Abstract
Backgrounds: The ratio of gamma-glutamyl transferase (GGT) to alanine aminotransferase (ALT) is a predictive biomarker for hepatitis and hepatocellular carcinoma (HCC). In this study, the relationship between GGT/ALT ratio and vascular invasion was explored in hepatitis B virus (HBV)-related HCC and tumor prognosis. Methods: Totally 558 patients were involved in this study. Univariate and multivariate logistic analysis were used to evaluate GGT/ALT as the risk factor of vascular invasion. Prognostic value of GGT/ALT was investigated by univariate and multivariate Cox analysis combined with Kaplan Meier curves. In order to reduce confounding bias, subgroup analysis and propensity score matching (PSM) were performed. Results: Patients were divided into high and low GGT/ALT groups with an optimal cut-off value of 2.95 in predicting vascular invasion. In univariate and multivariate logistic regression, high GGT/ALT group was listed as the independent risk factors for vascular invasion(P=0.03), the other risk factors included age (P=0.001), α-fetoprotein (AFP) (P=0.026), tumor size (P<0.001), tumor capsule (P=0.018), pathological differentiation (P<0.001) and Barcelona Clinic Liver Cancer (BCLC) classification (P<0.001). In survival analysis, high GGT/ALT ratio was associated with decreased overall survival (OS) (HR: 1.38; 95% CI: 1.03, 1.87; P<0.0001) and disease-free survival (DFS) rates (HR: 1.32; 95% CI: 1.03, 1.87; P<0.0001). In sensitivity analysis, comparable results were furtherly confirmed by subgroup analysis. In PSM analysis, GGT/ALT was still associated with vascular invasion independently (OR, 186; 95% CI, 1.23, 3.33). Conclusion: Preoperative GGT/ALT has good predictive value for vascular invasion, tumor severity and outcome in HBV-related HCC patients.
Effects of hepatitis B virus infection, alanine aminotransferase, aspartate aminotransferase and gamma-glutamyl transferase on prediabetes and diabetes mellitus: A cohort study
