Predictive value of gamma-glutamyl transpeptidase to lymphocyte count ratio in hepatocellular carcinoma patients with microvascular invasion
Abstract Purpose: Microvascular invasion (MVI) is an independent risk factor for poor prognosis of hepatocellular Carcinoma (HCC), However, there is still a lack of preoperative markers to predict MVI of HCC. This study intends to explore the potential application value of gamma-glutamyl transpeptidase to lymphocyte count ratio (GLR) in predicting MVI of HCC, and provide guidance of clinical diagnosis and treatment.Patients and methods: From March 2010 to December 2015, 230 HCC patients underwent surgical treatment in Affiliated Hospitals of Guilin Medical University were selected. Clinicopathological parameters between MVI group (n = 115) and non-MVI group (n = 115) were comparative analyzed. Gamma-glutamyl transpeptidase (GGT) to lymphocyte count ratio (GLR) was used as the key risk factor of HCC with MVI and its optimal cut-off value was estimated by using the receiver operating characteristic (ROC) curve. Kaplan-meier method was used to analyze the survival of HCC patients, and univariate and multivariate Cox regression analysis were used to establish independent predictors affecting postoperative HCC patients.Results: The level of GLR in the MVI group and non-MVI group was 84.83 ± 61.84 and 38.42 ± 33.52 (p < 0.001) respectively. According to the ROC curve analysis, the optimal cut-off value of GLR was 56, and the area under ROC curve (AUC) was 0.781 (95%CI, 0.719 - 0.833) for risk prediction in HCC patients with MVI. Multivariate analysis results showed that the tumor size > 5 cm, HCC combined with MVI and GLR > 56 are independent risk factors for poor prognosis of HCC patients. In addition, compared with non-MVI group, patients with MVI had shorter progression-free survival (PFS) rates and overall survival (OS).Conclusion: GLR could be a predictive biomarker of HCC after operation and a potential predictor of HCC patients combined with MVI.