LDH and GGT/ALT Ratio as Novel Prognostic Biomarkers in Hepatocellular Carcinoma Patients after Liver Transplantation

Background. Liver inflammation indices reflect its inflammatory microenvironment, which may play a role in the proliferation, invasion, and migration of carcinoma. This study is aimed at exploring the prognostic significance of serum lactate dehydrogenase (LDH) levels and gamma-glutamyl transferase...

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Autores principales:	Qi Zhang, Xingyuan Jiao
Formato:	article
Lenguaje:	EN
Publicado:	Hindawi Limited 2021
Materias:	Computer applications to medicine. Medical informatics R858-859.7
Acceso en línea:	https://doaj.org/article/0d7f527532f34cefab0be8ac19ea2c02
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spelling	oai:doaj.org-article:0d7f527532f34cefab0be8ac19ea2c022021-11-29T00:56:27ZLDH and GGT/ALT Ratio as Novel Prognostic Biomarkers in Hepatocellular Carcinoma Patients after Liver Transplantation1748-671810.1155/2021/9809990https://doaj.org/article/0d7f527532f34cefab0be8ac19ea2c022021-01-01T00:00:00Zhttp://dx.doi.org/10.1155/2021/9809990https://doaj.org/toc/1748-6718Background. Liver inflammation indices reflect its inflammatory microenvironment, which may play a role in the proliferation, invasion, and migration of carcinoma. This study is aimed at exploring the prognostic significance of serum lactate dehydrogenase (LDH) levels and gamma-glutamyl transferase (GGT)/alanine aminotransferase (ALT) ratio in hepatocellular carcinoma after liver transplant (LT). Methods. We retrospectively analyzed data from 155 patients with a pathologically confirmed diagnosis of hepatocellular carcinoma who received LT between January 2013 and September 2017. We used receiver operating characteristics (ROC) curves to determine the optimal LDH and GGT/ALT ratio cut-off values. The Kaplan–Meier method and the logarithmic rank test were used to compare the survival curves without recurrence (RFS) and overall survival (OS). Univariate and multivariate analyses were used to identify factors associated with survival. Results. Serum LDH levels were significantly associated with the Child-Pugh score (P=0.037), largest tumor size (<50 vs. ≥50 mm) (P=0.017), tumor count (<3 vs. ≥3) (P=0.009), microvascular invasion (P=0.006), and the Milan criteria (P≤0.001). The serum GGT/ALT ratio was significantly correlated with alpha-fetoprotein (AFP) levels (of <400 vs. ≥400 ng/ml) (P≤0.001), largest tumor size (of <50 vs. ≥50 mm) (P≤0.001), the Edmondson grade (I-II vs. III-IV) (P=0.028), microvascular invasion (P≤0.001), and the Milan (P=0.002) and Hangzhou criteria (P=0.018). The survival curves showed that the patients with high LDH and the GGT/ALT ratio were associated with poor RFS and OS (P<0.05). Univariate and multivariate analyses showed that AFP levels of ≥400 ng/ml, largest tumor size of ≥50 mm, microvascular invasion, LDH levels of ≥213.5 U/l, and the GGT/ALT ratio of ≥3.1338 were factors independently associated with RFS. Conclusion. Elevated LDH levels and the GGT/ALT ratio before LT were associated with poor OS and RFS in the present study. These factors could be used in the prognostication of patients with hepatocellular carcinoma undergoing LT.Qi ZhangXingyuan JiaoHindawi LimitedarticleComputer applications to medicine. Medical informaticsR858-859.7ENComputational and Mathematical Methods in Medicine, Vol 2021 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Computer applications to medicine. Medical informatics R858-859.7
spellingShingle	Computer applications to medicine. Medical informatics R858-859.7 Qi Zhang Xingyuan Jiao LDH and GGT/ALT Ratio as Novel Prognostic Biomarkers in Hepatocellular Carcinoma Patients after Liver Transplantation
description	Background. Liver inflammation indices reflect its inflammatory microenvironment, which may play a role in the proliferation, invasion, and migration of carcinoma. This study is aimed at exploring the prognostic significance of serum lactate dehydrogenase (LDH) levels and gamma-glutamyl transferase (GGT)/alanine aminotransferase (ALT) ratio in hepatocellular carcinoma after liver transplant (LT). Methods. We retrospectively analyzed data from 155 patients with a pathologically confirmed diagnosis of hepatocellular carcinoma who received LT between January 2013 and September 2017. We used receiver operating characteristics (ROC) curves to determine the optimal LDH and GGT/ALT ratio cut-off values. The Kaplan–Meier method and the logarithmic rank test were used to compare the survival curves without recurrence (RFS) and overall survival (OS). Univariate and multivariate analyses were used to identify factors associated with survival. Results. Serum LDH levels were significantly associated with the Child-Pugh score (P=0.037), largest tumor size (<50 vs. ≥50 mm) (P=0.017), tumor count (<3 vs. ≥3) (P=0.009), microvascular invasion (P=0.006), and the Milan criteria (P≤0.001). The serum GGT/ALT ratio was significantly correlated with alpha-fetoprotein (AFP) levels (of <400 vs. ≥400 ng/ml) (P≤0.001), largest tumor size (of <50 vs. ≥50 mm) (P≤0.001), the Edmondson grade (I-II vs. III-IV) (P=0.028), microvascular invasion (P≤0.001), and the Milan (P=0.002) and Hangzhou criteria (P=0.018). The survival curves showed that the patients with high LDH and the GGT/ALT ratio were associated with poor RFS and OS (P<0.05). Univariate and multivariate analyses showed that AFP levels of ≥400 ng/ml, largest tumor size of ≥50 mm, microvascular invasion, LDH levels of ≥213.5 U/l, and the GGT/ALT ratio of ≥3.1338 were factors independently associated with RFS. Conclusion. Elevated LDH levels and the GGT/ALT ratio before LT were associated with poor OS and RFS in the present study. These factors could be used in the prognostication of patients with hepatocellular carcinoma undergoing LT.
format	article
author	Qi Zhang Xingyuan Jiao
author_facet	Qi Zhang Xingyuan Jiao
author_sort	Qi Zhang
title	LDH and GGT/ALT Ratio as Novel Prognostic Biomarkers in Hepatocellular Carcinoma Patients after Liver Transplantation
title_short	LDH and GGT/ALT Ratio as Novel Prognostic Biomarkers in Hepatocellular Carcinoma Patients after Liver Transplantation
title_full	LDH and GGT/ALT Ratio as Novel Prognostic Biomarkers in Hepatocellular Carcinoma Patients after Liver Transplantation
title_fullStr	LDH and GGT/ALT Ratio as Novel Prognostic Biomarkers in Hepatocellular Carcinoma Patients after Liver Transplantation
title_full_unstemmed	LDH and GGT/ALT Ratio as Novel Prognostic Biomarkers in Hepatocellular Carcinoma Patients after Liver Transplantation
title_sort	ldh and ggt/alt ratio as novel prognostic biomarkers in hepatocellular carcinoma patients after liver transplantation
publisher	Hindawi Limited
publishDate	2021
url	https://doaj.org/article/0d7f527532f34cefab0be8ac19ea2c02
work_keys_str_mv	AT qizhang ldhandggtaltratioasnovelprognosticbiomarkersinhepatocellularcarcinomapatientsafterlivertransplantation AT xingyuanjiao ldhandggtaltratioasnovelprognosticbiomarkersinhepatocellularcarcinomapatientsafterlivertransplantation
_version_	1718407689708503040

LDH and GGT/ALT Ratio as Novel Prognostic Biomarkers in Hepatocellular Carcinoma Patients after Liver Transplantation

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