Predictive Value Of Gamma-glutamyl Transpeptidase To Lymphocyte Count Ratio In Hepatocellular Carcinoma Patients With Microvascular Invasion

Objective: Microvascular invasion(MVI)is an independent risk factor for poor prognosis in hepatocellular carcinoma(HCC).However,there is still a lack of preoperative markers to predict MVI in HCC.This study intends to explore the potential application value of the gamma-glutamyl transpeptidase(GGT)to lymphocyte count ratio(GLR)in predicting MVI in HCC and provide guidance for clinical diagnosis and treatment.Methods: From March 2010 to December 2015,230 HCC patients who underwent surgical treatment in the Affiliated Hospital of Guilin Medical University were selected.Clinicopathological parameters between the MVI group(n = 115)and the non-MVI group(n = 115)were comparatively analyzed.The GLR was used as the potential risk factor for HCC with MVI,and its optimal cut-off value was estimated by using the receiver operating characteristic(ROC)curve.The Kaplan-Meier method was used to analyze the survival of HCC patients,and univariate and multivariate Cox regression analyses were used to establish independent predictors affecting postoperative HCC patients.Results: The GLR levels in the MVI group and non-MVI group were 84.83 ± 61.84 and 38.42 ± 33.52(p < 0.001),respectively.According to ROC curve analysis,the optimal cut-off value of GLR was 56.0,and the area under the ROC curve(AUC)was 0.781(95% confidence interval(CI),0.719-0.833)for the risk prediction of MVI in HCC patients.Multivariate analysis showed that tumor size > 5 cm,HCC combined with MVI and GLR > 56.0 were independent risk factors for poor prognosis in HCC patients.In addition,compared with the non-MVI group,patients in the MVI group had shorter progression-free survival(PFS)and overall survival(OS).Conclusions: GLR could be a predictive biomarker of HCC post operation and a potential predictor of HCC combined with MVI.