Predictive value of preoperative GLR levels for postoperative tumor recurrence in liver transplant recipients with liver cancer
Objective To investigate the predictive value of preoperative γ-glutamyl transferase/lymphocyte count ratio(GLR)levels for postoperative tumor recurrence in liver transplant recipients with liver cancer.Methods The clinical data of 158 recipients who were diagnosed with hepatocellular carcinoma(hereinafter referred to as liver cancer)and received liver transplantation at the No.900 Hospital of the Joint Logistics Support Force of the Chinese People's Liberation Army from January 2008 to October 2022 were retrospectively analyzed.X-tile software,the Kaplan-Meier method,univariate and multivariate Cox regression,and other statistical methods were performed.The predictive value of preoperative GLR levels for postoperative tumor recurrence in liver transplant recipients with liver cancer and the risk factors for tumor recurrence in liver cancer patients post-liver transplantation were analyzed.Results The X-tile software analysis confirmed that 96.8 was the optimal cutoff value for the preoperative GLR level to predict recurrence.The grouping threshold for survival analysis using the GLR cutoff value was 96.8.The tumor recurrence rates at 1,3,and 5 years after surgery in the low-level GLR group(90 cases)and the high-level GLR group were 19.3％vs.44.2％,31.8％vs.60.0％,and 34.1％vs.62.9％(68 cases),respectively,and the differences were statistically significant between the two groups(P＜0.05).The Kaplan-Meier survival curve analysis results showed that the overall postoperative survival rate and recurrence-free survival rate were significantly lower in the high-level GLR group than the low-level GLR group(P＜0.05).The univariate Cox analysis result showed that there were statistically significant differences in preoperative aspartate aminotransferase,alpha fetoprotein,surgery time,maximum diameter of a solitary tumor,presence or absence of microvascular invasion,presence or absence of portal vein tumor thrombus,and preoperative GLR levels between the two groups(P＜0.05).Multivariate Cox analysis results showed that preoperative alpha-fetoprotein ≥400 ng/ml,GLR≥96.8,and the maximum diameter of a solitary tumor ≥5.0 cm were independent risk factors for postoperative tumor recurrence in liver transplant recipients with liver cancer(P＜0.05).Conclusion GLR levels have a certain predictive value for postoperative tumor recurrence in liver transplant recipients with liver cancer.Furthermore,the postoperative tumor recurrence rate is relatively high when the preoperative GLR level in liver transplant recipients with liver cancer is ≥96.8.
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