Serum gamma-glutamyl transpeptidase-to-platelet ratio (GPR) can predict the prognosis of hepatocellular carcinoma: a meta-analysis and systematic review

Abstract

Background:The relationship between serum gamma-glutamyl transpeptidase-to-platelet ratio (GPR) before treatment and the prognosis of patients with hepatocellular carcinoma (HCC) is unclear. Here, we review and summarize existing data and try to determine the predictive value of GPR in the treatment of HCC.Methods: We searched Web of Science, PubMed, Embase and China national knowledge infrastructure (CNKI) for clinical trials investigating GPR and HCC in participants with and without HCC. We developed the inclusion criteria based on the principle of population-intervention-result-control-study design. Studies that do not meet the standards were excluded. Studies were subjected to quality assessments using the Cochrane Risk of Bias Tool for cluster-randomized control trials. Sensitivity, statistical, heterogeneity, and publication bias analyses on STATA version 16.1 (STATA 2020).Results: The pooled data from 7 studies of 1,952 patients showed that the specificity of GPR for predicting the prognosis of HCC was 0.67 (95% CI: 0.61-0.73), and the sensitivity was 0.62 (95% CI: 0.57-0.67). The Fagan chart prediction shows that the patient's GPR indicates the prognostic effect of HCC. The positive predictive value is 32%, which is significantly higher than before. The ROC curve is used to analyze the effectiveness of GPR in predicting the prognosis of HCC, and the area under the curve (AUC) is 0.69 (0.65-0.73). There is no publication bias in this study (The Deek funnel chart, P=0.48).Discussion: Our results are similar to those of most previous studies, and meta-analysis showed that GPR has well sensitivity, accuracy, and prognostic value in HCC.

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.…”

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

“…A previous meta-analysis and systematic review published in April 2022 indicated the prognostic impact of GPR on HCC [25]. However, this study evaluated the specificity and sensitivity of GPR for predicting the prognosis of HCC and it evaluated only 1952 patients from seven studies.…”

The prognosis of breast cancer patients with bone metastasis could be potentially estimated based on blood routine test and biochemical examination at admission

“…Increasing studies demonstrated that indicators from blood routine test and biochemical examination might be used for prognostic prediction of cancers [ 14–16 ]. For almost all cancer patients, blood routine and biochemical examination are convenient, quick, and inexpensive examinations, from which the information about human metabolism, inflammation, and internal environmental conditions can be obtained.…”