-			1.036	0.533-2.013	0.917
Node- positive	2.038	1.365-3.042	< 0.001^a	1.269	0.835-1.928	0.265
Perineural invasion	1.252	0.773-1.116	0.169	0.973	0.591-1.603	0.914
Cirrhosis	1.589	1.074-2.351	0.020^a	-
TNM stage, III/I-II	-			1.294	0.607-2.761	0.505
BCLC, B-C/0-A	0.627	0.364-1.078	0.091	1.307	0.813-2.101	0.269
NLR, > 2.62/≤ 2.62	1.357	0.912-2.017	0.132	1.287	0.897-1.846	0.170
PLR, > 103/≤ 103	1.141	0.776-1.679	0.502	1.094	0.778-1.539	0.604
GLR, > 33.7/≤ 33.7	1.620	1.066-2.462	0.024^a	1.466	1.033-2.142	0.048^a
RFS
Age	-			0.991	0.976-1.006	0.236
HBsAg	1.367	0.974-1.919	0.071	-
Ascites	0.763	0.473-1.230	0.266	0.621	0.382-1.010	0.055
CA-199, ≥ 22/< 22	1.406	1.128-1.752	0.002^a	1.319	1.050-1.656	0.017^a
Tumor size	1.073	0.994-1.158	0.072	0.975	0.906-1.050	0.501
Tumor number, Multiple/Single	1.434	0.998-2.060	0.051	1.613	1.172-2.219	0.003^a
Tumor differentiation, Moderate-Poor/Well	2.068	0.635-6.734	0.228	3.617	1.114-11.741	0.032^a
Macrovascular invasion	1.149	0.785-1.682	0.475	-
Microvascular invasion	1.643	1.031-2.618	0.037^a	1.607	0.986-2.618	0.057
Liver capsule invasion	-			0.778	0.428-1.417	0.413
Node-positive	1.859	1.272-2.716	0.001^a	0.972	0.664-1.421	0.882
TNM stage, III/I-II	0.892	0.559-1.328	0.572	1.524	0.778-2.988	0.220
BCLC, B-C/0-A	0.784	0.480-1.280	0.331	1.339	0.859-2.087	0.198
NLR, > 2.62/≤ 2.62	1.128	0.811-1.571	0.474	1.352	0.967-1.891	0.077
PLR, > 103/≤ 103	1.125	0.809-1.565	0.483	0.805	0.589-1.100	0.173
GLR, > 33.7/≤ 33.7	1.471	1.029-2.103	0.034^a	1.480	1.057-2.070	0.022^a

^aP < 0.05. OS: Overall survival; RFS: Recurrence-free survival; HBV: Hepatitis B virus; CA-199: Carbohydrate antigen-199; TNM: Tumor-node-metastasis; BCLC: Barcelona Clinic Liver Cancer; GLR: Gamma-glutamyltransferase to lymphocyte ratio; HR: Hazard ratio; CI: Confidence interval.

Citation: Wang JJ, Li H, Li JX, Xu L, Wu H, Zeng Y. Preoperative gamma-glutamyltransferase to lymphocyte ratio predicts long-term outcomes in intrahepatic cholangiocarcinoma patients following hepatic resection. World J Gastroenterol 2020; 26(13): 1501-1512
URL: https://www.wjgnet.com/1007-9327/full/v26/i13/1501.htm
DOI: https://dx.doi.org/10.3748/wjg.v26.i13.1501