Copyright
©The Author(s) 2020.
World J Gastroenterol. Apr 7, 2020; 26(13): 1501-1512
Published online Apr 7, 2020. doi: 10.3748/wjg.v26.i13.1501
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 | ||
GLR ≤ 33.7 | GLR > 33.7 | GLR ≤ 33.7 | GLR > 33.7 | |||
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) | 0.024a | 38 (39.2) | 89 (53.6) | 0.030a |
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) | 0.005a | 29 (31.2) | 40 (24.2) | 0.043a |
Tumor size, cm | 5.14 (2.29) | 6.51 (2.78) | < 0.001a | 5.40 (2.22) | 6.36 (2.97) | 0.007a |
Solitary tumor, n (%) | 89 (83.2) | 102 (65.0) | 0.001a | 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) | 0.011a | 8 (8.2) | 53 (31.9) | < 0.001a |
Microvascular invasion, n (%) | 6 (5.6) | 23 (14.6) | 0.026a | 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) | 0.005a | 18 (18.6) | 47 (28.3) | 0.107 |
Perineural invasion, n (%) | 9 (8.4) | 27 (17.2) | 0.044a | 8 (8.2) | 35 (21.1) | 0.009a |
Cirrhosis, n (%) | 27 (25.2) | 53 (33.8) | 0.174 | 19 (19.6) | 46 (27.7) | 0.182 |
TNM stage, n (%) | 0.002a | 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 (%) | < 0.001a | < 0.001a | ||||
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) |
Table 2 Univariate analysis in the derivation cohort
Variables | Overall survival | Recurrence-free survival | ||||
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 | 0.080a | 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 | 0.025a | 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 | 0.045a | 1.532 | 0.988-2.376 | 0.056a |
CA-199 (≥ 22/< 22) | 0.953 | 0.926-0.981 | 0.001a | 1.546 | 1.259-1.899 | < 0.001a |
Tumor size | 1.075 | 1.012-1.141 | 0.019a | 1.123 | 1.063-1.187 | < 0.001a |
Tumor number, Multiple/Single | 1.655 | 1.172-2.328 | 0.004a | 1.893 | 1.388-2.582 | < 0.001a |
Tumor differentiation, Moderate-Poor/Well | 1.891 | 0.699-5.115 | 0.209 | 3.277 | 1.045-10.274 | 0.042a |
Macrovascular invasion | 1.371 | 0.953-1.972 | 0.089a | 1.277 | 0.913-1.787 | 0.153 |
Microvascular invasion | 1.619 | 1.029-2.548 | 0.037a | 1.983 | 1.306-3.012 | 0.001a |
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 | < 0.001a | 2.484 | 1.810-3.409 | < 0.001a |
Perineural invasion | 1.737 | 1.129-2.673 | 0.012a | 1.245 | 0.821-1.887 | 0.302 |
Cirrhosis | 1.526 | 1.094-2.130 | 0.013a | 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 | 0.044a |
BCLC, B-C/0-A | 1.295 | 0.906-1.850 | 0.156 | 1.607 | 1.150-2.246 | 0.005a |
NLR, > 2.62/≤ 2.62 | 1.701 | 1.221-2.371 | 0.002a | 1.422 | 1.057-1.912 | 0.020a |
PLR, > 103/≤ 103 | 1.366 | 0.983-1.897 | 0.063a | 1.360 | 1.009-1.833 | 0.043a |
GLR, > 33.7/≤ 33.7 | 2.316 | 1.617-3.316 | < 0.001a | 1.931 | 1.413-2.639 | < 0.001a |
Table 3 Univariate analysis in the validation cohort
Variables | Overall survival | Recurrence-free survival | ||||
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 | 0.048a |
CA-199, ≥ 22/< 22 | 1.744 | 1.390-2.188 | < 0.001a | 1.402 | 1.140-1.722 | 0.001a |
Tumor size | 1.054 | 0.997-1.115 | 0.064a | 1.084 | 1.030-1.141 | 0.002a |
Tumor number, Multiple/Single | 1.845 | 1.344-2.531 | < 0.001a | 1.874 | 1.397-2.513 | < 0.001a |
Tumor differentiation, Moderate-Poor/Well | 13.449 | 1.881-96.150 | 0.010 | 6.053 | 1.930-18.982 | 0.002a |
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 | 0.005a | 2.023 | 1.290-3.172 | 0.002a |
Liver capsule invasion | 1.553 | 1.118-2.159 | 0.009a | 1.280 | 0.955-1.716 | 0.099a |
Node-positive | 2.009 | 1.438-2.808 | < 0.001a | 1.525 | 1.115-2.085 | 0.008a |
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 | 0.002a | 1.413 | 1.035-1.929 | 0.029 |
BCLC, B-C/0-A | 1.619 | 1.136-2.308 | 0.008a | 1.849 | 1.335-2.562 | < 0.001a |
NLR, > 2.62/≤ 2.62 | 1.649 | 1.202-2.261 | 0.002a | 1.635 | 1.226-2.180 | 0.001a |
PLR, > 103/≤ 103 | 1.417 | 1.036-1.938 | 0.029a | 1.065 | 0.803-1.414 | 0.661 |
GLR, > 33.7/≤ 33.7 | 1.826 | 1.300-2.565 | 0.001a | 1.780 | 1.315-2.408 | < 0.001a |
Table 4 Multivariate analysis of prognostic factors for overall survival and recurrence-free survival
OS | Derivation cohort (n = 264) | Validation cohort (n = 263) | ||||
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 | < 0.001a | 1.612 | 1.252-2.075 | < 0.001a |
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 | 0.019a | 1.677 | 1.189-2.366 | 0.003a |
Tumor differentiation, Moderate-Poor/Well | - | 7.927 | 1.083-58.02 | 0.042a | ||
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 | < 0.001a | 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 | 0.020a | - | ||
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 | 0.024a | 1.466 | 1.033-2.142 | 0.048a |
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 | 0.002a | 1.319 | 1.050-1.656 | 0.017a |
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 | 0.003a |
Tumor differentiation, Moderate-Poor/Well | 2.068 | 0.635-6.734 | 0.228 | 3.617 | 1.114-11.741 | 0.032a |
Macrovascular invasion | 1.149 | 0.785-1.682 | 0.475 | - | ||
Microvascular invasion | 1.643 | 1.031-2.618 | 0.037a | 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 | 0.001a | 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 | 0.034a | 1.480 | 1.057-2.070 | 0.022a |
- 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