Prognostic Significance of Globulin/Low-Density Lipoprotein Ratio In Patients With Hepatocellular Carcinoma After Local Ablative Therapy

Abstract Background: Low-density lipoprotein (LDL) and globulin have been found to be predictors for some malignant tumors, but their predictive value in hepatocellular carcinoma (HCC) has hardly to be elucidated. This study assessed the prognostic significance of globulin to low-density lipoprotein ratio (GLR) in HCC patients before ablation.Materials and methods: This study analyzed 312 HCC patients hospitalized and underwent ablative treatment in Beijing You 'an Hospital, Capital Medical University, from January 1, 2012 to January 1, 2017. Cox regression analysis was used to assess the factors independently associated with recurrence and survival. The optimal cut-off value and prognostic role of GLR and other markers were evaluated via the receiver operating characteristic-ROC curves and the Youden index. Overall survival (OS) and recurrence-free survival (RFS) were calculated by Kaplan-Meier analysis, and compared between groups using the log-rank.Result: Univariate and multivariate analysis found that the tumor number (HR: 1.676;95%CI: 1.113-2.526), tumor size (HR: 1.967;95%CI: 1.251-3.092), GLR (HR: 1.028;95%CI: 1.004-1.052) were independent risk factors of relapse; while etiology (HR: 1.328;95%CI: 1.052-1.677), tumor number (HR: 1.615;95%CI: 1.015-2.570), tumor size (HR: 2.061; 95%CI: 1.243-3.418), Fib (HR: 0.73; 95%CI: 0.535-0.996) and GLR (HR: 1.031;95%CI: 1.003-1.06) were related to overall survival. We classified the patients into groups with high and low levels of GLR based on the optimal cut-off value of GLR identified by generating receiver operating characteristics (ROC) curve. The cumulative 1-, 3-, and 5-year RFS rates in the low GLR group were 76.4%, 53.8% and 43.4%, while those in the high GLR group were 71%, 31% and 22%, respectively (P <0.001). Concerning OS, the low GLR group showed a 1-, 3- and 5-year OS of 99.5%, 92.0% and 80.2% versus 98%, 73% and 63% for the high GLR group (P <0.001). Finally, patients were stratified by GLR and tumor size. The outcomes revealed that patients in group A (GLR<16.54 and tumor size ≤30mm) showed better prognosis than group B (GLR≥16.54 and tumor size≤30mm or GLR<16.54 and tumor size >30mm) and group C (GLR≥16.54 and tumor size >30mm) (P <0.001). Conclusions: Preoperative GLR ratio could serve as a biomarker to predict prognosis in HCC patients who underwent complete ablation.

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The Application Value of Lipoprotein Particle Numbers in the Diagnosis of HBV-Related Hepatocellular Carcinoma with BCLC Stage 0-A

Journal of Personalized Medicine ◽

10.3390/jpm11111143 ◽

2021 ◽

Vol 11 (11) ◽

pp. 1143

Author(s):

Duo Zuo ◽

Haohua An ◽

Jianhua Li ◽

Jiawei Xiao ◽

Li Ren

Keyword(s):

Hepatocellular Carcinoma ◽

Lipid Metabolism ◽

Prediction Models ◽

Low Density Lipoprotein ◽

Prognostic Significance ◽

Density Lipoprotein ◽

Serum Lipoprotein ◽

Low Density ◽

Clinical Value ◽

Lipoprotein Subfractions

Early diagnosis is essential for improving the prognosis and survival of patients with hepatocellular carcinoma (HCC). This study aims to explore the clinical value of lipoprotein subfractions in the diagnosis of hepatitis B virus (HBV)-related HCC. Lipoprotein subfractions were detected by 1H-NMR spectroscopy, and the pattern-recognition method and binary logistic regression were performed to classify distinct serum profiles and construct prediction models for HCC diagnosis. Differentially expressed proteins associated with lipid metabolism were detected by LC-MS/MS, and the potential prognostic significance of the mRNA expression was evaluated by Kaplan–Meier survival analysis. The diagnostic panel constructed from the serum particle number of very-low-density lipoprotein (VLDL), intermediate-density lipoprotein (IDL), and low-density lipoprotein (LDL-1~LDL-6) achieved higher accuracy for the diagnosis of HBV-related HCC and HBV-related benign liver disease (LD) than that constructed from serum alpha-fetoprotein (AFP) alone in the training set (AUC: 0.850 vs. AUC: 0.831) and validation set (AUC: 0.926 vs. AUC: 0.833). Furthermore, the panel achieved good diagnostic performance in distinguishing AFP-negative HCC from AFP-negative LD (AUC: 0.773). We also found that lipoprotein lipase (LPL) transcript levels showed a significant increase in cancerous tissue and that high expression was significantly positively correlated with the poor prognosis of patients. Our research provides new insight for the development of diagnostic biomarkers for HCC, and abnormal lipid metabolism and LPL-mediated abnormal serum lipoprotein metabolism may be important factors in promoting HCC development.

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Reduced expression of low-density lipoprotein receptor in hepatocellular carcinoma with paraneoplastic hypercholesterolemia

Journal of Gastroenterology and Hepatology ◽

10.1111/j.1440-1746.2007.05115.x ◽

2008 ◽

Vol 23 (7pt2) ◽

pp. e153-e156 ◽

Cited By ~ 13

Author(s):

Tetsuro Sohda ◽

Kaoru Iwata ◽

Yuji Kitamura ◽

Norihisa Suzuki ◽

Yasuaki Takeyama ◽

...

Keyword(s):

Hepatocellular Carcinoma ◽

Low Density Lipoprotein ◽

Density Lipoprotein ◽

Low Density ◽

Lipoprotein Receptor ◽

Low Density Lipoprotein Receptor ◽

Density Lipoprotein Receptor

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Differentiating Familial Chylomicronemia Syndrome From Multifactorial Severe Hypertriglyceridemia by Clinical Profiles

Journal of the Endocrine Society ◽

10.1210/js.2019-00214 ◽

2019 ◽

Vol 3 (12) ◽

pp. 2397-2410 ◽

Cited By ~ 5

Author(s):

Louis St L O’Dea ◽

James MacDougall ◽

Veronica J Alexander ◽

Andres Digenio ◽

Brant Hubbard ◽

...

Keyword(s):

Low Density Lipoprotein ◽

Density Lipoprotein ◽

Clinical Information ◽

Lipoprotein Cholesterol ◽

Low Density ◽

Operating Characteristics ◽

Low Density Lipoprotein Cholesterol ◽

Two Phase ◽

Severe Hypertriglyceridemia ◽

Primary Model

Abstract Context Differentiation between familial chylomicronemia syndrome (FCS, type 1 hyperlipoproteinemia), a rare metabolic disorder, and the more common multifactorial severe hypertriglyceridemia (sHTG, type 5 hyperlipoproteinemia) is challenging because of their overlapping symptoms but important in patient management. Objective To assess whether readily obtainable clinical information beyond triglycerides can effectively diagnose and differentiate patients with FCS from those with sHTG, based on well-curated data from two intervention studies of these conditions. Methods The analysis included 154 patients from two phase 3 clinical trials of patients with sHTG, one cohort with genetically confirmed FCS (n = 49) and one with multifactorial sHTG (n = 105). Logistic regression analyses were performed to determine the ability of variables (patient demographics, medical history, and baseline lipids, individually or in sets) to differentiate the patient populations. Receiver operating characteristics were used to determine the variable sets with the highest accuracy (percentage of times actual values matched predicted) and optimal sensitivity and specificity. Results The primary model diagnosed 45 of 49 patients with FCS and 99 of 105 patients with sHTG correctly. Optimal sensitivity for all available parameters (n = 17) was 91.8%, optimal specificity was 94.3%, and accuracy was 93.5%. Fasting low-density lipoprotein cholesterol (LDL-C) provided the highest individual predictability. However, a three-variable set of ultracentrifugally measured LDL-C, body mass index, and pancreatitis history differentiated the diseases with a near similar accuracy of 91.0%, and adding high-density lipoprotein cholesterol and very low-density lipoprotein cholesterol for a five-variable set provided a small incremental increase in accuracy (92.2%). Conclusions In the absence of genetic testing, hypertriglyceridemic patients with FCS and sHTG can be differentiated with a high degree of accuracy by analyzing readily obtainable clinical information.

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LDH and GGT/ALT Ratio as Novel Prognostic Biomarkers in Hepatocellular Carcinoma Patients after Liver Transplantation

Computational and Mathematical Methods in Medicine ◽

10.1155/2021/9809990 ◽

2021 ◽

Vol 2021 ◽

pp. 1-8

Author(s):

Qi Zhang ◽

Xingyuan Jiao

Keyword(s):

Hepatocellular Carcinoma ◽

Tumor Size ◽

Multivariate Analyses ◽

Prognostic Significance ◽

Microvascular Invasion ◽

Serum Lactate Dehydrogenase ◽

Gamma Glutamyl Transferase ◽

Operating Characteristics ◽

Survival Curves ◽

Glutamyl Transferase

Background. Liver inflammation indices reflect its inflammatory microenvironment, which may play a role in the proliferation, invasion, and migration of carcinoma. This study is aimed at exploring the prognostic significance of serum lactate dehydrogenase (LDH) levels and gamma-glutamyl transferase (GGT)/alanine aminotransferase (ALT) ratio in hepatocellular carcinoma after liver transplant (LT). Methods. We retrospectively analyzed data from 155 patients with a pathologically confirmed diagnosis of hepatocellular carcinoma who received LT between January 2013 and September 2017. We used receiver operating characteristics (ROC) curves to determine the optimal LDH and GGT/ALT ratio cut-off values. The Kaplan–Meier method and the logarithmic rank test were used to compare the survival curves without recurrence (RFS) and overall survival (OS). Univariate and multivariate analyses were used to identify factors associated with survival. Results. Serum LDH levels were significantly associated with the Child-Pugh score ( P = 0.037 ), largest tumor size (<50 vs. ≥50 mm) ( P = 0.017 ), tumor count (<3 vs. ≥3) ( P = 0.009 ), microvascular invasion ( P = 0.006 ), and the Milan criteria ( P ≤ 0.001 ). The serum GGT/ALT ratio was significantly correlated with alpha-fetoprotein (AFP) levels (of <400 vs. ≥400 ng/ml) ( P ≤ 0.001 ), largest tumor size (of <50 vs. ≥50 mm) ( P ≤ 0.001 ), the Edmondson grade (I-II vs. III-IV) ( P = 0.028 ), microvascular invasion ( P ≤ 0.001 ), and the Milan ( P = 0.002 ) and Hangzhou criteria ( P = 0.018 ). The survival curves showed that the patients with high LDH and the GGT/ALT ratio were associated with poor RFS and OS ( P < 0.05 ). Univariate and multivariate analyses showed that AFP levels of ≥400 ng/ml, largest tumor size of ≥50 mm, microvascular invasion, LDH levels of ≥213.5 U/l, and the GGT/ALT ratio of ≥3.1338 were factors independently associated with RFS. Conclusion. Elevated LDH levels and the GGT/ALT ratio before LT were associated with poor OS and RFS in the present study. These factors could be used in the prognostication of patients with hepatocellular carcinoma undergoing LT.

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