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©The Author(s) 2024. Published by Baishideng Publishing Group Inc. All rights reserved.
Prognostic utility of gamma-glutamyl transpeptidase to platelet ratio in patients with solitary hepatitis B virus-related hepatocellular carcinoma after hepatectomy
Cheng-Kun Yang, Zhong-Liu Wei, Xiao-Qiang Shen, Yu-Xuan Jia, Qiong-Yuan Wu, Yong-Guang Wei, Hao Su, Wei Qin, Xi-Wen Liao, Guang-Zhi Zhu, Tao Peng
Cheng-Kun Yang, Zhong-Liu Wei, Xiao-Qiang Shen, Yu-Xuan Jia, Yong-Guang Wei, Hao Su, Wei Qin, Xi-Wen Liao, Guang-Zhi Zhu, Tao Peng, Department of Hepatobiliary Surgery, The First Affiliated Hospital of Guangxi Medical University, Nanning 530021, Guangxi Zhuang Autonomous Region, China
Cheng-Kun Yang, Zhong-Liu Wei, Xiao-Qiang Shen, Yu-Xuan Jia, Yong-Guang Wei, Hao Su, Wei Qin, Xi-Wen Liao, Guang-Zhi Zhu, Tao Peng, Guangxi Key Laboratory of Enhanced Recovery after Surgery for Gastrointestinal Cancer, Nanning 530021, Guangxi Zhuang Autonomous Region, China
Qiong-Yuan Wu, Department of Tuina, Nanning Hospital of Traditional Chinese Medicine, Nanning 530022, Guangxi Zhuang Autonomous Region, China
Author contributions: Yang CK and Peng T designed the study; Yang CK, Wei ZL, Shen XQ, Jia YX, and Wu QY performed research; Yang CK, Wei ZL, Shen XQ, Jia YX, Wu QY and Wei XL provided sample collection and clinical support; Yang CK, Wei YG, Su H, Liao XW, Zhu GZ and Qin W contributed to data interpretation; Yang CK and Wei ZL wrote the manuscript; Peng T critically revised the manuscript and participated in the analysis and interpretation of the data; all of the authors read and approved the final version of the manuscript to be published.
Supported by The National Natural Science Foundation of China, No. 81560535, No. 81802874 and No. 81072321; and The Self-funded Scientific Research Project of Health Commission in Guangxi Zhuang Autonomous Region, China, No. Z20210977.
Institutional review board statement: This study was approved by The Ethics Committee of The First Affiliated Hospital of Guangxi Medical University, China.
Informed consent statement: All participants signed written informed consent before study commencement.
Conflict-of-interest statement: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.
Data sharing statement: The datasets generated during and/or analyzed during the current study are available from the corresponding author on reasonable request.
STROBE statement: The authors have read the STROBE Statement-checklist of items, and the manuscript was prepared and revised according to the STROBE Statement-checklist of items.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See:
https://creativecommons.org/Licenses/by-nc/4.0/ Corresponding author: Tao Peng, MD, PhD, Professor, Department of Hepatobiliary Surgery, The First Affiliated Hospital of Guangxi Medical University, No. 6 Shuangyong Road, Nanning 530021, Guangxi Zhuang Autonomous Region, China.
pengtaogmu@163.com
Received: February 28, 2024
Revised: September 12, 2024
Accepted: September 29, 2024
Published online: December 15, 2024
Processing time: 258 Days and 2.4 Hours
BACKGROUND
The prognostic impact of preoperative gamma-glutamyl transpeptidase to platelet ratio (GPR) levels in patients with solitary hepatitis B virus (HBV)-related hepatocellular carcinoma (HCC) following radical resection has not been established.
AIM
To examine the clinical utility of GPR for prognosis prediction in solitary HBV-related HCC patients.
METHODS
A total of 1167 solitary HBV-related HCC patients were retrospectively analyzed. GPR levels were compared with 908 non-HCC individuals. Overall survival (OS) and recurrence-free survival (RFS) were evaluated, and cox proportional hazard model analyses were performed to identify independent risk factors. Differences in characteristics were adjusted by propensity score matching (PSM). Subgroup and stratified survival analyses for HCC risks were performed, and a linear trend of the hazard ratio (HR) according to GPR levels was constructed.
RESULTS
GPR levels of patients with solitary HBV-related HCC were higher than those with hepatic hemangiomas, chronic hepatitis B and healthy control (adjusted P < 0.05). Variable bias was diminished after the PSM balance test. The low GPR group had improved OS (P < 0.001) and RFS (P < 0.001) in the PSM analysis and when combined with other variables. Multivariate cox analyses suggested that low GPR levels were associated with a better OS (HR = 0.5, 95%CI: 0.36-0.7, P < 0.001) and RFS (HR = 0.57, 95%CI: 0.44-0.73, P < 0.001). This same trend was confirmed in subgroup analyses. Prognostic nomograms were constructed and the calibration curves showed that GPR had good survival prediction. Moreover, stratified survival analyses found that GPR > 0.6 was associated with a worse OS and higher recurrence rate (P for trend < 0.001).
CONCLUSION
Preoperative GPR can serve as a noninvasive indicator to predict the prognosis of patients with solitary HBV-related HCC.
Core Tip: In this study, we assessed the prognostic value of gamma-glutamyl transpeptidase to platelet ratio (GPR) in early hepatitis B virus (HBV)-related hepatocellular carcinoma (HCC) patients. We evaluated the clinical utility of preoperative GPR in predicting outcomes for solitary HBV-related HCC patients using propensity score matching, restricted cubic spline, survival analyses and stratified analyses. Preoperative GPR levels facilitate recurrence monitoring and inform treatment strategies, potentially enhancing the quality of life for HCC patients.
