The influence of the quantitative changes of γ-glutamyl transpeptidase on the prognosis of hepatocellular carcinoma patients undergoing hepatectomy
10.3781/j.issn.1000-7431.2024.2312-0656
- VernacularTitle:围手术期谷氨酰转肽酶变化量对原发性肝细胞癌患者行肝切除手术预后的影响
- Author:
Kai QU
1
,
2
,
3
;
Kun YANG
;
Jia JIA
;
Yuan LIU
;
Xiaohua MA
;
Yunxiang LONG
;
Kunjin WU
;
Kaibo YANG
;
Xing ZHANG
;
Chang LIU
Author Information
1. 西安交通大学第二附属医院肝胆胰与肝移植外科,陕西 西安 710004
2. 西安交通大学未来技术学院,陕西 西安 710049
3. 外科重症与生命支持教育部重点实验室,陕西 西安 710049
- Keywords:
Hepatectomy;
Liver function;
Quantitative change;
Prognosis
- From:
Tumor
2024;44(2):146-157
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To explore the assessment value of liver enzyme changes before and after hepatectomy on the prognosis of patients with primary hepatocellular carcinoma(HCC). Methods:A retrospective analysis was conducted on the clinical data of 421 patients with primary HCC who received at the First and Second Affiliated Hospitals of Xi'an Jiaotong University from January 2016 to December 2020.The univariate and multivariate COX regression analyses were used to screen the risk factors affecting the prognosis of patients with primary HCC,and the optimal cut-off value was selected to group the most valuable indicators among them,further analyzing the different factors among subgroups.The Kaplan-Meier method was used to assess the prognosis of the subgroups,and the survival curves were plotted and statistically tested. Results:Multivariate COX regression analysis revealed that Barcelona Clinic Liver Cancer(BCLC)stage,tumor number,alpha-fetoprotein(AFP),the quantitative change of γ-glutamyl transpeptidase(GGT)and total bilirubin(TBIL)before and after surgery were independent risk factors affecting the prognosis of patients with primary HCC(P＜0.01),and there were differences in hepatitis B virus surface antigen(HBsAg),TNM stage,BCLC stage,tumor size,tumor number,tumor differentiation degree,AFP,surgery type,intraoperative bleeding volume,postoperative albumin-bilirubin(ALBI)and white blood cell count between the high and low GGT variation groups(P＜0.05).Kaplan-Meier survival analysis showed that the prognosis of patients with primary HCC between the high and low GGT variation groups was significantly different,with a hazard ratio of 2.603 for mortality and 1.449 for recurrence(both P＜0.01). Conclusion:The quantitative change of GGT before and after hepatectomy has an evaluation value for the prognosis of patients with primary HCC,and the quantitative change of GGT greater than 29.5 is an independent risk factor for the prognosis of patients with primary HCC.
