WANG Jintao , HAN Boqiang , AN Dongjun , HE Jincheng , LI Hongmei , YANG Lin , XU Yao , ZHANG Cheng
  • Department of Hepatobiliary Surgery, Xianyang Central Hospital, Xianyang, Shaanxi 712000, P. R. China;
ZHANG Cheng, Email: ztx3716336@126.com
gamma-glutamyl transpeptidase to platelet ratio; primary liver cancer; prognosis; risk factor; nomogram
10.7507/1007-9424.202211041
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Objective To explore the relation between preoperative serum gamma-glutamyl transpeptidase to platelet ratio (GPR) and overall survival (OS) of patients with hepatitis B virus-associated hepatocellular carcinoma (Abbreviated as “patients with HCC”), and to establish a nomogram for predicting OS. Methods According to the inclusion and exclusion criteria, the clinicopathologic data of patients with HCC who underwent radical resection in the Department of Hepatobiliary Surgery of Xianyang Central Hospital, from January 15, 2012 to December 15, 2018, were retrospectively analyzed. The optimal critical value of GPR was determined by receiver operating characteristic curve, then the patients were divided into a low GPR group (GPR was optimal critical value or less ) and high GPR group (GPR was more optimal critical value). The Kaplan-Meier method was used to draw the survival curve and analyze the OS of patients. The univariate and multivariate Cox proportional hazards regression model were used to analyze the factors influencing prognosis in the patients with HCC. According to the risk factors of OS for patients with HCC, a nomogram was established. The consistency index and calibration curve in predicting the 3-year and 5-year accumulative OS rates of patients with HCC were evaluated. Results A total of 213 patients were gathered. The optimal critical value of GPR was 0.906. There were 114 patients in the low GPR group and 99 patients in the high GPR group. The Kaplan-Meier survival curve analysis showed that the 1-, 3- and 5-year accumulative OS rates were 99.1%, 81.8%, 60.6% in the low GPR group, respectively, which were 74.2%, 49.1%, 35.7% in the low GPR group, respectively. The OS curve of the low GPR group was better than that of the high GPR group (χ2=25.893, P<0.001). The multivariate analysis results showed that the microvascular invasion, incomplete capsule, intraoperative bleeding ＞1 000 mL, postoperative complications, GPR >0.906, low tumor differentiation, and late TNM stage did not contribute to accumulative OS in the patients with HCC (P<0.05). The consistency index (95%CI) of the nomogram in predicting accumulative OS rates at 3- and 5-year for patients with HCC were 0.761 (0.739, 0.783) and 0.735 (0.702, 0.838), respectively. The calibration curves of 3- and 5-year accumulative OS rates of the nomogram were in good agreement with the actual results. Conclusions Preoperative GPR is associated with OS, and patients with higher GPR have worse prognosis. The nomogram based on GPR has a good accuracy and differentiation.

Citation： WANG Jintao, HAN Boqiang, AN Dongjun, HE Jincheng, LI Hongmei, YANG Lin, XU Yao, ZHANG Cheng. Nomogram based on preoperative serum gamma-glutamyl transpeptidase to platelet ratio for survival prediction of hepatitis B virus-associated hepatocellular carcinoma. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2023, 30(4): 450-455. doi: 10.7507/1007-9424.202211041 Copy

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