Serum GGT/ALT ratio predicts vascular invasion in HBV-related HCC

Abstract

Background The gamma-glutamyl transferase (GGT) to alanine aminotransferase (ALT) ratio has been reported as an effective predictor of the severity of hepatitis and HCC. The purpose of this study was to determine the role of the GGT/ALT ratio in the prediction of vascular invasion and survival outcomes in patients with hepatitis B virus (HBV)-related hepatocellular carcinoma (HCC). Methods The risk factors for vascular invasion were determined by univariate/multivariate logistic analysis. The cut-off value of GGT/ALT in predicting vascular invasion was calculated using the receiver operating characteristic (ROC) curve. The prognostic value of GGT/ALT was examined by Cox analysis and Kaplan–Meier curves. Sensitivity analysis, such as subgroup analysis and propensity score matching (PSM), was performed to reduce potential confounding bias. Results A high GGT/ALT ratio was identified as an independent risk factor for vascular invasion (P = 0.03). The correlation analysis suggested that higher GGT/ALT was associated with more severe tumour burdens, including vascular invasion (P < 0.001), tumour volume > 5 cm (P < 0.001), poor pathological differentiation (P = 0.042), more severe BCLC (P < 0.001) and ALBI grade (P = 0.007). In the survival analysis, a high GGT/ALT ratio was associated with poor overall survival (OS) (HR: 1.38; 95% CI 1.03, 1.87; P < 0.0001) and disease-free survival (DFS) (HR: 1.32; 95% CI 1.03, 1.87; P < 0.0001). In the subgroup analysis, similar results were consistently observed across most subgroups. In PSM analysis, GGT/ALT remained independently associated with vascular invasion (OR, 186; 95% CI 1.23, 3.33). Conclusion The GGT/ALT ratio was a potential effective factor in the prediction of vascular invasion and prognosis in patients with HBV-related HCC.

A new model based on gamma-glutamyl transpeptidase to lymphocyte ratio and systemic immune-inflammation index can effectively predict the recurrence of hepatocellular carcinoma after liver transplantation

“…Gamma-glutamyltransferase (GGT), as a cell surface enzyme, has been proven to be a marker of many cancers ( 29 – 31 ). Tumor invasion and the release of inflammatory factors often lead to the destruction of hepatocytes, which is characterized by increased GGT in the peripheral blood ( 32 , 33 ). It has been reported that GGT is a reliable marker of oxidative stress, and the increased expression of GGT in tumor cells is associated with the production of ROS, which can promote the invasion and migration of tumor cells ( 34 , 35 ).…”

Prognostic value of combined inflammatory and nutritional biomarkers in HCC within the Milan criteria after hepatectomy

“…Vascular invasion is a significant but poor prognostic factor of survival in patients with HCC ( 45 ), Luo et al. disclosed that a high GGT/ALT ratio was identified as an independent risk factor for vascular invasion in patients with HCC ( 46 ). Additionally, Ju et al.…”

“…Yang et al reported that hepatitis B patients with a higher GGT/ALT ratio were more likely to develop liver cancer (44). Vascular invasion is a significant but poor prognostic factor of survival in patients with HCC (45), Luo et al disclosed that a high GGT/ALT ratio was identified as an independent risk factor for vascular invasion in patients with HCC (46). Additionally, Ju et al observed that a higher GGT/ ALT ratio correlated with a more severe tumor burden in patients with HBV-related HCC, including tumor size, tumor capsule, and shortened survival time (18).…”

Bioinformatics Analysis and Validation of the Role of Lnc-RAB11B-AS1 in the Development and Prognosis of Hepatocellular Carcinoma

“…Our experimental data disclosed a negative correlation between RAB11B expression and pathology grade, T-Bil, GGT, and PD-L1. T-Bil and GGT are both important indicators of liver function in patients and are combined with other objective parameters in clinical diagnosis, such as ALBI score, which is considered a gold standard for the diagnosis of HCC patients [ 43 , 44 ]. Abnormally upregulated T-Bil or GGT is often associated with the occurrence of hepatitis, obstructive jaundice, or cirrhosis.…”