Prognostic impact of gamma-glutamyl transpeptidase to platelets ratio on hepatocellular carcinoma patients who have undergone surgery: a meta-analysis and systematic review

Abstract

Gamma-glutamyl transpeptidase to platelet ratio (GPR) is an inflammatory index and has been used as a prognostic index for a variety of tumors. However, the association between GPR and hepatocellular carcinoma (HCC) still remained controversial. Therefore, we performed a meta-analysis to determine the prognostic impact of GPR on HCC patients. PubMed, Embase, Cochrane Library, Web of Science, the Chinese National Knowledge Infrastructure, Wanfang Database, Chinese VIP Database, the US Clinical Trials Registry, and the Chinese Clinical Trials Registry were searched from inception to December 2022. A hazard ratio (HR) with a 95% confidence interval (CI) was used to evaluate the association between preoperative GPR and the prognosis of HCC patients. Ten cohort studies including 4706 HCC patients were identified. This meta-analysis showed that higher GPRs were closely related to worse overall survival (HR: 1.79; 95% CI: 1.35–2.39; P < 0.001; I 2 = 82.7%), recurrence-free survival (HR: 1.30; 95% CI: 1.16–1.46; P < 0.001; I 2 = 0%), and disease-free survival (HR: 1.84; 95% CI: 1.58–2.15; P < 0.001; I 2 = 25.4%) in patients with HCC. This meta-analysis suggests that preoperative GPR appears to be significantly associated with the prognosis of HCC patients who have undergone surgery and may be an effective prognostic marker. Trial registration: PROSPERO: CRD42021296219.

Predictive nomograms based on gamma-glutamyl transpeptidase to prealbumin ratio for prognosis of hepatocellular carcinoma patients without microvascular invasion

“…Elevated GGT levels have been implicated in tumor formation and progression through various mechanisms [ 15 ]. Consequently, previous studies have recommended utilizing the GGT to platelet ratio as a prognostic marker for HCC patients [ 16 , 17 ]. Additionally, individuals with malignant tumors often experience compromised nutritional status due to heightened metabolism and chronic inflammation [ 18 ], leading to decreased PA levels.…”

Multiple Machine-Learning Fusion Model Based on Gd-EOB-DTPA-Enhanced MRI and Aminotransferase-to-Platelet Ratio and Gamma-Glutamyl Transferase-to-Platelet Ratio to Predict Microvascular Invasion in Solitary Hepatocellular Carcinoma: A Multicenter Study

“…The conclusions drawn between different studies are also inconsistent, and the best cutoff values are also different. [18][19][20] In addition, some previous studies have suggested that aminotransferase-to-platelet ratio (APRI) [21][22][23] and gamma-glutamyl transferase-to-platelet ratio (GPR) [24][25][26] are independent risk factors for shorter survival and higher recurrence after HCC surgery. However, it is still uncertain whether preoperative APRI or GPR can predict MVI in solitary HCC, and there is no report on the relationship between APRI/GPR and MVI.…”

“…39 Several previous studies have shown that APRI and GPR were independent risk factors for shorter OS and high recurrence after HCC surgery. [21][22][23][24][25][26] Additionally, a recent meta-analysis (4706 HCCs) showed a significant correlation between preoperative GPR and postoperative prognosis in HCC patients, with higher GPR closely associated with poorer OS (HR: 1.79; P<0.001). 26 However, MVI is the most direct predictive signal for early intrahepatic micrometastasis in HCC and the most important source of tumor recurrence or poor prognosis.…”

“…[21][22][23][24][25][26] Additionally, a recent meta-analysis (4706 HCCs) showed a significant correlation between preoperative GPR and postoperative prognosis in HCC patients, with higher GPR closely associated with poorer OS (HR: 1.79; P<0.001). 26 However, MVI is the most direct predictive signal for early intrahepatic micrometastasis in HCC and the most important source of tumor recurrence or poor prognosis. Our study first indicates that APRI ≥ 0.283 and GPR ≥ 0.482 are independent predictors for MVI.…”