Relationship Between γ-glutamyl Transpeptidase Albumin Ratio And Prognosis Of Hepatocellular Carcinoma Patients Undergoing Radical Hepatectomy

Objective: More and more attention has been paid to the prognosis of hepatocellular carcinoma(HCC)patients with radical hepatectomy.The aim of this study was to investigate the relationship between the ratio of γ-glutamyl transpeptidase(GGT)to albumin(ALB)and the prognosis of HCC patients undergoing radical hepatectomy.Methods: We constructed a retrospective cohort study that included 592 patients with hepatocellular carcinoma after radical hepatectomy from March 2013 to March 2022 using the active health management platform of the People’s Hospital of Guangxi Zhuang Autonomous Region,and collected general and clinical data of the patients.Cox regression was applied to analyze the clinical data of 592 patients,and all eligible patients were equally divided into three groups,T1(N=197),T2(N=197)and T3(N=198),based on the GGT to ALB ratio(GAR),to compare the three groups differences in each clinicopathological parameter between the three groups were compared.To assess the prognostic risk associated with GAR,the Kaplan-Meier method was used to assess the overall survival(OS),recurrence free survival(RFS)of HCC patients after surgery.Cox risk proportional regression model was used to analyze the risk factors of GAR on the prognosis of HCC patients.Results: After follow-up,it was shown by Kaplan-Meier survival curves that the higher the GAR,the worse the prognosis of the patients,with a statistically significant difference(P< 0.0001).In the univariate analysis,we found that gender(male),alfa-fetoprotein(AFP),Child-Pugh(B),portal vein tumor thrombus(PVTT),tumor size,microvascular invasion(MVI),and degree of tumor differentiation were associated with poor prognosis.Older age,hepatitis B virus(HBV),AFP,PVTT,number of tumors(multiple),tumor size,MVI,hepatic tegument invasion,and low tumor differentiation were independent risk factors for OS,and older age,hepatitis B virus(HBV),AFP,PVTT,number of tumors(multiple),tumor size,MVI,hepatic tegument invasion,and low tumor differentiation were independent risk factors for RFS.In multifactorial analysis,high GAR ratio remained a risk factor for poor prognosis in patients undergoing radical hepatectomy by adjusted model II after adjusting for sex,age,preoperative Child-Pugh stage,number of tumors,tumor size,MVI,PVTT,and hepatic tegument invasion.Conclusion: This study showed that as GAR increased,it suggested a worse prognosis for patients after radical hepatectomy.