Gamma-glutamyl transferase-to-lymphocyte ratio as a prognostic marker in patients with hepatocellular carcinoma undergoing hepatectomy

doi:10.4240/wjgs.v17.i2.98578

Advanced Search

BPG is committed to discovery and dissemination of knowledge

Home / Archive / Volume 17, Issue 2

This Article

Academic Content and Language Evaluation of This Article

CrossCheck and Google Search of This Article

Academic Rules and Norms of This Article

Supplementary Materials of This Article

Citation of this article

Corresponding Author of This Article

Research Domain of This Article

Article-Type of This Article

Open-Access Policy of This Article

Times Cited Counts in Google of This Article

Number of Hits and Downloads for This Article

Total Article Views (108)

All Articles published online

The chart showing PDF series, HTML series, Figures (1-5) series, Tables (1-3) series.

Item

Count

PDF

HTML

Figures (1-5)

Tables (1-3)

Sum=60

Publishing Process of This Article

The chart showing Browse series, Download series.

Item

Count

Browse

Download

Sum=40

Feb 27, 2025 (publication date) through Jan 24, 2025

Times Cited of This Article

Times Cited (0)

Journal Information of This Article

Publication Name

World Journal of Gastrointestinal Surgery

ISSN

1948-9366

Publisher of This Article

Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA

Retrospective Study

World J Gastrointest Surg. Feb 27, 2025; 17(2): 98578
Published online Feb 27, 2025. doi: 10.4240/wjgs.v17.i2.98578

Table 1 Correlation between gamma-glutamyl transferase-to-lymphocyte ratio and clinical and pathological characteristics of hepatocellular carcinoma

Variables	Total (n = 293)	GLR-low (n = 139)	GLR-high (n = 154)	χ²	P value
Sex				7.000	0.008^a
Male	248 (84.6)	109 (78.4)	139 (90.3)
Female	45 (15.4)	30 (21.6)	15 (9.7)
Age (year)				2.731	0.10
< 60	187 (63.8)	96 (69.1)	91 (59.1)
≥ 60	106 (36.2)	43 (30.9)	63 (40.9)
BMI (kg/m²)				10.748	0.005^a
< 18.5	24 (8.2)	19 (13.7)	5 (3.2)
18.5-24	203 (69.3)	89 (64.0)	114 (74.0)
> 24	66 (22.5)	31 (22.3)	35 (22.7)
Ascites				0.210	0.647
Negative	273 (93.2)	131 (94.2)	142 (92.2)
Positive	20 (6.8)	8 (5.8)	12 (7.8)
WBC (10⁹/L)				1.629	0.202
> 10	29 (9.9)	10 (7.2)	19 (12.3)
4-10	264 (90.1)	129 (92.8)	135 (87.7)
Monocyte (10⁹/L)				0.897	0.344
> 0.8	13 (4.4)	4 (2.9)	9 (5.8)
0.3-0.8	280 (95.6)	135 (97.1)	145 (94.2)
RDW				0.023	0.880
> 18	25 (8.5)	11 (7.9)	14 (9.1)
10-18	268 (91.5)	128 (92.1)	140 (90.9)
ALT (U/L)				1.358	0.244
> 40	106 (36.2)	45 (32.4)	61 (39.6)
≤ 40	187 (63.8)	94 (67.6)	93 (60.4)
AST (U/L)				12.848	< 0.001^a
> 40	117 (39.9)	40 (28.8)	77 (50.0)
≤ 40	176 (60.1)	99 (71.2)	77 (50.0)
ALB (g/L)				4.250	0.039
< 40	47 (16.0)	59 (42.4)	85 (55.2)
≥ 40	246 (84.0)	80 (57.6)	69 (44.8)
ALP (U/L)				18.103	< 0.001^a
> 150	103 (35.2)	31 (22.3)	72 (46.8)
40-150	190 (64.8)	108 (77.3)	82 (53.2)
TBIL (μmol/L)				13.794	< 0.001^a
> 17.1	142 (48.5)	51 (36.7)	91 (59.1)
3.4-17.1	151 (51.5)	88 (63.3)	63 (40.9)
DBIL (μmol/L)				0.300	0.584
> 6.8	62 (21.2)	27 (19.4)	35 (22.7)
0-6.8	231 (78.8)	112 (80.6)	119 (77.3)
PT (second)				0.028	0.866
> 13	84 (28.7)	41 (29.5)	43 (27.9)
11-13	209 (71.3)	98 (70.5)	111 (72.1)
HBsAg				0.009	0.925
Positive	51 (17.4)	25 (18.0)	26 (16.9)
Negative	242 (82.6)	114 (82.0)	128 (83.1)
AFP (μg/L)				5.676	0.017^a
≥ 25	178 (60.8)	74 (53.2)	104 (67.5)
< 25	115 (39.2)	65 (46.8)	50 (32.5)
Tumor count				9.902	0.002^a
Single	251 (85.7)	129 (92.8)	122 (79.2)
Multiple	42 (14.3)	10 (7.2)	32 (20.8)
Tumor diameter (cm)				28.262	< 0.001^a
≤ 2	57 (19.5)	40 (28.8)	17 (11.0)
> 2, ≤ 5	122 (41.6)	65 (46.8)	57 (37.0)
> 5, ≤ 10	67 (22.9)	22 (15.8)	45 (29.2)
> 10	47 (16.0)	12 (8.6)	35 (22.8)
Degree of differentiation				3.819	0.148
Low and low-medium	50 (17.1)	22 (15.8)	28 (18.2)
Medium and high-medium	222 (75.8)	111 (79.9)	111 (72.1)
High	21 (7.1)	6 (4.3)	15 (9.7)
MVI				16.516	< 0.001^a
0	183 (62.5)	101 (72.7)	82 (53.3)
1	71 (24.2)	30 (21.6)	41 (26.6)
2	39 (13.3)	8 (5.7)	31 (20.1)
Child-Pugh grade
A	285 (97.3)	138 (99.3)	147 (95.5)	2.720	0.099
B	8 (2.7)	1 (0.7)	7 (4.5)
C	0 (0)	0 (0)	0 (0)
Postoperative TACE				5.064	0.024^a
Yes	107 (36.5)	41 (29.5)	66 (42.9)
No	186 (63.5)	98 (70.5)	88 (57.1)
PLR				22.216	< 0.001^a
Low	159 (54.3)	96 (69.1)	63 (40.9)
High	134 (45.7)	43 (30.9)	91 (59.1)
NLR				15.753	< 0.001^a
Low	132 (45.1)	80 (57.6)	52 (33.8)
High	161 (54.9)	59 (42.4)	102 (66.2)

^aP < 0.05.

Data presented as n (%). AFP: α-fetoprotein; ALB: Albumin; ALP: Alkaline phosphatase; ALT: Alanine aminotransferase; AST: Aspartate aminotransferase; BMI: Body mass index; DBIL: Direct bilirubin; GLR: Gamma-glutamyl transferase-to-lymphocyte ratio; HBsAg: Hepatitis B surface antigen; MVI: Microvascular invasion; NLR: Neutrophil-to-lymphocyte ratio; PLR: Platelet-to-lymphocyte ratio; PT: Prothrombin time; RDW: Red cell distribution width; TACE: Transarterial chemoembolization; TBIL: Total bilirubin.

Table 2 Proportional hazards assumption test for different factors

Variables	χ²	P value
Sex	7.476	0.006^a
Age (year)	0.001	0.970
BMI (kg/m²)	0.035	0.852
Monocytes (10⁹/L)	0.515	0.473
WBC (10⁹/L)	0.279	0.597
RDW	0.006	0.939
PT (second)	0.443	0.505
ALT (U/L)	0.710	0.399
AST (U/L)	0.469	0.493
ALB (g/L)	0.634	0.426
ALP (U/L)	2.389	0.122
TBIL (μmol/L)	1.391	0.238
DBIL (μmol/L)	0.283	0.595
Child-Pugh grade	0.100	0.751
NLR	0.020	0.887
PLR	1.388	0.239
GLR	11.335	< 0.001^a
AFP (μg/L)	0.144	0.704
MVI	8.482	0.004^a
Tumor count	0.096	0.757
Tumor diameter (cm)	1.464	0.226
HBsAg	0.097	0.756
Ascites	0.915	0.339
Postoperative TACE	1.314	0.252
Degree of differentiation	11.451	< 0.001^a

^aP < 0.05 is indicative of a violation of the proportional hazards assumption.

ALB: Albumin; ALP: Alkaline phosphatase; ALT: Alanine aminotransferase; AST: Aspartate aminotransferase; BMI: Body mass index; DBIL: Direct bilirubin; GLR: Gamma-glutamyl transferase-to-lymphocyte ratio; HBsAg: Hepatitis B surface antigen; NLR: Neutrophil-to-lymphocyte ratio; PLR: Platelet-to-lymphocyte ratio; PT: Prothrombin time; RDW: Red cell distribution width; TACE: Transarterial chemoembolization; TBIL: Total bilirubin.

Table 3 Multivariate analysis of different factors for overall survival

Variables	HR (95%CI)	P value
Age (year)	0.977 (0.956-0.998)	0.024^a
ALT (U/L)	0.995 (0.992-0.997)	0.185
ALB (g/L)	0.961 (0.907-0.995)	0.151
TBIL (μmol/L)	1.035 (1.008-1.070)	0.045^a
DBIL (μmol/L)	0.949 (0.918-0.982)	0.103
PLR	0.995 (0.991-0.997)	< 0.001^a
Postoperative TACE	0.443 (0.325-0.601)	0.001^a
Child-Pugh grade	0.655 (0.525-0.849)	0.006^a
Sex, month
0-13	2.639 (1.234-3.508)	0.024^a
14-26	1.908 (0.732-2.498)	0.168
> 26	0.383 (0.100-0.722)	0.552
GLR, month
0-13	1.002 (1.002-1.005)	0.022^a
14-26	1.008 (1.004-1.010)	< 0.001^a
> 26	1.011 (1.007-1.014)	< 0.001^a
MVI, month
0-13	2.166 (1.295-3.613)	0.003^a
14-26	1.254 (0.783-2.010)	0.381
> 26	0.510 (0.188-1.386)	0.187
Degree of differentiation, month
0-13	0.354 (0.223-0.561)	< 0.001^a
14-26	0.541 (0.332-0.881)	0.004^a
> 26	0.910 (0.506-1.639)	0.591

^aP < 0.05.

ALB: Albumin; ALT: Alanine aminotransferase; CI: Confidence interval; DBIL: Direct bilirubin; GLR: Gamma-glutamyl transferase-to-lymphocyte ratio; HR: Hazard ratio; MVI: Microvascular invasion; PLR: Platelet-to-lymphocyte ratio; TACE: Transarterial chemoembolization; TBIL: Total bilirubin.

Citation: Zhou PC, Huang R, Wang HT, Yang J, Peng JD, Fu ZX, Liao WJ, Ma HQ, Wu LQ, Li EL. Gamma-glutamyl transferase-to-lymphocyte ratio as a prognostic marker in patients with hepatocellular carcinoma undergoing hepatectomy. World J Gastrointest Surg 2025; 17(2): 98578
URL: https://www.wjgnet.com/1948-9366/full/v17/i2/98578.htm
DOI: https://dx.doi.org/10.4240/wjgs.v17.i2.98578