Correlation Study Of GGT/AST、GPR、AFP And Hepatitis B Cirrhosis Combined With Primary Liver Cancer

Objective:To explore the clinical value of gamma-glutamyl transferase to platelet ratio(GPR)and gamma-glutamyl transferase to Aspartate aminotransferase ratio(GGT/AST)and alpha-fetoprotein(AFP)in predicting hepatitis B cirrhosis combined with primary liver cancer,in order to provide economical and convenient indicators for clinical screening of primary liver cancer.Methods:A collection of 105 patients with hepatitis B cirrhosis who were hospitalized at the Affiliated Hospital of Yanbian University from January 2012 to October 2021(Hepatitis B cirrhosis group),98 patients with hepatitis B cirrhosis combined with primary liver cancer who were hospitalized for the first time during the same period(Hepatitis B cirrhosis combined with liver cancer group).The patients with hepatitis B cirrhosis combined with primary liver cancer were divided into small liver cancer group and large liver cancer group according to tumor size,54 cases of small liver cancer group(diameter ≤5cm),44 cases of large liver cancer group(diameter >5cm).The general clinical data of the patients were recorded,and the routine blood and liver function and other indicator after admission,including WBC,PLT,NEU,LYM,MON count,AST,ALT,GGT,and AFP values.Respectively calculate the GPR values and GGT/AST value,and the tumor size of patients with hepatitis B cirrhosis complicated with primary liver cancer was recorded according to imaging reports(the number of tumours was taken as the largest diameter of the tumour for single tumours and the largest diameter of the largest tumour for multiple tumours).The correlation between tumor size and GPR,GGT/AST,AFP and other indicators was analyzed by Spearman or Pearson,and Receiver operator characteristic curve(ROC)method was used to analyze the predictive value of GPR,GGT/AST and AFP in patients with hepatitis B cirrhosis complicated with primary liver cancer.Results:1.There was no statistical difference in gender and ethnicity between the hepatitis B cirrhosis group and the hepatitis B cirrhosis combined with liver cancer group(P>0.05);when comparing age,the mean age of the hepatitis B cirrhosis combined with liver cancer group was greater than that of the hepatitis B cirrhosis group,and the difference was statistically significant(P<0.05).2.The PLT,AST and GGT levels in the hepatitis B cirrhosis combined with liver cancer group were all higher than those in the hepatitis B cirrhosis group,and the difference was statistically significant(P < 0.05).3.The levels of GGT/AST,GPR and AFP in the hepatitis B cirrhosis combined with liver cancer group were higher than those in the hepatitis B cirrhosis group,the differences were statistically significant(P < 0.05).4.The levels of WBC,PLT,NEU,GGT,and AFP were higher in the large liver cancer group than in the small liver cancer group,and the differences were statistically significant(P < 0.05),and there were differences in GPR and GGT/AST between the small and large liver cancer groups,but not statistically significant(P > 0.05).5.Tumour size was positively correlated with WBC,PLT,NEU,GGT,GGT/AST and AFP,with correlation coefficients of 0.205,0.468,0.253,0.268,0.204 and 0.357 respectively(P<0.05)Tumour size was not correlated with GPR,with a correlation coefficient of 0.052(P>0.05)6.Age,AFP,GPR,GGT/AST as risk factors for hepatitis B cirrhosis complicated with primary liver cancer.7.AFP,GPR and GGT/AST were used to predict PLC,the area under the curve was(0.794vs0.708vs0.742),the sensitivity was(63.3%vs60.2%vs75.5%)and the specificity was(85.7%vs75.2%vs61.9%);AFP,GPR and GGT/AST were used to predict small liver cancer,the area under the curve was(0.724vs0.703vs0.702),the sensitivity was(50.0%vs55.6%vs57.4%)and the specificity was(85.7%vs79.0%vs74.3%);AFP,GPR and GGT/AST were used for the predict of large liver cancer,The area under the curve was(0.879vs0.715vs0.790),the sensitivity was(79.5%vs59.1%vs841%),and the specificity was(89.5%vs78.1%vs63.8%).When AFP,GPR and GGT/AST were combined for the predict of PLC,small liver cancer and large liver cancer,the area under the curve was 0.852,0.787 and 0.936,the sensitivity was 64.3%,79.6% and 84.1%,and the specificity was 94.3%,64.8% and 92.4%.The possibility of PLC should be suspected when laboratory tests in patients with hepatitis B cirrhosis suggest AFP > 22.630ng/m L,GPR > 1.596 and GGT/AST > 1.000.Conclusion:GPR and GGT/AST have certain predict value in hepatitis B cirrhosis combined with primary liver cancer,the combined detection with AFP can improve the predictive efficiency of hepatitis B cirrhosis combined with primary liver cancer.