| Background: Currently,clinically,there is still a lack of effective biomarkers for recurrence monitoring and survival prognosis evaluation after radical resection of hepatocellular carcinoma(HCC)with alpha-fetoprotein(AFP)negative(≤20 ng/ml).Methods: The clinicopathological data of 606 patients(303 in the AFP-negative group and 303 in the AFP-positive group)who underwent radical resection of HCC were analyzed retrospectively.For postoperative relapse within a year,receiver operating characteristic(ROC)curve determined in patient assessment GLR AFP negative HCC optimum cutoff value,the method of using the Kaplan-Meier overall survival for patients of different packet(OS)and The recurrence rate is evaluated and analyzed.Univariate analysis and multivariate Cox risk proportional regression model were used to determine independent prognostic factors.Results:The gamma-glutamyl transpeptidase to lymphocyte count ratio(GLR)of patients in AFP-negative group was lower than that in AFP-positive group(P < 0.001).The GLR level of the early-recurrence group was higher than that of the non-early-recurrence group(P = 0.003).GLR had fairly accuracy in predicting the early-recurrence of HCC patients [c-index =0.654(95% CI,0.606-0.702);AUC= 0.681(95% CI,0.625-0.733)].Univariate analysis showed that patients with tumor size < 5 cm,no microvascular invasion,single tumor,no metastasis,BCLC stage 0 – A,no recurrence and GLR ≤ 45.0had longer disease-free survival(DFS)and overall survival(OS)among AFP-negative HCC patients.In addition,multivariate Cox proportional hazards regression analysis showed that tumor size < 5 cm(P = 0.003),no recurrence(P< 0.001)and GLR < 45.0(P < 0.001)were independent predictors of longer OS.Conclusion: GLR may be a potential indicator for early recurrence monitoring and prognosis evaluation in HCC patients with AFP-negative after radical resection. |
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