ObjectiveTo research prognostic prediction value of serum γ-glutamyltransferase-to-prealbumin ratio (GPR) for patients with hepatocellular carcinoma (HCC) after radical resection. MethodsThe clinical data of HCC patients undergoing radical resection from January 2013 to November 2021 were analyzed retrospectively. The optimal critical value of GPR was determined by receiver operating characteristic (ROC) curve. The patients were allocated into the low GPR group (GPR was the optimal critical value or less) and the high GPR group (GPR was greater than the optimal critical value). The differences of clinicopathologic characteristics were compared between the two groups. The overall survival (OS) and relapse-free survival (RFS) were analyzed by the Kaplan-Meier survival curve and compared by the log-rank test between the two groups. The risk factors affecting the OS and RFS of patients with HCC were analyzed by univariate and multivariate Cox regression, and the predictive value of GPR on the OS was evaluated by ROC curve. ResultsA total of 216 eligible HCC patients were gathered. The optimal critical value of GPR was 0.29, 93 cases were in the low GPR group and 123 cases were in the high GPR group. Compared with the low GPR group, the proportions of the patients with preoperative alanine aminotransferase >50 U/L, albumin <40 g/L, total bilirubin ≥34.2 μmol/L, tumor size >5 cm, multiple tumor lesions, stage Ⅲ of China liver cancer staging (CNLC), and major hepatectomy (liver segment resection was 3 or more) were higher in the high GPR group (P<0.05). The Kaplan-Meier survival curve showed that the OS and RFS of the low GPR group were better than those of the high GPR group (χ2=14.356, P＜0.001; χ2=7.963, P=0.005). Cox regression multivariate analysis showed that the preoperative alpha-fetoprotein (AFP) ≥400 μg/L, GPR >0.29, stage Ⅲ of CNLC, and operation time (more than 3 h) were the risk factors for OS and RFS of HCC patients (P<0.05). The area under the ROC curve of GPR alone and it in combination with risk factors (preoperative AFP and CNLC stage, respectively) and in combination with the above three indicators to predict the OS of patients with HCC were 0.636, 0.712, 0.696, and 0.737, respectively. ConclusionFrom the results of this study, GPR is associated with the postoperative survival of patients with HCC after radical resection, and GPR in combination with preoperative AFP and CNLC stage has a certain predictive value for the OS.
摘要:目的: 探討血清前白蛋白(prealbumin,PAB)、膽堿脂酶(cholinesterase,ChE)、總膽汁酸(total bile acid,TBA)在肝硬化中的檢測價值。 方法 :測定105例肝硬化患者和30例健康人的前白蛋白、膽堿脂酶、總膽汁酸活性及肝功能生化指標,并按ChildPugh分級進行比較。 結果 :肝硬化組前白蛋白含量、膽堿脂酶活性均較對照組顯著降低;按ChildPugh分級比較,肝硬化組前白蛋白含量在Child A級與對照組、B級與A級之間、在C級與B級之間差異有顯著性(Plt;001);膽堿脂酶活性在Child A級與對照組、B級與A級、C級與B級之間差異有顯著性(Plt;001)。總膽汁酸在Child B級與A級,C級與B級間有顯著差異性,在A級與對照組間差異無顯著性。 結論 :血清前白蛋白、膽堿脂酶在肝硬化早期評估中有很重要的價值,而總膽汁酸在肝硬化預后的判定中有重要價值。 Abstract: Objective: To evaluate the role of prealbumin (PAB), cholinesterase (ChE), and total bile acid (TBA) in evaluating liver reserve function in patients with liver cirrhosis. Methods : One hundred and five serum samples from patients with liver cirrhosis were detected in PAB, ChE, TBA and other biochemical markers. All patients were classified in accordance with ChildPugh scale. Results : For PAB, the differences among ChildPugh A, B, C and healthy group were statistically significant (t=1254, 1887, 2316) (Plt;001). For ChE, the differences among ChildPugh A, B, C and healthy group were statistically significant (t=1288, 0856, 1002) (Plt;001). For TBA, the differences among ChildPugh C group, B group and A group were statistically significant (t=0526, 1081)(Plt;001), the difference among ChildPugh A group and healthy group was not statistically significant (t=5615) (Pgt;005). Conclusion : PAB and ChE reflect liver reserve function earlier in patients with liver cirrhosis. The role of TBA is important in reflecting prognosis in patients with liver cirrhosis.