Prognostic value of serum γ-glutamyl transferase in unresectable hepatocellular carcinoma patients treated with transcatheter arterial chemoembolization combined with conformal radiotherapy

Abstract

The detection of γ-glutamyl transferase (GGT) has previously been reported to be useful in the diagnosis in hepatocellular carcinoma (HCC). The aim of the present study was to investigate the baseline serum GGT levels in patients with intermediate HCC (Barcelona Clinic Liver Cancer stage B) following treatment with transcatheter arterial chemoembolization (TACE) combined with three-dimensional conformal radiotherapy (3DCRT). A total of 154 intermediate HCC patients with Child-Pugh grade A were retrospectively investigated. Receiver operating characteristic (ROC) analysis was used to determine the optimal threshold for the GGT serum levels, and univariate and multivariate analyses were used to establish the prognostic factors. The median overall survival (OS) time was 24.3 months. The optimal threshold for GGT was 85 U/L (sensitivity, 75.13%; specificity, 69.81%; and area under the ROC curve, 0.763). The one-, three- and five-year OS rates were 79.9, 49.7 and 17.2%, respectively, for patients with low GGT levels (≤85 U/l) and 52.3, 22.1 and 8.5%, respectively, for patients with high GGT levels (>85 U/l) (P=0.007). The results indicated that the serum GGT level was an independent prognostic factor (hazard ratio=2.32; P=0.007) for OS. Furthermore, in subgroups stratified according to serum α-fetoprotein, gross tumor volume and radiation dose, serum GGT was also found to correlate with OS (P<0.05). Therefore, the baseline GGT level may be a significant prognostic factor for intermediate HCC patients with Child-Pugh grade A following TACE combined with 3DCRT.

Risk factors for early postoperative recurrence in single and small hepatitis B virus-associated primary hepatocellular carcinoma

“… 31 , 32 Studies have also shown that GGT levels were associated with hepatocarcinogenesis and prognosis of patients with HCC. 32 – 34 Moreover, previous studies also proposed that alcohol intake could increase ALT and GGT levels in HCC patients independent of smoking, 35 and alcohol consumption had a deleterious effect on HCC prognosis, especially in patients with hepatitis virus infection. 36 …”

Exploring the clinical value of preoperative serum gamma-glutamyl transferase levels in the management of patients with hepatocellular carcinoma receiving postoperative adjuvant transarterial chemoembolization

“…In fact, γ-GT has been identified to be associated with prognosis of patients receiving TACE as an initial treatment, and baseline γ-GT levels has also been found to be a significant prognostic factor for patients with intermediate HCC receiving TACE and conformal radiotherapy [15,36]. But the clinical value of γ-GT levels to guide the performance of PA-TACE has rarely been explored.…”

Advances of diagnostic and mechanistic studies of γ-glutamyl transpeptidase in hepatocellular carcinoma

“…GGT was utilized as a diagnostic tumor biomarker for liver disease with a high sensitivity of 83-100%, but it only has a low specificity of 32% (10). Therefore, long since GGT was not utilized as an (29,(36)(37)(38)(39)(40). The combination of GGT and other indicators, such as tumor size, tumor number, MVI, or laboratory data for AFP and DCP, should be paid more attention when deciding a treatment and predicting the curative results for patients with HCC (41).…”